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San Martín-López JV, Mesa N, Bernal-Bello D, Morales-Ortega A, Rivilla M, Guerrero M, Calderón R, Farfán AI, Rivas L, Soria G, Izquierdo A, Madroñal E, Duarte M, Piedrabuena S, Toledano-Macías M, Marrero J, de Ancos C, Frutos B, Cristóbal R, Velázquez L, Mora B, Cuenca P, Satué JÁ, Ayala-Larrañaga I, Carpintero L, Lara C, Llerena ÁR, García V, García de Viedma V, Prieto S, González-Pereira N, Bravo C, Mariño C, Lechuga LA, Tarancón J, Gonzalo S, Moreno S, Ruiz-Giardin JM. Seven Epidemic Waves of COVID-19 in a Hospital in Madrid: Analysis of Severity and Associated Factors. Viruses 2023; 15:1839. [PMID: 37766248 PMCID: PMC10538062 DOI: 10.3390/v15091839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 08/21/2023] [Accepted: 08/28/2023] [Indexed: 09/29/2023] Open
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.
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Affiliation(s)
- Juan Víctor San Martín-López
- Servicio de Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain; (N.M.); (D.B.-B.); (A.M.-O.); (M.R.); (M.G.); (R.C.); (A.I.F.); (L.R.); (G.S.); (A.I.); (E.M.); (M.D.); (S.P.); (M.T.-M.); (J.M.); (C.d.A.); (B.F.); (R.C.); (L.V.); (B.M.); (P.C.); (J.Á.S.); (I.A.-L.); (L.C.); (C.L.); (Á.R.L.); (V.G.); (V.G.d.V.); (S.G.); (J.M.R.-G.)
- CIBERINFEC, Instituto de Salud Carlos III, Madrid, 28029 Madrid, Spain;
| | - Nieves Mesa
- Servicio de Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain; (N.M.); (D.B.-B.); (A.M.-O.); (M.R.); (M.G.); (R.C.); (A.I.F.); (L.R.); (G.S.); (A.I.); (E.M.); (M.D.); (S.P.); (M.T.-M.); (J.M.); (C.d.A.); (B.F.); (R.C.); (L.V.); (B.M.); (P.C.); (J.Á.S.); (I.A.-L.); (L.C.); (C.L.); (Á.R.L.); (V.G.); (V.G.d.V.); (S.G.); (J.M.R.-G.)
| | - David Bernal-Bello
- Servicio de Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain; (N.M.); (D.B.-B.); (A.M.-O.); (M.R.); (M.G.); (R.C.); (A.I.F.); (L.R.); (G.S.); (A.I.); (E.M.); (M.D.); (S.P.); (M.T.-M.); (J.M.); (C.d.A.); (B.F.); (R.C.); (L.V.); (B.M.); (P.C.); (J.Á.S.); (I.A.-L.); (L.C.); (C.L.); (Á.R.L.); (V.G.); (V.G.d.V.); (S.G.); (J.M.R.-G.)
| | - Alejandro Morales-Ortega
- Servicio de Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain; (N.M.); (D.B.-B.); (A.M.-O.); (M.R.); (M.G.); (R.C.); (A.I.F.); (L.R.); (G.S.); (A.I.); (E.M.); (M.D.); (S.P.); (M.T.-M.); (J.M.); (C.d.A.); (B.F.); (R.C.); (L.V.); (B.M.); (P.C.); (J.Á.S.); (I.A.-L.); (L.C.); (C.L.); (Á.R.L.); (V.G.); (V.G.d.V.); (S.G.); (J.M.R.-G.)
- Departamento de Medicina y Especialidades Médicas, Universidad de Alcalá, 28871 Madrid, Spain
| | - Marta Rivilla
- Servicio de Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain; (N.M.); (D.B.-B.); (A.M.-O.); (M.R.); (M.G.); (R.C.); (A.I.F.); (L.R.); (G.S.); (A.I.); (E.M.); (M.D.); (S.P.); (M.T.-M.); (J.M.); (C.d.A.); (B.F.); (R.C.); (L.V.); (B.M.); (P.C.); (J.Á.S.); (I.A.-L.); (L.C.); (C.L.); (Á.R.L.); (V.G.); (V.G.d.V.); (S.G.); (J.M.R.-G.)
| | - Marta Guerrero
- Servicio de Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain; (N.M.); (D.B.-B.); (A.M.-O.); (M.R.); (M.G.); (R.C.); (A.I.F.); (L.R.); (G.S.); (A.I.); (E.M.); (M.D.); (S.P.); (M.T.-M.); (J.M.); (C.d.A.); (B.F.); (R.C.); (L.V.); (B.M.); (P.C.); (J.Á.S.); (I.A.-L.); (L.C.); (C.L.); (Á.R.L.); (V.G.); (V.G.d.V.); (S.G.); (J.M.R.-G.)
