Evolving mortality and clinical outcomes of hospitalized subjects during successive COVID-19 waves in Catalonia, Spain

Global Epidemiology

Mercè Gasa¹  Anna Maria Moreno¹  Josep Rebull¹  Jose Luís Morales-Rull²  Kamlesh Khunti³  Benito Almirante⁴  Teresa Auguet⁵  Maria Rexach⁶  Roger Paredes⁷  Francesc Vidal⁸  Xavier Serra-Picamal⁹  Jaume Ferrer^1,10  Josep M. Argimon^1,11  Albert Roso-Llorach^1,12  Francesc X. Cos^1,13  Meritxell Pallejà-Millán^1,13  Lourdes Mateu^1,14  Ana Lerida^1,15  Carlota Gudiol^1,15  Gladis Sabater^1,15  Antoni Rosell^1,15 

[1] CIBER de Enfermedades Respiratorias (CIBERES), Barcelona, Spain;Department of Respiratory Medicine, Hospital Universitari Germans Trias i Pujol, Badalona, Catalonia, Spain;Department of Respiratory Medicine, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain;Infectious Diseases Department, Hospital Universitari Germans Trias i Pujol, Badalona, Catalonia, Spain;Infectious Diseases Department, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain;Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol (IGTP), Badalona, Catalonia, Spain;Institut d'investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Catalonia, Spain;Spanish Network for Research in Infectious Disease (REIPI), Instituto de Salud Carlos III, Madrid, Spain;Universitat Autònoma de Barcelona, Bellaterra (Cerdanyola del Vallès), Catalonia, Spain;Universitat de Vic-UCC, Vic, Catalonia, Spain;Department of Respiratory Medicine, Bellvitge University Hospital, L'Hospitalet de Llobregat, Catalonia, Spain;Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut Jordi Gol i Gorina (IDIAPJGol), Barcelona, Catalonia, Spain;Institut Català de la Salut (ICS), Barcelona, Catalonia, Spain;Unitat de Suport a la Recerca Tarragona-Reus, Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Reus, Catalonia, Spain;Universitat Autònoma de Barcelona, Bellaterra (Cerdanyola del Vallès), Catalonia, Spain;

关键词: Coronavirus disease 2019 (Covid-19);    Hospital mortality;    Clinical characteristics;    Socioeconomic characteristics;    Risk factors;   

DOI  :  

来源: DOAJ

【 摘 要 】

Background: The changes in shield strategies, treatments, emergence variants, and healthcare pathways might shift the profile and outcome of patients hospitalized with COVID-19 in successive waves of the outbreak. Methods: We retrospectively analysed the characteristics and in-hospital outcomes of all patients admitted with COVID-19 in eight university hospitals of Catalonia (North-East Spain) between Feb 28, 2020 and Feb 28, 2021. Using a 7-joinpoint regression analysis, we split admissions into four waves. The main hospital outcomes included 30-day mortality and admission to intensive care unit (ICU). Findings: The analysis included 17,027 subjects admitted during the first wave (6800; 39.9%), summer wave (1807; 10.6%), second wave (3804; 22.3%), and third wave (4616; 27.1%). The highest 30-day mortality rate was reported during the first wave (17%) and decreased afterwards, remaining stable at 13% in the second and third waves (overall 30% reduction); the lowest mortality was reported during the summer wave (8%, 50% reduction). ICU admission became progressively more frequent during successive waves. In Cox regression analysis, the main factors contributing to differences in 30-day mortality were the epidemic wave, followed by gender, age, diabetes, chronic kidney disease, and neoplasms. Interpretation: Although in-hospital COVID-19 mortality remains high, it decreased substantially after the first wave and is highly dependent of patient's characteristics and ICU availability. Highest mortality reductions occurred during a wave characterized by younger individuals, an increasingly frequent scenario as vaccination campaigns progress. Funding: This work did not receive specific funding.

【 授权许可】

Unknown