The first wave of the COVID-19 pandemic in Spain: characterisation of cases and risk factors for severe outcomes, as at 27 April 2020

Redondo-Bravo, Lidia; Sierra Moros, Maria Jose; Martinez Sanchez, Elena Vanessa; Lorusso, Nicola; Carmona Ubago, Alberto; Gallardo Garcia, Virtudes; Sanchez Villanueva, Pilar; Puy Azon, Adela; Guimbao Bescos, Joaquin; Boone, An L. D.; Fernandez Ibanez, Ana; Alvarez Fernandez, Blanca; Nicolau Riutort, Antonio; Salom Castell, Magdalena; Gimenez Duran, Jaume; Nunez Gallo, Domingo; Rojo Moreno, Magdalena Lucia; Blasco de la Fuente, Aniceto; Viloria Raymundo, Luis Javier; Hernandez Perena, Marcos; Chico Mena, Matilde; Humanes Aparicio, Sonia; Illescas Fernandez, Maria Soledad; Fernandez Arribas, Socorro; Marcos Rodriguez, Ma del Henar; Martinez-Pino, Isabel; Jan, Mireia; Martinez, ANA; Ciruela, Pilar; Villatoro Bongiorno, Katja; March Yague, Aina; Perez Panades, Jordi; Lopez-Tercero Torvisco, Maria del Mar; Gordillo Romero, Cecilia; Caleya Olivas, Beatriz; De Miguel Garcia, Sara; Cordoba Deorador, Esther; Gil Montalban, Elisa; del Valle Arrojo, Manuel; Abraira Garcia, Luisa; Boullosa Cortes, Antonio; Garcia-Fulgue

Publicación: EUROSURVEILLANCE
2020
VL / 25 - BP / 15 - EP / 27
abstract
Background: The first wave of the coronavirus disease (COVID-19) pandemic spread rapidly in Spain, one of Europe's most affected countries. A national lockdown was implemented on 15 March 2020. Aim: To describe reported cases and the impact of national lockdown, and to identify disease severity risk factors. Methods: National surveillance data were used to describe PCR-confirmed cases as at 27 April 2020. We compared case characteristics by severity categories (hospitalisation, admission to intensive care unit (ICU), death) and identified severity risk factors using multivariable regression. Results: The epidemic peaked on 20 March. Of 218,652 COVID-19 cases, 45.4% were hospitalised, 4.6% were admitted to ICU and 11.9% died. Among those who died, 94.8% had at least one underlying disease. Healthcare workers (HCWs) represented 22.9% of cases. Males were more likely to have severe outcomes than females. Cardiovascular disease was a consistent risk factor. Patients with pneumonia had higher odds of hospitalisation (odds ratio (OR): 26.63; 95% confidence interval (CI): 25.03-28.33). The strongest predictor of death was age >= 80 years (OR: 28.4; 95% CI: 19.85-40.78). Among underlying diseases, chronic renal disease had highest odds of death (OR: 1.47; 95% CI: 1.29-1.68). Conclusions: COVID-19 case numbers began declining 6 days after the national lockdown. The first wave of the COVID-19 pandemic in Spain had a severe impact on elderly people. Patients with cardiovascular or renal conditions were at higher risk for severe outcomes. A high proportion of cases were HCWs. Enhanced surveillance and control measures in these subgroups are crucial during future COVID-19 waves.
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