| | - Ruth Calderón
- Servicio de Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain; (N.M.); (D.B.-B.); (A.M.-O.); (M.R.); (M.G.); (R.C.); (A.I.F.); (L.R.); (G.S.); (A.I.); (E.M.); (M.D.); (S.P.); (M.T.-M.); (J.M.); (C.d.A.); (B.F.); (R.C.); (L.V.); (B.M.); (P.C.); (J.Á.S.); (I.A.-L.); (L.C.); (C.L.); (Á.R.L.); (V.G.); (V.G.d.V.); (S.G.); (J.M.R.-G.)
| | - Ana I. Farfán
- Servicio de Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain; (N.M.); (D.B.-B.); (A.M.-O.); (M.R.); (M.G.); (R.C.); (A.I.F.); (L.R.); (G.S.); (A.I.); (E.M.); (M.D.); (S.P.); (M.T.-M.); (J.M.); (C.d.A.); (B.F.); (R.C.); (L.V.); (B.M.); (P.C.); (J.Á.S.); (I.A.-L.); (L.C.); (C.L.); (Á.R.L.); (V.G.); (V.G.d.V.); (S.G.); (J.M.R.-G.)
| | - Luis Rivas
- Servicio de Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain; (N.M.); (D.B.-B.); (A.M.-O.); (M.R.); (M.G.); (R.C.); (A.I.F.); (L.R.); (G.S.); (A.I.); (E.M.); (M.D.); (S.P.); (M.T.-M.); (J.M.); (C.d.A.); (B.F.); (R.C.); (L.V.); (B.M.); (P.C.); (J.Á.S.); (I.A.-L.); (L.C.); (C.L.); (Á.R.L.); (V.G.); (V.G.d.V.); (S.G.); (J.M.R.-G.)
| | - Guillermo Soria
- Servicio de Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain; (N.M.); (D.B.-B.); (A.M.-O.); (M.R.); (M.G.); (R.C.); (A.I.F.); (L.R.); (G.S.); (A.I.); (E.M.); (M.D.); (S.P.); (M.T.-M.); (J.M.); (C.d.A.); (B.F.); (R.C.); (L.V.); (B.M.); (P.C.); (J.Á.S.); (I.A.-L.); (L.C.); (C.L.); (Á.R.L.); (V.G.); (V.G.d.V.); (S.G.); (J.M.R.-G.)
| | - Aída Izquierdo
- Servicio de Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain; (N.M.); (D.B.-B.); (A.M.-O.); (M.R.); (M.G.); (R.C.); (A.I.F.); (L.R.); (G.S.); (A.I.); (E.M.); (M.D.); (S.P.); (M.T.-M.); (J.M.); (C.d.A.); (B.F.); (R.C.); (L.V.); (B.M.); (P.C.); (J.Á.S.); (I.A.-L.); (L.C.); (C.L.); (Á.R.L.); (V.G.); (V.G.d.V.); (S.G.); (J.M.R.-G.)
| | - Elena Madroñal
- Servicio de Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain; (N.M.); (D.B.-B.); (A.M.-O.); (M.R.); (M.G.); (R.C.); (A.I.F.); (L.R.); (G.S.); (A.I.); (E.M.); (M.D.); (S.P.); (M.T.-M.); (J.M.); (C.d.A.); (B.F.); (R.C.); (L.V.); (B.M.); (P.C.); (J.Á.S.); (I.A.-L.); (L.C.); (C.L.); (Á.R.L.); (V.G.); (V.G.d.V.); (S.G.); (J.M.R.-G.)
| | - Miguel Duarte
- Servicio de Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain; (N.M.); (D.B.-B.); (A.M.-O.); (M.R.); (M.G.); (R.C.); (A.I.F.); (L.R.); (G.S.); (A.I.); (E.M.); (M.D.); (S.P.); (M.T.-M.); (J.M.); (C.d.A.); (B.F.); (R.C.); (L.V.); (B.M.); (P.C.); (J.Á.S.); (I.A.-L.); (L.C.); (C.L.); (Á.R.L.); (V.G.); (V.G.d.V.); (S.G.); (J.M.R.-G.)
| | - Sara Piedrabuena
- Servicio de Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain; (N.M.); (D.B.-B.); (A.M.-O.); (M.R.); (M.G.); (R.C.); (A.I.F.); (L.R.); (G.S.); (A.I.); (E.M.); (M.D.); (S.P.); (M.T.-M.); (J.M.); (C.d.A.); (B.F.); (R.C.); (L.V.); (B.M.); (P.C.); (J.Á.S.); (I.A.-L.); (L.C.); (C.L.); (Á.R.L.); (V.G.); (V.G.d.V.); (S.G.); (J.M.R.-G.)
| | - María Toledano-Macías
- Servicio de Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain; (N.M.); (D.B.-B.); (A.M.-O.); (M.R.); (M.G.); (R.C.); (A.I.F.); (L.R.); (G.S.); (A.I.); (E.M.); (M.D.); (S.P.); (M.T.-M.); (J.M.); (C.d.A.); (B.F.); (R.C.); (L.V.); (B.M.); (P.C.); (J.Á.S.); (I.A.-L.); (L.C.); (C.L.); (Á.R.L.); (V.G.); (V.G.d.V.); (S.G.); (J.M.R.-G.)
