Modesto M Maestre-Muñiz1, Ángel Arias2,3, Laura Arias-González4,5, Basilio Angulo-Lara1, Alfredo J Lucendo3,4,5. 1. Department of Internal Medicine, Hospital General de Tomelloso, 13700 Ciudad Real, Spain. 2. Research Unit, Hospital General La Mancha Centro, Alcázar de San Juan, 13600 Ciudad Real, Spain. 3. Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Spain. 4. Department of Gastroenterology, Hospital General de Tomelloso, 13700 Ciudad Real, Spain. 5. Instituto de Investigación Sanitaria La Princesa, 28006 Madrid, Spain.
Abstract
BACKGROUND: Risk factors for in-hospital mortality from severe coronavirus disease 2019 (COVID-19) infection have been identified in studies mainly carried out in urban-based teaching hospitals. However, there is little data for rural populations attending community hospitals during the first wave of the pandemic. METHODS: A retrospective, single-center cohort study was undertaken among inpatients at a rural community hospital in Spain. Electronic medical records of the 444 patients (56.5% males) admitted due to severe SARS-CoV-2 infection during 26 February 2020-31 May 2020 were reviewed. RESULTS: Mean age was 71.2 ± 14.6 years (rank 22-98), with 69.8% over 65. At least one comorbidity was present in 410 patients (92.3%), with chronic obstructive pulmonary disease (COPD) present in 21.7%. Overall in-hospital mortality was 32%. Multivariate analysis of factors associated with death identified patients' age (with a cumulative effect per decade), COPD as a comorbidity, and respiratory insufficiency at the point of admission. No additional comorbid conditions proved significant. Among analytical values, increased serum creatinine, LDH > 500 mg/dL, thrombocytopenia (<150 × 109/per L), and lymphopenia (<1000 cells/µL) were all independently associated with mortality during admission. CONCLUSIONS: Age remained the major determinant for COVID-19-caused mortality; COPD was the only comorbidity independently associated with in-hospital death, together with respiratory insufficiency and analytical markers at admission.
BACKGROUND: Risk factors for in-hospital mortality from severe coronavirus disease 2019 (COVID-19) infection have been identified in studies mainly carried out in urban-based teaching hospitals. However, there is little data for rural populations attending community hospitals during the first wave of the pandemic. METHODS: A retrospective, single-center cohort study was undertaken among inpatients at a rural community hospital in Spain. Electronic medical records of the 444 patients (56.5% males) admitted due to severe SARS-CoV-2 infection during 26 February 2020-31 May 2020 were reviewed. RESULTS: Mean age was 71.2 ± 14.6 years (rank 22-98), with 69.8% over 65. At least one comorbidity was present in 410 patients (92.3%), with chronic obstructive pulmonary disease (COPD) present in 21.7%. Overall in-hospital mortality was 32%. Multivariate analysis of factors associated with death identified patients' age (with a cumulative effect per decade), COPD as a comorbidity, and respiratory insufficiency at the point of admission. No additional comorbid conditions proved significant. Among analytical values, increased serum creatinine, LDH > 500 mg/dL, thrombocytopenia (<150 × 109/per L), and lymphopenia (<1000 cells/µL) were all independently associated with mortality during admission. CONCLUSIONS: Age remained the major determinant for COVID-19-caused mortality; COPD was the only comorbidity independently associated with in-hospital death, together with respiratory insufficiency and analytical markers at admission.
Authors: J M Casas-Rojo; J M Antón-Santos; J Millán-Núñez-Cortés; C Lumbreras-Bermejo; J M Ramos-Rincón; E Roy-Vallejo; A Artero-Mora; F Arnalich-Fernández; J M García-Bruñén; J A Vargas-Núñez; S J Freire-Castro; L Manzano-Espinosa; I Perales-Fraile; A Crestelo-Viéitez; F Puchades-Gimeno; E Rodilla-Sala; M N Solís-Marquínez; D Bonet-Tur; M P Fidalgo-Moreno; E M Fonseca-Aizpuru; F J Carrasco-Sánchez; E Rabadán-Pejenaute; M Rubio-Rivas; J D Torres-Peña; R Gómez-Huelgas Journal: Rev Clin Esp (Barc) Date: 2020-07-19
Authors: Yuwei Liu; Xuebei Du; Jing Chen; Yalei Jin; Li Peng; Harry H X Wang; Mingqi Luo; Ling Chen; Yan Zhao Journal: J Infect Date: 2020-04-10 Impact factor: 6.072
Authors: Justin J Turcotte; Barry R Meisenberg; James H MacDonald; Nandakumar Menon; Marcia B Fowler; Michaline West; Jane Rhule; Sadaf S Qureshi; Eileen B MacDonald Journal: PLoS One Date: 2020-08-12 Impact factor: 3.240
Authors: Piotr Rola; Adrian Doroszko; Małgorzata Trocha; Katarzyna Giniewicz; Krzysztof Kujawa; Marek Skarupski; Jakub Gawryś; Tomasz Matys; Ewa Szahidewicz-Krupska; Damian Gajecki; Barbara Adamik; Krzysztof Kaliszewski; Katarzyna Kilis-Pstrusinska; Krzysztof Letachowicz; Agnieszka Matera-Witkiewicz; Michał Pomorski; Marcin Protasiewicz; Konrad Majchrzak; Janusz Sokołowski; Ewa Anita Jankowska; Katarzyna Madziarska Journal: J Clin Med Date: 2022-02-14 Impact factor: 4.241
Authors: Alberto Grassi; Luca Andriolo; Davide Golinelli; Dario Tedesco; Simona Rosa; Pasquale Gramegna; Jacopo Ciaffi; Riccardo Meliconi; Maria Paola Landini; Giuseppe Filardo; Maria Pia Fantini; Stefano Zaffagnini Journal: Int J Environ Res Public Health Date: 2021-05-13 Impact factor: 3.390