Viruses (Aug 2023)
Seven Epidemic Waves of COVID-19 in a Hospital in Madrid: Analysis of Severity and Associated Factors
- Juan Víctor San Martín-López,
- Nieves Mesa,
- David Bernal-Bello,
- Alejandro Morales-Ortega,
- Marta Rivilla,
- Marta Guerrero,
- Ruth Calderón,
- Ana I. Farfán,
- Luis Rivas,
- Guillermo Soria,
- Aída Izquierdo,
- Elena Madroñal,
- Miguel Duarte,
- Sara Piedrabuena,
- María Toledano-Macías,
- Jorge Marrero,
- Cristina de Ancos,
- Begoña Frutos,
- Rafael Cristóbal,
- Laura Velázquez,
- Belén Mora,
- Paula Cuenca,
- José Á. Satué,
- Ibone Ayala-Larrañaga,
- Lorena Carpintero,
- Celia Lara,
- Álvaro R. Llerena,
- Virginia García,
- Vanessa García de Viedma,
- Santiago Prieto,
- Natalia González-Pereira,
- Cristina Bravo,
- Carolina Mariño,
- Luis Antonio Lechuga,
- Jorge Tarancón,
- Sonia Gonzalo,
- Santiago Moreno,
- José M. Ruiz-Giardin
Affiliations
- Juan Víctor San Martín-López
- Servicio de Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain
- Nieves Mesa
- Servicio de Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain
- David Bernal-Bello
- Servicio de Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain
- Alejandro Morales-Ortega
- Servicio de Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain
- Marta Rivilla
- Servicio de Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain
- Marta Guerrero
- Servicio de Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain
- Ruth Calderón
- Servicio de Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain
- Ana I. Farfán
- Servicio de Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain
- Luis Rivas
- Servicio de Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain
- Guillermo Soria
- Servicio de Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain
- Aída Izquierdo
- Servicio de Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain
- Elena Madroñal
- Servicio de Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain
- Miguel Duarte
- Servicio de Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain
- Sara Piedrabuena
- Servicio de Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain
- María Toledano-Macías
- Servicio de Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain
- Jorge Marrero
- Servicio de Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain
- Cristina de Ancos
- Servicio de Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain
- Begoña Frutos
- Servicio de Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain
- Rafael Cristóbal
- Servicio de Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain
- Laura Velázquez
- Servicio de Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain
- Belén Mora
- Servicio de Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain
- Paula Cuenca
- Servicio de Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain
- José Á. Satué
- Servicio de Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain
- Ibone Ayala-Larrañaga
- Servicio de Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain
- Lorena Carpintero
- Servicio de Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain
- Celia Lara
- Servicio de Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain
- Álvaro R. Llerena
- Servicio de Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain
- Virginia García
- Servicio de Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain
- Vanessa García de Viedma
- Servicio de Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain
- Santiago Prieto
- Servicio de Laboratorio Clínico, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain
- Natalia González-Pereira
- Servicio de Laboratorio Clínico, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain
- Cristina Bravo
- Servicio de Farmacia, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain
- Carolina Mariño
- Servicio de Farmacia, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain
- Luis Antonio Lechuga
- Sistemas, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain
- Jorge Tarancón
- Sistemas, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain
- Sonia Gonzalo
- Servicio de Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain
- Santiago Moreno
- CIBERINFEC, Instituto de Salud Carlos III, Madrid, 28029 Madrid, Spain
- José M. Ruiz-Giardin
- Servicio de Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain
- DOI
- https://doi.org/10.3390/v15091839
- Journal volume & issue
-
Vol. 15,
no. 9
p. 1839
Abstract
(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.
Keywords