| | - Jorge Marrero
- Servicio de Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain; (N.M.); (D.B.-B.); (A.M.-O.); (M.R.); (M.G.); (R.C.); (A.I.F.); (L.R.); (G.S.); (A.I.); (E.M.); (M.D.); (S.P.); (M.T.-M.); (J.M.); (C.d.A.); (B.F.); (R.C.); (L.V.); (B.M.); (P.C.); (J.Á.S.); (I.A.-L.); (L.C.); (C.L.); (Á.R.L.); (V.G.); (V.G.d.V.); (S.G.); (J.M.R.-G.)
| | - Cristina de Ancos
- Servicio de Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain; (N.M.); (D.B.-B.); (A.M.-O.); (M.R.); (M.G.); (R.C.); (A.I.F.); (L.R.); (G.S.); (A.I.); (E.M.); (M.D.); (S.P.); (M.T.-M.); (J.M.); (C.d.A.); (B.F.); (R.C.); (L.V.); (B.M.); (P.C.); (J.Á.S.); (I.A.-L.); (L.C.); (C.L.); (Á.R.L.); (V.G.); (V.G.d.V.); (S.G.); (J.M.R.-G.)
| | - Begoña Frutos
- Servicio de Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain; (N.M.); (D.B.-B.); (A.M.-O.); (M.R.); (M.G.); (R.C.); (A.I.F.); (L.R.); (G.S.); (A.I.); (E.M.); (M.D.); (S.P.); (M.T.-M.); (J.M.); (C.d.A.); (B.F.); (R.C.); (L.V.); (B.M.); (P.C.); (J.Á.S.); (I.A.-L.); (L.C.); (C.L.); (Á.R.L.); (V.G.); (V.G.d.V.); (S.G.); (J.M.R.-G.)
| | - Rafael Cristóbal
- Servicio de Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain; (N.M.); (D.B.-B.); (A.M.-O.); (M.R.); (M.G.); (R.C.); (A.I.F.); (L.R.); (G.S.); (A.I.); (E.M.); (M.D.); (S.P.); (M.T.-M.); (J.M.); (C.d.A.); (B.F.); (R.C.); (L.V.); (B.M.); (P.C.); (J.Á.S.); (I.A.-L.); (L.C.); (C.L.); (Á.R.L.); (V.G.); (V.G.d.V.); (S.G.); (J.M.R.-G.)
| | - Laura Velázquez
- Servicio de Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain; (N.M.); (D.B.-B.); (A.M.-O.); (M.R.); (M.G.); (R.C.); (A.I.F.); (L.R.); (G.S.); (A.I.); (E.M.); (M.D.); (S.P.); (M.T.-M.); (J.M.); (C.d.A.); (B.F.); (R.C.); (L.V.); (B.M.); (P.C.); (J.Á.S.); (I.A.-L.); (L.C.); (C.L.); (Á.R.L.); (V.G.); (V.G.d.V.); (S.G.); (J.M.R.-G.)
| | - Belén Mora
- Servicio de Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain; (N.M.); (D.B.-B.); (A.M.-O.); (M.R.); (M.G.); (R.C.); (A.I.F.); (L.R.); (G.S.); (A.I.); (E.M.); (M.D.); (S.P.); (M.T.-M.); (J.M.); (C.d.A.); (B.F.); (R.C.); (L.V.); (B.M.); (P.C.); (J.Á.S.); (I.A.-L.); (L.C.); (C.L.); (Á.R.L.); (V.G.); (V.G.d.V.); (S.G.); (J.M.R.-G.)
| | - Paula Cuenca
- Servicio de Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain; (N.M.); (D.B.-B.); (A.M.-O.); (M.R.); (M.G.); (R.C.); (A.I.F.); (L.R.); (G.S.); (A.I.); (E.M.); (M.D.); (S.P.); (M.T.-M.); (J.M.); (C.d.A.); (B.F.); (R.C.); (L.V.); (B.M.); (P.C.); (J.Á.S.); (I.A.-L.); (L.C.); (C.L.); (Á.R.L.); (V.G.); (V.G.d.V.); (S.G.); (J.M.R.-G.)
| | - José Á. Satué
- Servicio de Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain; (N.M.); (D.B.-B.); (A.M.-O.); (M.R.); (M.G.); (R.C.); (A.I.F.); (L.R.); (G.S.); (A.I.); (E.M.); (M.D.); (S.P.); (M.T.-M.); (J.M.); (C.d.A.); (B.F.); (R.C.); (L.V.); (B.M.); (P.C.); (J.Á.S.); (I.A.-L.); (L.C.); (C.L.); (Á.R.L.); (V.G.); (V.G.d.V.); (S.G.); (J.M.R.-G.)
