Clinical Profile, Treatment and Predictors during the First COVID-19 Wave: A Population-Based Registry Analysis from Castile and Leon Hospitals.

Eduardo Gutiérrez-Abejón,Eduardo Tamayo,Débora Martín-García,Francisco Herrera-Gómez,F Javier Álvarez

doi:10.3390/ijerph17249360

Abstract

The first wave of the COVID-19 pandemic collapsed the hospitals in Castile and Leon (Spain). An analysis of the clinical characteristics, drug therapies and principal outcome predictors in the COVID-19 hospitalized patients from 1 March to 31 May 2020 is presented through a population-based registry study. Hospital stay variables, ventilation mode data and clinical outcomes were observed. In Castile and Leon hospitals, 7307 COVID-19 patients were admitted, with 57.05% being male and a median of 76 years. The mortality rate was 24.43%, with a high incidence of severe acute respiratory syndrome (SARS) (14.03%) and acute kidney injury (AKI) (10.87%). The most used medicines were antibiotics (90.83%), antimalarials (42.63%), steroids (44.37%) and antivirals, such as lopinavir/ritonavir (42.63%). The use of tocilizumab (9.37%) and anti-SIRS (systemic inflammatory response syndrome) medicines (7.34%) were remarkable. Fundamentally, death occurred more likely over 65 years of age (OR: 9.05). In addition, the need for ventilation was associated with a higher probability of death (OR: 3.59), SARS (OR: 5.14) and AKI (OR: 2.31). The drug-use pattern had been modified throughout the COVID-19 first wave. Multiple factors, such as age, gender and the need for mechanical ventilation, were related to the worst evolution prognosis of the disease.

Highlights

The outbreak of a novel coronavirus in December 2019, which originated in Wuhan (China) and later spread to the rest of the world, represents a great threat to global health [1,2]
Highest incidence was observed in severe acute respiratory syndrome (SARS) (14.03%) and acute kidney injury (AKI) (10.87%), and the mortality rate was
The “health system collapse” caused by the COVID-19 pandemic in Spain forced rapid therapeutic decisions and pharmacological protocol development based on poor available scientific evidence

Summary

Introduction

The outbreak of a novel coronavirus in December 2019, which originated in Wuhan (China) and later spread to the rest of the world, represents a great threat to global health [1,2]. It is an RNA betacoronavirus, denominated as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), belonging to the same family as SARS-CoV and the Middle East respiratory syndrome coronavirus (MERS-CoV) [3,4,5]. Res. Public Health 2020, 17, 9360; doi:10.3390/ijerph17249360 www.mdpi.com/journal/ijerph

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