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Observational Study
. 2021 Aug;34(4):342-352.
doi: 10.37201/req/050.2021. Epub 2021 May 19.

Clinical characteristics and outcomes of 1,331 patients with COVID-19: HM Spanish Cohort

P Cardinal-Fernández #  1 , E Garcia Cuesta #, J Barberán #, J F Varona, A Estirado, A Moreno, J Villanueva, M Villareal, O Baez-Pravia, J Menéndez, P Villares, A López Escobar, J Rodríguez-Pascual, C Almirall, E Domínguez, C Pey, A Ferreiro, M Revilla Amores, N Sánchez, S Ruiz de Aguiar, J M Castellano
Affiliations
Observational Study

Clinical characteristics and outcomes of 1,331 patients with COVID-19: HM Spanish Cohort

P Cardinal-Fernández et al. Rev Esp Quimioter. 2021 Aug.

Abstract
in English, Spanish

Objective: Spain is one of the European countries most affected by the COVID-19 pandemic. Epidemiologic studies are warranted to improve the disease understanding, evaluate the care procedure and prepare for futures waves. The aim of the study was to describe epidemiologic characteristics associated with hospitalized patients with COVID-19.

Methods: This real-world, observational, multicenter and retrospective study screened all consecutive patients admitted to 8 Spanish private hospitals. Inclusion criteria: hospitalized adults (age≥18 years old) with clinically and radiologically findings compatible with COVID-19 disease from March 1st to April 5th, 2020. Exclusion criteria: patients presenting negative PCR for SARS-CoV-2 during the first 7 days from hospital admission, transfer to a hospital not belonging to the HM consortium, lack of data and discharge against medical advice in emergency departments.

Results: One thousand and three hundred thirty-one COVID-19 patients (medium age 66.9 years old; males n= 841, medium length of hospital stayed 8 days, non-survivors n=233) were analyzed. One hundred and fifteen were admitted to intensive care unit (medium length of stay 16 days, invasive mechanical ventilation n= 95, septic shock n= 37 and renal replacement therapy n= 17). Age, male gender, leukocytes, platelets, oxygen saturation, chronic therapy with steroids and treatment with hydroxychloroquine/azithromycin were independent factors associated with mortality. The proportion of patients that survive and received tocilizumab and steroids were lesser and higher respectively than those that die, but their association was not significant.

Conclusions: Overall crude mortality rate was 17.5%, rising up to 36.5% in the subgroup of patients that were admitted to the intensive care unit. Seven factors impact in hospital mortality. No immunomodulatory intervention were associated with in-hospital mortality.

Introducción: España es uno de los países europeos más afectados por la pandemia de COVID-19. Conocer las características epidemiológicas y evolutivas permitirá mejorar la comprensión de la enfermedad, evaluar el procedimiento de atención y prepararse para las olas futuras. El objetivo del estudio fue describir las características epidemiológicas asociadas a los pacientes hospitalizados por COVID-19.

Material y métodos: Diseño observacional, multicéntrico y retrospectivo del mundo real realizado en 8 hospitales privados de España. Criterios de inclusión: adultos hospitalizados (edad≥18 años) con hallazgos clínicos y radiológicos compatibles con enfermedad COVID-19 entre el 1 de marzo al 5 de abril de 2020. Criterios de exclusión: PCR negativa para SARSCoV-2 durante los primeros 7 días de ingreso hospitalario, traslado a un hospital no perteneciente al consorcio HM, falta de datos y alta contra consejo médico en urgencias.

Resultados: Se analizaron 1.331 pacientes con COVID-19 (edad media 66,9 años; varones n = 841, estancia media hospitalaria 8 días, no supervivientes n = 233). Ciento quince ingresaron en la unidad de cuidados intensivos (estancia media 16 días, ventilación mecánica invasiva n = 95, choque séptico n = 37 y terapia renal sustitutiva n = 17). La edad, el sexo masculino, los leucocitos, las plaquetas, la saturación de oxígeno, la terapia crónica con esteroides y el tratamiento con hidroxicloroquina / azitromicina fueron factores independientes asociados con la mortalidad.

Conclusiones: La tasa de mortalidad bruta global fue del 17,5%, elevándose hasta el 36,5% en el subgrupo de pacientes que ingresaron en la unidad de cuidados intensivos. Siete factores impactan en la mortalidad hospitalaria.

Keywords: COVID-19; SARS-CoV-2; epidemiology; pandemic.

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Conflict of interest statement

all authors declare no conflict of interest

Figures

Figure 1
Figure 1
Hospital admission per day (absolute and accumulative frequency) and patients at hospital each day Right: absolute frequency of hospital admission per day. Middle: accumulative frequency of admission. Left: patients at hospital per day (red: all patients, green: patients admitted to the intensive care unit) Red: all patients; green: ICU admissions. Arrow: Spanish´s lockdown beggining.
Figure 2
Figure 2
Pharmacological interventions (survival analysis)
See this image and copyright information in PMC

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