| | - Ibone Ayala-Larrañaga
- Servicio de Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain; (N.M.); (D.B.-B.); (A.M.-O.); (M.R.); (M.G.); (R.C.); (A.I.F.); (L.R.); (G.S.); (A.I.); (E.M.); (M.D.); (S.P.); (M.T.-M.); (J.M.); (C.d.A.); (B.F.); (R.C.); (L.V.); (B.M.); (P.C.); (J.Á.S.); (I.A.-L.); (L.C.); (C.L.); (Á.R.L.); (V.G.); (V.G.d.V.); (S.G.); (J.M.R.-G.)
| | - Lorena Carpintero
- Servicio de Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain; (N.M.); (D.B.-B.); (A.M.-O.); (M.R.); (M.G.); (R.C.); (A.I.F.); (L.R.); (G.S.); (A.I.); (E.M.); (M.D.); (S.P.); (M.T.-M.); (J.M.); (C.d.A.); (B.F.); (R.C.); (L.V.); (B.M.); (P.C.); (J.Á.S.); (I.A.-L.); (L.C.); (C.L.); (Á.R.L.); (V.G.); (V.G.d.V.); (S.G.); (J.M.R.-G.)
| | - Celia Lara
- Servicio de Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain; (N.M.); (D.B.-B.); (A.M.-O.); (M.R.); (M.G.); (R.C.); (A.I.F.); (L.R.); (G.S.); (A.I.); (E.M.); (M.D.); (S.P.); (M.T.-M.); (J.M.); (C.d.A.); (B.F.); (R.C.); (L.V.); (B.M.); (P.C.); (J.Á.S.); (I.A.-L.); (L.C.); (C.L.); (Á.R.L.); (V.G.); (V.G.d.V.); (S.G.); (J.M.R.-G.)
| | - Álvaro R. Llerena
- Servicio de Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain; (N.M.); (D.B.-B.); (A.M.-O.); (M.R.); (M.G.); (R.C.); (A.I.F.); (L.R.); (G.S.); (A.I.); (E.M.); (M.D.); (S.P.); (M.T.-M.); (J.M.); (C.d.A.); (B.F.); (R.C.); (L.V.); (B.M.); (P.C.); (J.Á.S.); (I.A.-L.); (L.C.); (C.L.); (Á.R.L.); (V.G.); (V.G.d.V.); (S.G.); (J.M.R.-G.)
| | - Virginia García
- Servicio de Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain; (N.M.); (D.B.-B.); (A.M.-O.); (M.R.); (M.G.); (R.C.); (A.I.F.); (L.R.); (G.S.); (A.I.); (E.M.); (M.D.); (S.P.); (M.T.-M.); (J.M.); (C.d.A.); (B.F.); (R.C.); (L.V.); (B.M.); (P.C.); (J.Á.S.); (I.A.-L.); (L.C.); (C.L.); (Á.R.L.); (V.G.); (V.G.d.V.); (S.G.); (J.M.R.-G.)
| | - Vanessa García de Viedma
- Servicio de Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain; (N.M.); (D.B.-B.); (A.M.-O.); (M.R.); (M.G.); (R.C.); (A.I.F.); (L.R.); (G.S.); (A.I.); (E.M.); (M.D.); (S.P.); (M.T.-M.); (J.M.); (C.d.A.); (B.F.); (R.C.); (L.V.); (B.M.); (P.C.); (J.Á.S.); (I.A.-L.); (L.C.); (C.L.); (Á.R.L.); (V.G.); (V.G.d.V.); (S.G.); (J.M.R.-G.)
| | - Santiago Prieto
- Servicio de Laboratorio Clínico, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain; (S.P.); (N.G.-P.)
| | - Natalia González-Pereira
- Servicio de Laboratorio Clínico, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain; (S.P.); (N.G.-P.)
| | - Cristina Bravo
- Servicio de Farmacia, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain; (C.B.); (C.M.)
| | - Carolina Mariño
- Servicio de Farmacia, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain; (C.B.); (C.M.)
| | - Luis Antonio Lechuga
- Sistemas, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain; (L.A.L.); (J.T.)
| | - Jorge Tarancón
- Sistemas, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain; (L.A.L.); (J.T.)
| | - Sonia Gonzalo
- Servicio de Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain; (N.M.); (D.B.-B.); (A.M.-O.); (M.R.); (M.G.); (R.C.); (A.I.F.); (L.R.); (G.S.); (A.I.); (E.M.); (M.D.); (S.P.); (M.T.-M.); (J.M.); (C.d.A.); (B.F.); (R.C.); (L.V.); (B.M.); (P.C.); (J.Á.S.); (I.A.-L.); (L.C.); (C.L.); (Á.R.L.); (V.G.); (V.G.d.V.); (S.G.); (J.M.R.-G.)
