A Cohort of Patients with COVID-19 in a Major Teaching Hospital in Europe

Abstract

Background: Since the confirmation of the first patient infected with SARS-CoV-2 in Spain in January 2020, the epidemic has grown rapidly, with the greatest impact on the region of Madrid. This article describes the first 2226 adult patients with COVID-19, consecutively admitted to La Paz University Hospital in Madrid. Methods: Our cohort included all patients consecutively hospitalized who had a final outcome (death or discharge) in a 1286-bed hospital of Madrid (Spain) from 25 February (first case admitted) to 19 April 2020. The data were manually entered into an electronic case report form, which was monitored prior to the analysis. Results: We consecutively included 2226 adult patients admitted to the hospital who either died (460) or were discharged (1766). The patients’ median age was 61 years, and 51.8% were women. The most common comorbidity was arterial hypertension (41.3%), and the most common symptom on admission was fever (71.2%). The median time from disease onset to hospital admission was 6 days. The overall mortality was 20.7% and was higher in men (26.6% vs. 15.1%). Seventy-five patients with a final outcome were transferred to the intensive care unit (ICU) (3.4%). Most patients admitted to the ICU were men, and the median age was 64 years. Baseline laboratory values on admission were consistent with an impaired immune-inflammatory profile. Conclusions: We provide a description of the first large cohort of hospitalized patients with COVID-19 in Europe. Advanced age, male sex, the presence of comorbidities and abnormal laboratory values were more common among the patients with fatal outcomes.

COVID-19 in Grade 4–5 Chronic Kidney Disease Patients

“…Fever was the most common, followed by cough, dyspnea, and fatigue. Chest x-ray findings showed pneumonia in 6 cases, with bilateral lung involvement in 5 of them, in agreement with many other studies [2,7,8]. Interestingly, as previously noted in hemodialysis patients in a short series [9], 2 patients did not present respiratory symptoms but showed a gastrointestinal pattern, with nausea and diarrhea as the presenting features.…”

“…The coronavirus disease 2019 (COVID-19) pandemic has affected over 233,000 people in Spain since early March 2020 [1]. The reported fatality rate in the general population with COVID-19 admitted to a large tertiary Spanish hospital was 20.7%, with 34% in the subgroup aged 70-79 years [2]. Chronic kidney disease (CKD) patients have several conditions that make them a target population for the virus, i.e., an older age, comorbidities, and a frail immunological system.…”

COVID-19 ICU and Mechanical Ventilation Patient Characteristics and Outcomes - A Systematic Review and Meta-analysis

“…Of these, 6,875 patients were on IMV. Nine studies were from the USA [8][9][10][11]17,18,23,25,26], 13 from China [12,14,16,[20][21][22][27][28][29][30][31][32][33], two from the UK [24,32], and one each from Italy [15], Spain [13], France [19], and Mexico [35]. (Table 1) Fifteen studies were good and 13 were fair as assessed by the NIH tool.…”

“…Follow-up duration was insu cient or unreported in seven [8,10,12,14,26,29,35] among which three had fair assessments. Of note, 14 studies [8,9,[12][13][14][15][17][18][19]21,22,24,25,34] had over 20% of patients with unknown outcome at endpoint of which 8 had fair assessment. Figure 3).…”

“…When a mean value of a continuous outcome was missing, methods by Wan [7] were utilized to impute the needed value for the meta-analysis. Since some studies [8,9,[10][11][12][13][14][15][16][17][18][19][20][21][22][23] included patients still hospitalized at endpoint (n=4,697, 37.8%), we considered two mortality scenarios methodologically: (1) best case scenario by pooling patients with known outcome and (2) worst case scenario by pooling those still hospitalized with non-survivors.…”