During the first COVID-19 pandemic wave in Spain, 50% of deaths occurred in nursing homes, making it necessary for some hospitals to support these facilities with the care of infected patients. This study compares origin, characteristics, and mortality of patients admitted with COVID-19 during six pandemic waves in the Hospital Central de la Cruz Roja in Madrid. It is a retrospective observational study of patients ≥ 80 years old, admitted with an acute SARS-CoV-2 infection, with a total of 546 patients included, whose final outcome was death or discharge. During the first wave, those from nursing homes had a higher risk of death than those from home; during the two successive waves, the risk was higher for those from home; and in the last two waves, the risk equalized and decreased exponentially in both groups. Men had 72% higher risk of death than women. For each year of age, the risk increased by 4% (p = 0.036). For each Charlson index point, the risk increased by 14% (p = 0.019). Individuals in nursing homes, despite being older with higher comorbidity, did not show a higher overall lethality. The mortality decreased progressively in each successive wave due to high vaccination rates and COVID-19 control measures in this population.

The variation on birth weight is associated with several outcomes early on in life and low birth weight (LBW) increases the risk of morbidity and mortality. Some environmental exposures during pregnancy, such as particulate matters and other traffic-related pollutants can have a significant effect on pregnant women and fetuses. The aim of this study is to estimate the effect of exposure to traffic density during pregnancy over birth weight in Spain, from 2000–2017. This was a retrospective, cross-sectional study using the information from Spain Birth Registry Statistics database. The traffic density was measured using the Annual average daily traffic. Multivariate linear regression models using birth weight and traffic density were performed, as well as a logistic regression model to estimated Odds ratios for LBW and GAM models to evaluate the non-linear effect. Our findings showed that increases in traffic density were associated with reduction of birth weight and increases of LBW risk. Moreover, exposure to high and very-high traffic-density during pregnancy were associated with reduction of birth weight and increase on LBW risk comparing with exposure to low number of cars trespassing the neighborhoods. The results of this study agree with previous literature and highlights the need of effective policies for reducing traffic density in residential neighborhoods of cities and towns.

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Air pollution is considered an ongoing major public health and environmental issue around the globe, affecting the most vulnerable, such as pregnant women and fetuses. The aim of this study is to estimate the health impact and economic value on birth outcomes, such as low birthweight (LBW), preterm birth (PTB), small for gestational age (SGA), attributable to a reduction of PM10 levels in Spain. Reduction based on four scenarios was implemented: fulfillment of WHO guidelines and EU limits, and an attributable reduction of 15% and 50% in annual PM10 levels. Retrospective study on 288,229 live-born singleton children born between 2009–2010, using data from Spain Birth Registry Statistics database, as well as mean PM10 mass concentrations. Our finding showed that a decrease in annual exposure to PM10 appears to be associated with a decrease in the annual cases of LBW, SGA and PTB, as well as a reduction in hospital cost attributed to been born with LBW. Improving pregnancy outcomes by reducing the number of LBW up to 5% per year, will result in an estimate associated monetary saving of 50,000 to 7,000,000 euros annually. This study agrees with previous literature and highlights the need to implement, and ensure compliance with, stricter policies that regulate the maximum exposure to outdoor PM permitted in Spain, contributing to decreased environmental health risk, especially negative birth outcomes.