| | - Santiago Moreno
- CIBERINFEC, Instituto de Salud Carlos III, Madrid, 28029 Madrid, Spain;
- Departamento de Medicina y Especialidades Médicas, Universidad de Alcalá, 28871 Madrid, Spain
- Servicio de Enfermedades Infecciosas, Hospital U. Ramón y Cajal, IRYCIS, 28034 Madrid, Spain
| | - José M. Ruiz-Giardin
- Servicio de Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain; (N.M.); (D.B.-B.); (A.M.-O.); (M.R.); (M.G.); (R.C.); (A.I.F.); (L.R.); (G.S.); (A.I.); (E.M.); (M.D.); (S.P.); (M.T.-M.); (J.M.); (C.d.A.); (B.F.); (R.C.); (L.V.); (B.M.); (P.C.); (J.Á.S.); (I.A.-L.); (L.C.); (C.L.); (Á.R.L.); (V.G.); (V.G.d.V.); (S.G.); (J.M.R.-G.)
- CIBERINFEC, Instituto de Salud Carlos III, Madrid, 28029 Madrid, Spain;
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Ruiz-Giardin JM, Rivilla M, Mesa N, Morales A, Rivas L, Izquierdo A, Escribá A, San Martín JV, Bernal-Bello D, Madroñal E, Farfán AI, Guerrero M, Calderón R, Duarte MA, Piedrabuena SI, Toledano-Macías M, Satué JÁ, Marrero J, de Ancos CL, Frutos B, Cristóbal R, Soria G, Ayala-Larrañaga I, Carpintero L, de Hita M, Lara C, Llerena ÁR, García V, Jiménez R, García V, Saiz-Lou EM, Prieto S, González-Pereira N, Lechuga LA, Tarancón J, Gonzalo S. Comparative Study of Vaccinated and Unvaccinated Hospitalised Patients: A Retrospective Population Study of 500 Hospitalised Patients with SARS-CoV-2 Infection in a Spanish Population of 220,000 Inhabitants. Viruses 2022; 14:v14102284. [PMID: 36298839 PMCID: PMC9611498 DOI: 10.3390/v14102284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 10/12/2022] [Accepted: 10/13/2022] [Indexed: 11/23/2022] Open
Abstract
Objectives. This study aimed to compare the characteristics of fully and partially vaccinated or unvaccinated coronavirus disease 2019 (COVID-19) patients who were hospitalised in a population of 220,000 habitants. Methods: Retrospective, observational, and population studies were conducted on patients who were hospitalised due to COVID-19 from March to October 2021. We assessed the impact of vaccination and other risk factors through Cox multivariate analysis. Results: A total of 500 patients were hospitalised, among whom 77 (15.4%) were fully vaccinated, 86 (17.2%) were partially vaccinated, and 337 (67.4%) were unvaccinated. Fully vaccinated (FV) patients were older and had a higher Charlson index than those of partially vaccinated and unvaccinated patients (NFV). Bilateral pneumonia was more frequent among NFV (259/376 (68.9%)) than among FV patients (32/75 (42.7%)). The former had more intensive care unit admissions (63/423) than the latter (4/77); OR: 2.80; CI (1.07–9.47). Increasing age HZ: 1.1 (1.06–1.14)) and haematological disease at admission HZ: 2.99 (1.26–7.11)) were independent risk factors for higher mortality during the first 30 days of hospitalisation. The probability of an earlier discharge in the subgroup of 440 patients who did not die during the first 30 days of hospitalisation was related to age (older to younger: HZ: 0.98 (0.97–0.99)) and vaccination status. Conclusions: Among the patients hospitalised because of COVID-19, complete vaccination was associated with less severe forms of COVID-19, with an earlier discharge date. Age and haematological disease were related to a higher mortality rate during the first 30 days of hospitalisation.
