In-hospital mortality in patients hospitalized with COVID-19 during the first wave of the pandemic in a Spanish community hospital.

Abstract: Background: Spain is one of the European countries affected by the COVID-19 pandemic with a high number of recorded cases and deaths in Europe. Aim: To describe clinical characteristics and outcome of patients with COVID-19 hospitalized in a regional hospital in Spain. Methods: Clinical characteristics of the first COVID-19 patients hospitalised in the early days of the epidemic were recorded upon admission. A logistic regression multivariate analysis was performed to determine factors independently associated with a composite endpoint (death or ICU admission). Results: We included 100 patients, median age was 75 years and 52% were men. The most common comorbidities were hypertension (63%), diabetes (22%) and cardiovascular diseases (28%). The most common symptoms were fever (80%), cough (69%), fatigue (59%) and dyspnoea (52%) and 64% had respiratory insufficiency. Bilateral interstitial infiltrates (65%) and bilateral vertical “B-kerley” lines (82.6%) were the most common findings in chest radiographs and lung ultrasound. All patients received supplementary oxygen, 69% received medical treatment (hydroxychloroquine plus azithromycin the most common regimen) and 12% glucocorticoids. During hospitalization, 26% died, 10% were transferred to ICU and the remaining 62% were discharged at home. In the multivariate analysis a higher comorbidity burden (OR 1.4; 95% CI: 1.1-1.8) and higher C-reactive protein values on admission (OR 1.2; 95%CI: 1.1-1.4) were independent risk factors for the composite endpoint. Conclusions: Case-fatality rate of patients hospitalized with COVID-19 in the early days of the Spanish epidemic was 26%. A high comorbidity burden is associated to an increased risk of death or ICU admission.