Characteristics, complications and outcomes among 1549 patients hospitalised with COVID-19 in a secondary hospital in Madrid, Spain: a retrospective case series study

BMJ Open. 2020 Nov 10;10(11):e042398. doi: 10.1136/bmjopen-2020-042398.

Abstract

Objectives: To describe demographic, clinical, radiological and laboratory characteristics, as well as outcomes, of patients admitted for COVID-19 in a secondary hospital.

Design and setting: Retrospective case series of sequentially hospitalised patients with confirmed SARS-CoV-2, at Infanta Leonor University Hospital (ILUH) in Madrid, Spain.

Participants: All patients attended at ILUH testing positive to reverse transcriptase-PCR on nasopharyngeal swabs and diagnosed with COVID-19 between 1 March 2020 and 28 May 2020.

Results: A total of 1549 COVID-19 cases were included (median age 69 years (IQR 55.0-81.0), 57.5% men). 78.2% had at least one underlying comorbidity, the most frequent was hypertension (55.8%). Most frequent symptoms at presentation were fever (75.3%), cough (65.7%) and dyspnoea (58.1%). 81 (5.8%) patients were admitted to the intensive care unit (ICU) (median age 62 years (IQR 51-71); 74.1% men; median length of stay 9 days (IQR 5-19)) 82.7% of them needed invasive ventilation support. 1393 patients had an outcome at the end of the study period (case fatality ratio: 21.2% (296/1393)). The independent factors associated with fatality (OR; 95% CI): age (1.07; 1.06 to 1.09), male sex (2.86; 1.85 to 4.50), neurological disease (1.93; 1.19 to 3.13), chronic kidney disease (2.83; 1.40 to 5.71) and neoplasia (4.29; 2.40 to 7.67). The percentage of hospital beds occupied with COVID-19 almost doubled (702/361), with the number of patients in ICU quadrupling its capacity (32/8). Median length of stay was 9 days (IQR 6-14).

Conclusions: This study provides clinical characteristics, complications and outcomes of patients with COVID-19 admitted to a European secondary hospital. Fatal outcomes were similar to those reported by hospitals with a higher level of complexity.

Keywords: COVID-19; epidemiology; infectious diseases; public health.

MeSH terms

  • Acute Kidney Injury / physiopathology*
  • Acute Kidney Injury / therapy
  • Adrenal Cortex Hormones / therapeutic use
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Antibodies, Monoclonal, Humanized / therapeutic use
  • Antiviral Agents / therapeutic use
  • Betacoronavirus
  • COVID-19
  • Cardiovascular Diseases / epidemiology
  • Comorbidity
  • Coronavirus Infections / complications
  • Coronavirus Infections / mortality
  • Coronavirus Infections / physiopathology*
  • Coronavirus Infections / therapy
  • Cough / physiopathology
  • Dyspnea / physiopathology
  • Female
  • Fever / physiopathology
  • Hospitalization
  • Humans
  • Hypertension / epidemiology
  • Intensive Care Units
  • Length of Stay
  • Male
  • Middle Aged
  • Neoplasms
  • Nervous System Diseases / epidemiology
  • Pandemics
  • Pneumonia, Viral / complications
  • Pneumonia, Viral / mortality
  • Pneumonia, Viral / physiopathology*
  • Pneumonia, Viral / therapy
  • Pulmonary Disease, Chronic Obstructive / epidemiology
  • Renal Insufficiency, Chronic / epidemiology
  • Respiration, Artificial
  • Respiratory Distress Syndrome / physiopathology*
  • Respiratory Distress Syndrome / therapy
  • Retrospective Studies
  • SARS-CoV-2
  • Sex Factors
  • Spain / epidemiology

Substances

  • Adrenal Cortex Hormones
  • Antibodies, Monoclonal, Humanized
  • Antiviral Agents
  • tocilizumab