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Affiliation(s)
- José M. Ruiz-Giardin
- Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain
- CIBERINFEC, 28029 Madrid, Spain
- Correspondence: ; Tel.: +34-916006179
| | - Marta Rivilla
- Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain
| | - Nieves Mesa
- Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain
| | - Alejandro Morales
- Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain
| | - Luis Rivas
- Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain
| | - Aída Izquierdo
- Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain
| | - Almudena Escribá
- Oficina Regional de Coordinación de Transplante de la Comunidad de Madrid, 28046 Madrid, Spain
| | - Juan V. San Martín
- Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain
- CIBERINFEC, 28029 Madrid, Spain
| | - David Bernal-Bello
- Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain
| | - Elena Madroñal
- Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain
| | - Ana I. Farfán
- Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain
| | - Marta Guerrero
- Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain
| | - Ruth Calderón
- Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain
| | - Miguel A. Duarte
- Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain
| | - Sara I. Piedrabuena
- Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain
| | | | - José Á. Satué
- Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain
| | - Jorge Marrero
- Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain
| | | | - Begoña Frutos
- Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain
| | - Rafael Cristóbal
- Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain
| | - Guillermo Soria
- Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain
| | | | - Lorena Carpintero
- Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain
| | - Miguel de Hita
- Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain
| | - Celia Lara
- Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain
| | - Álvaro R. Llerena
- Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain
| | - Virginia García
- Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain
| | - Raquel Jiménez
- Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain
| | - Vanesa García
- Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain
| | - Elena M. Saiz-Lou
- Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain
| | - Santiago Prieto
- Laboratorio Clínico, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain
| | | | | | - Jorge Tarancón
- Sistemas, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain
| | - Sonia Gonzalo
- Medicina Interna, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain
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Hernández-Píriz A, Tung-Chen Y, Jiménez-Virumbrales D, Ayala-Larrañaga I, Barba-Martín R, Canora-Lebrato J, Zapatero-Gaviria A, García De Casasola-Sánchez G. Usefulness of lung ultrasound in the early identification of severe COVID-19: results from a prospective study. Med Ultrason 2022; 24:146-152. [PMID: 34762722 DOI: 10.11152/mu-3263] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
AIM There is growing evidence regarding the imaging findings of coronavirus disease 2019 (COVID-19) in lung ultrasound (LUS); however, its role in predicting the prognosis has yet to be explored. The aim of the study was to assess the relationship between lung ultrasound findings with the degree of respiratory failure measured by the PaO2/FiO2 ratio (PaFi) andthe prognosis of these patients: need for non-invasive mechanical ventilation (NIMV), admission to the Intensive Care Unit (ICU) and mortality. MATERIAL AND METHOD Prospective, longitudinal and observational study performed in patients with confirmed COVID-19 underwent a LUS examination and laboratory tests. RESULTS A total of 107 patients were enrolled: 93.4% with bilateral involvement and 73.83% presented at least one consolidation. A good inverse correlation (Rho Spearman coefficient -0.897) between the ultrasound score and PaFi was obtained. The AUC for identification of patients with more severe respiratory failure, a moderate and severe ARDS, was 0.97 (CI 95%: 0.95-1) and a cut-off score of 34.5 showed a sensitivity of 0.94 and a specificity of 0.91. The Kappa index showed a high concordance (0.83) of the classification by ultrasound lunginvolvement and ARDS. CONCLUSIONS The combination of the ultrasound score and the presence of respiratory failure can easily identify patients with a higher risk to present complications.
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Affiliation(s)
- Alba Hernández-Píriz
- - Department of Internal Medicine, Hospital Universitario Fuenlabrada, 28942 Fuenlabrada, Madrid, Spain - Department of Medicine, Universidad Rey Juan Carlos, 28933 Móstoles, Madrid, Spain - IFEMA Field Hospital, 28042 Madrid, Spain.
| | - Yale Tung-Chen
- - Department of Internal Medicine, Hospital Universitario Puerta de Hierro, 28222 Majadahonda, Madrid, Spain - Department of Medicine, Universidad Alfonso X, 28691 Villanueva de la Cañada, Madrid, Spain.
| | - David Jiménez-Virumbrales
- - Department of Cardiology, Hospital Universitario Severo Ochoa, 28911 Leganés, Spain - IFEMA Field Hospital, 28042 Madrid, Spain.
| | - Ibone Ayala-Larrañaga
- - Department of Internal Medicine, Hospital Universitario Fuenlabrada, 28942 Fuenlabrada, Madrid, Spain.
| | - Raquel Barba-Martín
- - Department of Internal Medicine, Hospital Rey Juan Carlos, 28933 Móstoles, Madrid, Spain - Department of Medicine, Universidad Rey Juan Carlos, 28933 Móstoles, Madrid, Spain - IFEMA Field Hospital, 28042 Madrid, Spain.
| | - Jesús Canora-Lebrato
- - Department of Internal Medicine, Hospital Universitario Fuenlabrada, 28942 Fuenlabrada, Madrid, Spain - Department of Medicine, Universidad Rey Juan Carlos, 28933 Móstoles, Madrid, Spain - IFEMA Field Hospital, 28042 Madrid, Spain.
| | - Antonio Zapatero-Gaviria
- - Department of Internal Medicine, Hospital Universitario Fuenlabrada, 28942 Fuenlabrada, Madrid, Spain - Department of Medicine, Universidad Rey Juan Carlos, 28933 Móstoles, Madrid, Spain - IFEMA Field Hospital, 28042 Madrid, Spain.
