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Observational Study
. 2025 Mar 3;38(2):97-107.
doi: 10.37201/req/110.2024. Epub 2025 Feb 14.

Epidemiology of the COVID-19 pneumonia in a group of hospitals from Madrid-Spain during the full period of the State of Alarm HM cohort

José Barberán  1 , María Ramos  2 , Julio Villanueva  2 , Paula Villares  3 , Mercedes Villareal  4 , María Vivas  4 , Susana Orche  5 , María Tejera-Gonzalez  6 , Justo M Menéndez  3 , Lenin Tolentino Hinojosa  7 , Cristina Almirall  8 , Leonor Antolin  2 , Lady Martinez  1 , Silvia Mendoza  9 , Adrián Pelaez  10 , María Segarra-Cañamares  11 , José E Guerrero  12 , Jesús Pelaez  4 , Pablo Cardinal-Fernández  13
Affiliations
Observational Study

Epidemiology of the COVID-19 pneumonia in a group of hospitals from Madrid-Spain during the full period of the State of Alarm HM cohort

José Barberán et al. Rev Esp Quimioter. .

Abstract
in English, Spanish

Introduction: To describe the epidemiology pattern of the COVID-19 pandemic during all Spanish State of Alarm.

Methods: Retrospective, observational, cohort and multicenter study. Inclusion criteria: age ≥18 years old, admitted for COVID-19 pneumonia in any of the centers of the HM Hospitals Group. Exclusion criteria: voluntary discharge, death in the emergency department, transfer to centers outside the HM group or incomplete data. State of Alarm period: 31/01/2020 to 05/07/2023. Predominant COVID-19 variant was defined when it exceeded 50% of the total isolates.

Results: During the study period, 2,992 patients were admitted due to a COVID-19 pneumonia, 295 patients (9.86%) non-survive. Survivors and non-survivors were different in age and comorbidities. However, both cohorts presented a similar net of interaction between comorbidities. Hospital admissions per week showed an evolution in "peaks" with "troughs". A total of 197 (6.48%) patients were admitted to the ICU, of whom 52 (26.39%) non-survive; this subgroup stood out for having a higher proportion of septic shock, orotracheal intubation and acute renal failure, as well as a lower proportion of pulmonary thromboembolism and delirium. Concerning the viral variants, the incidence for the original variant was 4.05 cases/day, for the alpha variant 3.82 cases/day, for the delta variant 1.16 cases/day and for the omicron variant 1.35 cases/day.

Conclusion: Almost 1 of 10 patients with COVID-19 pneumonia death, a proportion that increased to 1 of 4 in case of being admitted to the ICU. Unexpectedly, interaction between comorbidities did not differ between survivors and non-survivors patients. Predominant variants were associated with different hospital admission rates but not influence the presence of peak-troughs evolution of the pandemic.

Introducción: Describir el patrón epidemiológico de la pandemia de COVID-19 durante todo el estado de alarma en España.

Métodos: Estudio retrospectivo, observacional, de cohorte y multicéntrico. Criterios de inclusión: edad ≥18 años, ingreso por neumonía COVID-19 en cualquiera de los centros del Grupo de Hospitales HM. Criterios de exclusión: alta voluntaria, fallecimiento en el servicio de urgencias, traslado a centros fuera del grupo HM o datos incompletos. Estado de alarma: del 31/01/2020 al 05/07/2023. Se definió como variante predominante de COVID-19 aquella que superó el 50% de los aislamientos totales.

Resultados: Durante el período de estudio, se admitieron 2.992 pacientes por neumonía COVID-19, de los cuales 295 pacientes (9,86%) no sobrevivieron. Los sobrevivientes y no sobrevivientes mostraron diferencias en edad y comorbilidades. Sin embargo, ambas cohortes presentaron una red de interacción similar entre las comorbilidades. Los ingresos hospitalarios por semana mostraron una evolución en “picos” y “valles”. Un total de 197 pacientes (6,48%) fueron admitidos en la UCI, de los cuales 52 (26,39%) no sobrevivieron; este subgrupo se caracterizó por una mayor proporción de shock séptico, intubación orotraqueal e insuficiencia renal aguda, así como una menor proporción de tromboembolismo pulmonar y delirio. En relación con las variantes virales, la incidencia fue de 4,05 casos/día para la variante original, 3,82 casos/día para la variante alfa, 1,16 casos/día para la variante delta y 1,35 casos/día para la variante ómicron.

Conclusiones: Casi 1 de cada 10 pacientes con neumonía por COVID-19 falleció, proporción que aumentó a 1 de cada 4 en caso de ingreso en la UCI. De manera inesperada, la interacción entre comorbilidades no difería entre pacientes sobrevivientes y no sobrevivientes. Las variantes predominantes se asociaron a diferentes tasas de ingreso hospitalario, pero no influyeron en la evolución de picos y valles de la pandemia.

Keywords: COVID-19; Epidemiology; Health crisis; Pandemia; Pneumonia; SARS-CoV-2; VOCs variants.

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Conflict of interest statement

The authors declare that they have no conflicts of interest.

Figures

Figure 1.
Figure 1.
Evolution of COVID-19 pneumonia admissions aggregated between survivors and non-survivors at hospital discharge.
Figure 2.
Figure 2.
Comorbidities. Upper panel (right to left): dendogram (each row represents a patient); vertical column: yellow lines: survivors; black lines: non-survivors; main square: pink lines: presence of the comorbidity, skyline: absence of the comorbidity. Lower panel: A: all patients, B survivors and C non-survivors. HTA: high blood pressure; COPD: chronic obstructive pulmonary disease; ACV: cerebral stroke; ICC: chronic heart failure; IRC: chronic renal insufficiency.
See this image and copyright information in PMC

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