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BMJ Open ; 10(11): e042398, 2020 11 10.
Article in English | MEDLINE | ID: covidwho-919176

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.


Subject(s)
Acute Kidney Injury/physiopathology , Coronavirus Infections/physiopathology , Pneumonia, Viral/physiopathology , Respiratory Distress Syndrome/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/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/therapy , Pulmonary Disease, Chronic Obstructive/epidemiology , Renal Insufficiency, Chronic/epidemiology , Respiration, Artificial , Respiratory Distress Syndrome/therapy , Retrospective Studies , SARS-CoV-2 , Sex Factors , Spain/epidemiology
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