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4
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Duarte-Millán MA, Mesa-Plaza N, Guerrero-Santillán M, Morales-Ortega A, Bernal-Bello D, Farfán-Sedano AI, García de Viedma-García V, Velázquez-Ríos L, Frutos-Pérez B, De Ancos-Aracil CL, Soria Fernández-Llamazares G, Toledano-Macías M, Cristóbal-Bilbao R, Luquín-Ciuro N, Marrero-Francés J, Piedrabuena-García SI, Satué-Bartolomé JA, Gonzalo-Pascua S, Rivilla-Jiménez M, Carpintero-García L, Ayala-Larrañaga I, García-Bermúdez V, Lara-Montes C, Llerena-Riofrío ÁR, RIvas-Prado L, Walter S, Escriba-Barcena A, San Martín López JV, Ruíz-Giardín JM. Prognostic factors and combined use of tocilizumab and corticosteroids in a Spanish cohort of elderly COVID-19 patients. J Med Virol 2021; 94:1540-1549. [PMID: 34845754 PMCID: PMC9015514 DOI: 10.1002/jmv.27488] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 05/08/2021] [Accepted: 11/28/2021] [Indexed: 01/08/2023]
Abstract
Coronavirus disease 2019 (COVID‐19) infection in elderly patients is more aggressive and treatments have shown limited efficacy. Our objective is to describe the clinical course and to analyze the prognostic factors associated with a higher risk of mortality of a cohort of patients older than 80 years. In addition, we assess the efficacy of immunosuppressive treatments in this population. We analyzed the data from 163 patients older than 80 years admitted to our institution for COVID‐19, during March and April 2020. A Lasso regression model and subsequent multivariate Cox regression were performed to select variables predictive of death. We evaluated the efficacy of immunomodulatory therapy in three cohorts using adjusted survival analysis. The mortality rate was 43%. The mean age was 85.2 years. The disease was considered severe in 76.1% of the cases. Lasso regression and multivariate Cox regression indicated that factors correlated with hospital mortality were: age (hazard ratio [HR] 1.12, 95% confidence interval [CI]: 1.03–1.22), alcohol consumption (HR 3.15, 95% CI: 1.27–7.84), CRP > 10 mg/dL (HR 2.67, 95% CI: 1.36–5.24), and oxygen support with Venturi Mask (HR 6.37, 95% CI: 2.18–18.62) or reservoir (HR 7.87, 95% CI: 3.37–18.38). Previous treatment with antiplatelets was the only protective factor (HR 0.47, 95% CI: 0.23–0.96). In the adjusted treatment efficacy analysis, we found benefit in the combined use of tocilizumab (TCZ) and corticosteroids (CS) (HR 0.09, 95% CI: 0.01–0.74) compared to standard treatment, with no benefit of CS alone (HR 0.95, 95% CI: 0.53–1.71). Hospitalized elderly patients suffer from a severe and often fatal form of COVID‐19 disease. In this regard, several parameters might identify high‐risk patients upon admission. Combined use of TCZ and CS could improve survival. The COVID‐19 disease in the elderly population (> 80 years) is severe in most cases. We analyze which parameters at admission may be useful to better stratify the risk of mortality. Oxygen demand on admission is the most accurate parameter to determine prognosis. A combined use of corticosteroids and tocilizumab may improve overall survival versus corticosteroids alone or standard of care.
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Affiliation(s)
| | - Nieves Mesa-Plaza
- Department of Internal Medicine, Hospital Universitario de Fuenlabrada, Madrid, Spain
| | | | | | - David Bernal-Bello
- Department of Internal Medicine, Hospital Universitario de Fuenlabrada, Madrid, Spain
| | - Ana I Farfán-Sedano
- Department of Internal Medicine, Hospital Universitario de Fuenlabrada, Madrid, Spain
| | | | - Laura Velázquez-Ríos
- Department of Internal Medicine, Hospital Universitario de Fuenlabrada, Madrid, Spain
| | - Begoña Frutos-Pérez
- Department of Internal Medicine, Hospital Universitario de Fuenlabrada, Madrid, Spain
| | | | | | - María Toledano-Macías
- Department of Internal Medicine, Hospital Universitario de Fuenlabrada, Madrid, Spain
| | | | - Nuria Luquín-Ciuro
- Department of Internal Medicine, Hospital Universitario de Fuenlabrada, Madrid, Spain
| | - Jorge Marrero-Francés
- Department of Internal Medicine, Hospital Universitario de Fuenlabrada, Madrid, Spain
| | | | | | - Sonia Gonzalo-Pascua
- Department of Internal Medicine, Hospital Universitario de Fuenlabrada, Madrid, Spain
| | - Marta Rivilla-Jiménez
- Department of Internal Medicine, Hospital Universitario de Fuenlabrada, Madrid, Spain
| | | | - Ibone Ayala-Larrañaga
- Department of Internal Medicine, Hospital Universitario de Fuenlabrada, Madrid, Spain
| | | | - Celia Lara-Montes
- Department of Internal Medicine, Hospital Universitario de Fuenlabrada, Madrid, Spain
