Title: In-hospital mortality in patients hospitalized with
COVID-19 during the first wave of the pandemic in a Spanish community
hospital.
Abstract : Background : Spain is one of the European
countries affected by the COVID-19 pandemic with a high number of
recorded cases and deaths in Europe. Aim : To describe clinical
characteristics and outcome of patients with COVID-19 hospitalized in a
regional hospital in Spain. Methods : Clinical characteristics of
the first COVID-19 patients hospitalised in the early days of the
epidemic were recorded upon admission. A logistic regression
multivariate analysis was performed to determine factors independently
associated with a composite endpoint (death or ICU admission).Results : We included 100 patients, median age was 75 years and
52% were men. The most common comorbidities were hypertension (63%),
diabetes (22%) and cardiovascular diseases (28%). The most common
symptoms were fever (80%), cough (69%), fatigue (59%) and dyspnoea
(52%) and 64% had respiratory insufficiency. Bilateral interstitial
infiltrates (65%) and bilateral vertical “B-kerley” lines (82.6%)
were the most common findings in chest radiographs and lung ultrasound.
All patients received supplementary oxygen, 69% received medical
treatment (hydroxychloroquine plus azithromycin the most common regimen)
and 12% glucocorticoids. During hospitalization, 26% died, 10% were
transferred to ICU and the remaining 62% were discharged at home. In
the multivariate analysis a higher comorbidity burden (OR 1.4; 95% CI:
1.1-1.8) and higher C-reactive protein values on admission (OR 1.2;
95%CI: 1.1-1.4) were independent risk factors for the composite
endpoint. Conclusions : Case-fatality rate of patients
hospitalized with COVID-19 in the early days of the Spanish epidemic was
26%. A high comorbidity burden is associated to an increased risk of
death or ICU admission.
Keywords : COVID-19; severe acute respiratory syndrome
coronavirus 2