Major determinants of death in patients hospitalized with COVID-19 during the first epidemic wave in Madrid, Spain.
Journal
Medicine
ISSN: 1536-5964
Titre abrégé: Medicine (Baltimore)
Pays: United States
ID NLM: 2985248R
Informations de publication
Date de publication:
23 Apr 2021
23 Apr 2021
Historique:
received:
25
09
2020
accepted:
30
03
2021
entrez:
21
4
2021
pubmed:
22
4
2021
medline:
28
4
2021
Statut:
ppublish
Résumé
Spain is one of the European countries most largely affected by COVID-19, being Madrid the epicenter. A good knowledge of the main features of hospitalized patients during the complete lockdown should improve the management of new COVID-19 surges.All patients hospitalized at one large tertiary hospital in Madrid for suspected COVID-19 pneumonia from March 1 to May 31 were retrospectively identified.A total of 1752 patients were admitted with suspected pneumonia due to SARS-CoV-2 infection during the 3-month study period. The peak of daily admissions (n = 84) was reached on March 24, whereas the maximal cumulative number of hospitalized patients (n = 626) occurred on March 30. Overall, 85.3% had a positive PCR test for SARS-CoV-2 at least once during admission. Their median age was 65 (54-77) and 59.9% were male. The median length of hospitalization was of 7 (4-13) days. Roughly 6.5% were admitted at the intensive care unit.Death occurred in 242 (13.8%). Overall, 75% of deaths occurred in patients older than 75 years-old. It was 38.2% in patients hospitalized older than 80 years-old versus 2.2% in patients younger than 60 years-old (p < 0.001). Up to 94 (38.8%) of deceased patients had been transferred from nursing homes. The median Charlson co-morbidity score was 6 in deceased patients.The in-hospital mortality rate during the first wave of COVID-19 in Madrid was 14%. It was largely driven by older age, the presence of underlying chronic conditions (≥2) and living at nursing homes.
Identifiants
pubmed: 33879741
doi: 10.1097/MD.0000000000025634
pii: 00005792-202104230-00088
pmc: PMC8078308
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e25634Subventions
Organisme : Instituto de Salud Carlos III
ID : CM19/00223
Organisme : Instituto de Salud Carlos III
ID : CES12/003
Informations de copyright
Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc.
Déclaration de conflit d'intérêts
The authors have no conflicts of interest to disclose.
Références
Zhu N, Zhang D, Wang W, et al. A novel coronavirus from patients with pneumonia in China. 2019. N Engl J Med 2020;382:727–33.
WHO coronavirus disease (COVID-19) dashboard. Accessed date: July 22nd 2020). Available at: https://www.covid19.who.int/ .
Soriano V, Barreiro P. Why such excess of mortality for COVID-19 in Spain? Ther Adv Infect Dis 2020;7:2049936120932755.
Pollán M, Pérez-Gómez B, Pastor-Barriuso R, et al. Prevalence of SARS-CoV-2 in Spain (ENE-COVID): a nationwide, population-based seroepidemiological study. Lancet 2020;396:535–44.
Soriano V, Meiriño R, Corral O, et al. SARS-CoV-2 antibodies in adults in Madrid, Spain. Clin Infect Dis 2021;72:1101–2.
Dirección general de salud pública, Servicio madrileño de salud. Datos COVID-19 Comunidad de Madrid. Available at: https://www.comunidad.madrid/servicios/salud/2019-nuevo-coronavirus . (status report June 30, 2020).
Graselli G, Zangrillo A, Zanella A, et al. Baseline characteristics and outcomes of 1591 patients admitted to ICUs of the Lombardy Region, Italy. JAMA 2020;323;:1574–81.
Bushman D, Alroy K, Greene S, et al. Detection and genetic characterization of community-based SARS-CoV-2 infections - New York City, March 2020. MMWR 2020;69:918–22.