| | | | - Luis RIvas-Prado
- Department of Internal Medicine, Hospital Universitario de Fuenlabrada, Madrid, Spain
| | - Stefan Walter
- Methodological Support Unit, Hospital Universitario de Fuenlabrada, Madrid, Spain
| | | | | | - José M Ruíz-Giardín
- Department of Internal Medicine, Hospital Universitario de Fuenlabrada, Madrid, Spain
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5
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Hernández-Píriz A, Tung-Chen Y, Jiménez-Virumbrales D, Ayala-Larrañaga I, Barba-Martín R, Canora-Lebrato J, Zapatero-Gaviria A, Casasola-Sánchez GGD. Importance of Lung Ultrasound Follow-Up in Patients Who Had Recovered from Coronavirus Disease 2019: Results from a Prospective Study. J Clin Med 2021; 10:3196. [PMID: 34300362 PMCID: PMC8307687 DOI: 10.3390/jcm10143196] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2021] [Revised: 07/12/2021] [Accepted: 07/13/2021] [Indexed: 01/08/2023] Open
Abstract
There is growing evidence regarding the imaging findings of coronavirus disease 2019 (COVID-19) in lung ultrasounds, however, their role in predicting the prognosis has yet to be explored. Our objective was to assess the usefulness of lung ultrasound in the short-term follow-up (1 and 3 months) of patients with SARS-CoV-2 pneumonia, and to describe the progression of the most relevant lung ultrasound findings. We conducted a prospective, longitudinal and observational study performed in patients with confirmed COVID-19 who underwent a lung ultrasound examination during hospitalization and repeated it 1 and 3 months after hospital discharge. A total of 96 patients were enrolled. In the initial ultrasound, bilateral involvement was present in 100% of the patients with mild, moderate or severe ARDS. The most affected lung area was the posteroinferior (93.8%) followed by the lateral (88.7%). Subpleural consolidations were present in 68% of the patients and consolidations larger than 1 cm in 24%. One month after the initial study, only 20.8% had complete resolution on lung ultrasound. This percentage rose to 68.7% at 3 months. Residual lesions were observed in a significant percentage of patients who recovered from moderate or severe ARDS (32.4% and 61.5%, respectively). In conclusion, lung injury associated with COVID-19 might take time to resolve. The findings in this report support the use of lung ultrasound in the short-term follow-up of patients recovered from COVID-19, as a radiation-sparing, easy to use, novel care path worth exploring.
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Affiliation(s)
- Alba Hernández-Píriz
- Department of Internal Medicine, Hospital Universitario Fuenlabrada, 28942 Fuenlabrada, Madrid, Spain; (A.H.-P.); (I.A.-L.); (J.C.-L.); (A.Z.-G.)
- Department of Medicine, Universidad Rey Juan Carlos, 28933 Móstoles, Madrid, Spain;
- IFEMA Field Hospital, 28042 Madrid, Spain; (D.J.-V.); (G.G.D.C.-S.)
| | - Yale Tung-Chen
- Department of Internal Medicine, Hospital Universitario Puerta de Hierro, 28222 Majadahonda, Madrid, Spain
- Department of Medicine, Universidad Alfonso X, 28691 Villanueva de la Cañada, Madrid, Spain
| | - David Jiménez-Virumbrales
- IFEMA Field Hospital, 28042 Madrid, Spain; (D.J.-V.); (G.G.D.C.-S.)
- Department of Cardiology, Hospital Universitario Severo Ochoa, 28911 Leganés, Spain
| | - Ibone Ayala-Larrañaga
- Department of Internal Medicine, Hospital Universitario Fuenlabrada, 28942 Fuenlabrada, Madrid, Spain; (A.H.-P.); (I.A.-L.); (J.C.-L.); (A.Z.-G.)
| | - Raquel Barba-Martín
- Department of Medicine, Universidad Rey Juan Carlos, 28933 Móstoles, Madrid, Spain;
- IFEMA Field Hospital, 28042 Madrid, Spain; (D.J.-V.); (G.G.D.C.-S.)
- Department of Internal Medicine, Hospital Rey Juan Carlos, 28933 Móstoles, Madrid, Spain
| | - Jesús Canora-Lebrato
- Department of Internal Medicine, Hospital Universitario Fuenlabrada, 28942 Fuenlabrada, Madrid, Spain; (A.H.-P.); (I.A.-L.); (J.C.-L.); (A.Z.-G.)
- Department of Medicine, Universidad Rey Juan Carlos, 28933 Móstoles, Madrid, Spain;
- IFEMA Field Hospital, 28042 Madrid, Spain; (D.J.-V.); (G.G.D.C.-S.)
| | - Antonio Zapatero-Gaviria
- Department of Internal Medicine, Hospital Universitario Fuenlabrada, 28942 Fuenlabrada, Madrid, Spain; (A.H.-P.); (I.A.-L.); (J.C.-L.); (A.Z.-G.)
- Department of Medicine, Universidad Rey Juan Carlos, 28933 Móstoles, Madrid, Spain;
- IFEMA Field Hospital, 28042 Madrid, Spain; (D.J.-V.); (G.G.D.C.-S.)
| | - Gonzalo García De Casasola-Sánchez
- IFEMA Field Hospital, 28042 Madrid, Spain; (D.J.-V.); (G.G.D.C.-S.)
- Department of Internal Medicine, Hospital Infanta Cristina, 28981 Parla, Madrid, Spain
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