Risk factors associated with mortality in hospitalized patients with SARS-CoV-2 infection. A prospective, longitudinal, unicenter study in Reus, Spain.

Simona Iftimie,Pedro Garrido,Anna Hernández-Aguilera,Ana F López-Azcona,Ramon Descarrega-Reina,Josep M Simó,Jordi Camps,Jorge Joven,Manuel Vicente-Miralles,Antoni Castro,Francesc Riu,Muhammad Adrish

doi:10.1371/journal.pone.0234452

Abstract

Spain is one of the countries that has suffered the most from the impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the strain that causes coronavirus disease 2019 (COVID-19). However, there is a lack of information on the characteristics of this disease in the Spanish population. The objective of this study has been to characterize our patients from an epidemiological point of view and to identify the risk factors associated with mortality in our geographical area. We performed a prospective, longitudinal study on 188 hospitalized cases of SARS-Cov-2 infection in Hospital Universitari de Sant Joan, in Reus, Spain, admitted between 15th March 2020 and 30th April 2020. We recorded demographic data, signs and symptoms and comorbidities. We also calculated the Charlson and McCabe indices. A total of 43 deaths occurred during the study period. Deceased patients were older than the survivors (77.7 ± 13.1 vs. 62.8 ± 18.4 years; p < 0.001). Logistic regression analyses showed that fever, pneumonia, acute respiratory distress syndrome, diabetes mellitus and cancer were the variables that showed independent and statistically significant associations with mortality. The Charlson index was more efficient than the McCabe index in discriminating between deceased and survivors. This is one of the first studies to describe the factors associated with mortality in patients infected with SARS-CoV-2 in Spain, and one of the few in the Mediterranean area. We identified the main factors independently associated with mortality in our population. Further studies are needed to complete and confirm our findings.

Highlights

In January 2020, a new type of coronavirus was identified as the causative factor in a series of cases of severe pneumonia in the city of Wuhan, province of Hubei, in the People’s Republic of China [1]
Thirty-two patients were admitted to hospital due to causes unrelated to the suspicion of COVID-19 infection but gave a positive result in the RT-PCR
A total of 43 deaths occurred during the entire study period (Fig 1), so the case fatality rate was 22.9% based on the total number of COVID-19 hospitalized patients

Summary

Introduction

In January 2020, a new type of coronavirus was identified as the causative factor in a series of cases of severe pneumonia in the city of Wuhan, province of Hubei, in the People’s Republic of China [1]. The World Health Organization gave the official name ’COVID-19’ for this coronavirus disease, as well as the term ’severe acute respiratory syndrome coronavirus 2’ (SARSCoV-2) for the virus [2]. This virus is currently the cause of a global pandemic, producing hundreds of thousands of hospital admissions and deaths, with enormous effects on the health and life of the population and serious economic consequences for society. The incubation period for SARS-CoV-2 ranges from 5 to 6 days on average, with cases being possible from 0 to 14 days [5]. Symptoms of a different nature appear: neurological, such as altered consciousness or dizziness; cardiological, such as acute myocardial damage or heart failure; or ophthalmological, such as dry eye, blurred vision, foreign body sensation and conjunctival congestion [10,11,12,13]

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Results

Conclusion