European Centre for Disease Prevention and Control. Case definition for coronavirus disease 2019 (COVID-19), as of 29 May 2020. Available at: https://www.ecdc.europa.eu/en/covid-19/surveillance/case-definition .
Charlson M, Pompei P, Ales K, et al. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis 1987;40:373–83.
Nakeshbandi M, Maini R, Daniel P, et al. The impact of obesity on COVID-19 complications: a retrospective cohort study. Int J Obes 2020;44:1832–7.
Pan Y, Long L, Zhang D, et al. Potential false-negative nucleic acid testing results for severe acute respiratory syndrome coronavirus 2 from thermal inactivation of samples with low viral loads. Clin Chem 2020;66:794–801.
To K, Tsang O, Leung W, et al. Temporal profiles of viral load in posterior oropharyngeal saliva samples and serum antibody responses during infection by SARS-CoV-2: an observational cohort study. Lancet Infect Dis 2020;20:565–74.
Wu Z, McGoogan JM. Characteristics of an important lesson from the coronavirus disease 2019 (COVID-2019) outbreak in China: summary of a report of 72314 cases from the Chinese Center for Disease Control and Prevention. JAMA 2020.
CDC COVID-19 Response Team. Preliminary Estimates of the Prevalence of Selected Underlying Health Conditions Among Patients with Coronavirus Disease 2019 - United States, February 12-March 28, 2020. MMWR 2020;13:382–6.
Singh A, Gillies C, Singh R, et al. Prevalence of comorbidities and their association with mortality in patients with COVID-19: a systematic review and meta-analysis. Diabetes Obes Metab 2020.
Mallapaty S. The coronavirus is most deadly if you are old and male. Nature 2020;585:16–7.
Núñez-Gil I, Estrada V, Fernández-Pérez C, et al. The COVID-19 curve, health system overload, and mortality. Emergencias 2020;32:293–5.
Casas-Rojo JM, Antón-Santos JM, Millán-Núñez-Cortés J, et al. Clinical characteristics of patients hospitalized with COVID-19 in Spain: results from the SEMI-COVID-19 Registry. Rev Clin Esp 2020;2020:480–94.
Yehia B, Winegar A, Fogel R, et al. Association of race with mortality among patients hospitalized with coronavirus disease 2019 (COVID-19) at 92 US hospitals. JAMA Network Open 2020;3:e2018039.
Fernández-Cruz A, Ruiz-Antoran B, Muñoz-Gomez A, et al. Impact of glucocorticoid treatment in SARS-CoV-2 infection mortality: a retrospective controlled cohort study. Antimicrob Agents Chemother 2020;64:e01168–1220.
Somers E, Eschenauer G, Troost J, et al. Tocilizumab for treatment of mechanically ventilated patients with COVID-19. Clin Infect Dis 2020.
Guallar MP, Meiriño R, Donat-Vargas C, et al. Inoculum at the time of SARS-CoV-2 exposure and risk of disease severity. Int J Infect Dis 2020;97:290–2.
Cummings M, Bladwin M, Abrams D, et al. Epidemiology, clinical course, and outcomes of critically ill adults with COVID-19 in New York City: a prospective cohort study. Lancet 2020;395:1763–70.
Zheng Y, Ma Y, Zhang J, et al. COVID-19 and the cardiovascular system. Nat Rev Cardiol 2020;17:259–60.
Viriani S, Alonso A, Benjamin E, et al. Heart Disease and stroke statistics-2020 update: a report from the American Heart Association. Circulation 2020;141:e139–596.
Arons M, Hatfield K, Reddy S, et al. Presymptomatic SARS-CoV-2 infections and transmission in a skilled nursing facility. N Engl J Med 2020;382:2081–90.
Sanchez G, Biedron C, Fink L, et al. Initial and repeated point prevalence surveys to inform SARS-CoV-2 infection prevention in 26 skilled nursing facilities-Detroit, Michigan, March-May 2020. MMWR 2020;69:882–6.