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.