Major determinants of death in patients hospitalized with COVID-19 during the first epidemic wave in Madrid, Spain
Víctor Moreno‐Torres, Sara de la Fuente, Patricia Mills, Alejandro Muñoz, Elena Múñez, António Ramos, Ana Fernández‐Cruz, Ana Arias, Ilduara Pintos, Juan Antonio Vargas, Valentín Cuervas‐Mons, Carmen de Mendoza
Abstract
ABSTRACT: Spain is one of the European countries most largely affected by COVID-19, being Madrid the epicenter. A good knowledge of the main features of hospitalized patients during the complete lockdown should improve the management of new COVID-19 surges.All patients hospitalized at one large tertiary hospital in Madrid for suspected COVID-19 pneumonia from March 1 to May 31 were retrospectively identified.A total of 1752 patients were admitted with suspected pneumonia due to SARS-CoV-2 infection during the 3-month study period. The peak of daily admissions (n = 84) was reached on March 24, whereas the maximal cumulative number of hospitalized patients (n = 626) occurred on March 30. Overall, 85.3% had a positive PCR test for SARS-CoV-2 at least once during admission. Their median age was 65 (54-77) and 59.9% were male. The median length of hospitalization was of 7 (4-13) days. Roughly 6.5% were admitted at the intensive care unit.Death occurred in 242 (13.8%). Overall, 75% of deaths occurred in patients older than 75 years-old. It was 38.2% in patients hospitalized older than 80 years-old versus 2.2% in patients younger than 60 years-old (p < 0.001). Up to 94 (38.8%) of deceased patients had been transferred from nursing homes. The median Charlson co-morbidity score was 6 in deceased patients.The in-hospital mortality rate during the first wave of COVID-19 in Madrid was 14%. It was largely driven by older age, the presence of underlying chronic conditions (≥2) and living at nursing homes.