Seven Epidemic Waves of COVID-19 in a Hospital in Madrid: Analysis of Severity and Associated Factors.
Juan Víctor San Martín-LópezNieves MesaDavid Bernal-BelloAlejandro MoralesMarta RivillaMarta GuerreroRuth CalderónAna I FarfánLuis RivasGuillermo SoriaAída IzquierdoElena MadroñalMiguel Ángel Duarte-MillánSara PiedrabuenaMaría Toledano-MacíasJorge MarreroCristina de AncosBegoña FrutosRafael CristóbalLaura VelázquezBelén MoraPaula CuencaJosé Á SatuéIbone Ayala-LarrañagaLorena CarpinteroCelia LaraÁlvaro R LlerenaVirginia GarcíaVanessa García de ViedmaSantiago PrietoNatalia González-PereiraCristina BravoCarolina MariñoLuis Antonio LechugaJorge TarancónSonia Gonzalonull nullSantiago MorenoJosé Manuel Ruiz-GiardínPublished in: Viruses (2023)
(1) Background: COVID-19 has evolved during seven epidemic waves in Spain. Our objective was to describe changes in mortality and severity in our hospitalized patients. (2) Method: This study employed a descriptive, retrospective approach for COVID-19 patients admitted to the Hospital de Fuenlabrada (Madrid, Spain) until 31 December 2022. (3) Results: A total of 5510 admissions for COVID-19 were recorded. The first wave accounted for 1823 (33%) admissions and exhibited the highest proportion of severe patients: 65% with bilateral pneumonia and 83% with oxygen saturation under 94% during admission and elevated levels of CRP, IL-6, and D-dimer. In contrast, the seventh wave had the highest median age (79 years) and comorbidity (Charlson: 2.7), while only 3% of patients had bilateral pneumonia and 3% required intubation. The overall mortality rate was 10.3%. The first wave represented 39% of the total. The variables related to mortality were age (OR: 1.08, 1.07-1.09), cancer (OR: 1.99, 1.53-2.60), dementia (OR: 1.82, 1.20-2.75), the Charlson index (1.38, 1.31-1.47), the need for high-flow oxygen (OR: 6.10, 4.94-7.52), mechanical ventilation (OR: 11.554, 6.996-19.080), and CRP (OR: 1.04, 1.03-1.06). (4) Conclusions: The variables associated with mortality included age, comorbidity, respiratory failure, and inflammation. Differences in the baseline characteristics of admitted patients explained the differences in mortality in each wave. Differences observed between patients admitted in the latest wave and the earlier ones suggest that COVID-19 has evolved into a distinct disease, requiring a distinct approach.
Keyphrases
- coronavirus disease
- sars cov
- respiratory failure
- mechanical ventilation
- cardiovascular events
- ejection fraction
- risk factors
- newly diagnosed
- healthcare
- respiratory syndrome coronavirus
- intensive care unit
- emergency department
- magnetic resonance
- extracorporeal membrane oxygenation
- magnetic resonance imaging
- squamous cell carcinoma
- cross sectional
- mild cognitive impairment
- computed tomography
- cardiovascular disease
- papillary thyroid
- case report
- community acquired pneumonia