BMJ Open (Nov 2020)

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

  • Ane Abad-motos,
  • Jesús Troya,
  • Eva Jiménez,
  • Mario Fontán-Vela,
  • Jorge Valencia,
  • Ines Fernandez-Jimenez,
  • Elena Alba Álvaro-Alonso,
  • Elsa Izquierdo-García,
  • Andrea Lazaro Cebas,
  • Elisa Gallego Ruiz-Elvira,
  • Ana Josefa Tebar-Martinez,
  • Belén Garcia-Marina,
  • Gabriela Peña-Lillo,
  • Laura Macaya,
  • Pablo Ryan,
  • Mario Pérez-Butragueño,
  • Blanca Herrero Mendoza,
  • Natividad Plazas Andreu,
  • Liliana Vázquez Bol,
  • Sandra María Gadin López,
  • Álvaro Martínez Alcalá,
  • Sonia Pérez Gonzalez,
  • Amalia Martínez de la Gándara,
  • Alejandro Zuazua Gonzalez,
  • Javier Montoya Adarraga,
  • Miguel Ángel Lara Álvarez,
  • Enrique Calvo Aranda,
  • Rosa M Lorente Ramos,
  • María Alcantud,
  • Roberto Alcázar Arroyo,
  • Verónica Suberviola Sánchez-Caballero,
  • Ariela Candelario Cáceres,
  • Juan Churruca Sarasqueta,
  • Juan Torres Macho,
  • Ismael Escobar Rodríguez,
  • Raquel Ruíz Páez,
  • Alberto Esquivel López,
  • Pablo de la Cueva Dobao,
  • Natalia Blanca López,
  • José García Hinojosa,
  • Cristina Sevillano Collantes,
  • Alfonso Camacho Aroca,
  • Tamar Talaván Zañón,
  • María Ángeles Sánchez Úriz,
  • Carlos Bibiano Guillén,
  • Miguel Ángel López Arenas,
  • Margarita Gimeno Arández,
  • Francisco Javier Quintero Gutiérrez del Álamo

DOI
https://doi.org/10.1136/bmjopen-2020-042398
Journal volume & issue
Vol. 10, no. 11

Abstract

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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.