Mortality reduction in older COVID-19-patients hospitalized in Spain during the second pandemic wave from the SEMI-COVID-19 Registry
Abstract In 2020, the COVID-19 pandemic followed a two-wave pattern in most countries. Hospital admission for COVID-19 in one wave or another could have affected mortality, especially among the older persons. The objective of this study was to evaluate whether the admission of older patients during...
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| Format: | Article |
| Language: | English |
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Nature Portfolio
2023-10-01
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| Series: | Scientific Reports |
| Online Access: | https://doi.org/10.1038/s41598-023-42735-5 |
| _version_ | 1797559972110794752 |
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| author | José-Manuel Casas-Rojo Juan-Miguel Antón-Santos Jesús Millán-Núñez-Cortés Ricardo Gómez-Huelgas José-Manuel Ramos-Rincón Manuel Rubio-Rivas Miguel-Ángel Corrales-González Maria-Rosa Fernández-Madera-Martínez José-Luis Beato-Pérez Francisco Arnalich-Fernández Cristina Gállego-Lezaun Pablo Pérez-Martínez Sonia Molinos-Castro Yale Tung-Chen Manuel Madrazo Manuel Méndez-Bailón Daniel Monge-Monge Gema-María García-García Rosa García-Fenoll Noemí Gilabert Rebeca Fuerte-Martínez Marta Contreras-Sánchez Nicolás Rhyman Jorge Peris-García Carlos Lumbreras-Bermejo The SEMI-COVID-19 Network |
| author_facet | José-Manuel Casas-Rojo Juan-Miguel Antón-Santos Jesús Millán-Núñez-Cortés Ricardo Gómez-Huelgas José-Manuel Ramos-Rincón Manuel Rubio-Rivas Miguel-Ángel Corrales-González Maria-Rosa Fernández-Madera-Martínez José-Luis Beato-Pérez Francisco Arnalich-Fernández Cristina Gállego-Lezaun Pablo Pérez-Martínez Sonia Molinos-Castro Yale Tung-Chen Manuel Madrazo Manuel Méndez-Bailón Daniel Monge-Monge Gema-María García-García Rosa García-Fenoll Noemí Gilabert Rebeca Fuerte-Martínez Marta Contreras-Sánchez Nicolás Rhyman Jorge Peris-García Carlos Lumbreras-Bermejo The SEMI-COVID-19 Network |
| author_sort | José-Manuel Casas-Rojo |
| collection | DOAJ |
| description | Abstract In 2020, the COVID-19 pandemic followed a two-wave pattern in most countries. Hospital admission for COVID-19 in one wave or another could have affected mortality, especially among the older persons. The objective of this study was to evaluate whether the admission of older patients during the different waves, before SARS-CoV-2 vaccination was available, was associated with a different mortality. We compared the mortality rates of patients hospitalized during 2020 before (first wave) and after (second wave) July 7, 2020, included in the SEMI-COVID-19 Registry, a large, multicenter, retrospective cohort of patients admitted to 126 Spanish hospitals for COVID-19. A multivariate logistic regression analysis was performed to control for changes in either the patient or disease profile. As of December 26, 2022, 22,494 patients had been included (17,784 from the first wave and 4710 from the second one). Overall mortality was 20.4% in the first wave and 17.2% in the second wave (risk difference (RD) − 3.2%; 95% confidence interval (95% CI) − 4.4 to − 2.0). Only patients aged 70 and older (10,973 patients: 8571 in the first wave and 2386 in the second wave) had a significant reduction in mortality (RD − 7.6%; 95% CI − 9.7 to − 5.5) (unadjusted relative risk reduction: 21.6%). After adjusting for age, comorbidities, variables related to the severity of the disease, and treatment received, admission during the second wave remained a protective factor. In Spain, patients aged 70 years and older admitted during the second wave of the COVID-19 pandemic had a significantly lower risk of mortality, except in severely dependent persons in need of corticosteroid treatment. This effect is independent of patient characteristics, disease severity, or treatment received. This suggests a protective effect of a better standard of care, greater clinical expertise, or a lesser degree of healthcare system overload. |
| first_indexed | 2024-03-10T17:53:47Z |
| format | Article |
| id | doaj.art-62ee452eaff844f58913960216366b5e |
| institution | Directory Open Access Journal |
| issn | 2045-2322 |
| language | English |
| last_indexed | 2024-03-10T17:53:47Z |
| publishDate | 2023-10-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Scientific Reports |
| spelling | doaj.art-62ee452eaff844f58913960216366b5e2023-11-20T09:16:37ZengNature PortfolioScientific Reports2045-23222023-10-0113111810.1038/s41598-023-42735-5Mortality reduction in older COVID-19-patients hospitalized in Spain during the second pandemic wave from the SEMI-COVID-19 RegistryJosé-Manuel Casas-Rojo0Juan-Miguel Antón-Santos1Jesús Millán-Núñez-Cortés2Ricardo Gómez-Huelgas3José-Manuel Ramos-Rincón4Manuel Rubio-Rivas5Miguel-Ángel Corrales-González6Maria-Rosa Fernández-Madera-Martínez7José-Luis Beato-Pérez8Francisco Arnalich-Fernández9Cristina Gállego-Lezaun10Pablo Pérez-Martínez11Sonia Molinos-Castro12Yale Tung-Chen13Manuel Madrazo14Manuel Méndez-Bailón15Daniel Monge-Monge16Gema-María García-García17Rosa García-Fenoll18Noemí Gilabert19Rebeca Fuerte-Martínez20Marta Contreras-Sánchez21Nicolás Rhyman22Jorge Peris-García23Carlos Lumbreras-Bermejo24The SEMI-COVID-19 NetworkInternal Medicine Department, Infanta Cristina University HospitalInternal Medicine Department, Infanta Cristina University HospitalInternal Medicine Department, Gregorio Marañón University HospitalInternal Medicine Department, Regional University Hospital of Málaga, Biomedical Research Institute of Málaga (IBIMA), University of Málaga (UMA)Clinical Medicine Department, Miguel Hernandez University of ElcheInternal Medicine Department, Bellvitge University HospitalInternal Medicine Department, Costa del Sol HospitalInternal Medicine Department, Cabueñes University HospitalInternal Medicine Department, Complejo Hospitalario Universitario de AlbaceteInternal Medicine Department, Hospital Universitario La PazInternal Medicine Department, Hospital Royo VillanovaLipids and Atherosclerosis Unit, Department of Internal Medicine, Maimonides Biomedical Research Institute of Córdoba (IMIBIC), Reina Sofía University Hospital, University of Córdoba, CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII)Internal Medicine Department, Complejo Hospitalario Universitario de SantiagoInternal Medicine Department, Hospital Universitario Puerta de Hierro MajadahondaInternal Medicine Department, Hospital Universitario DoctorInternal Medicine Department, Hospital Clínico San CarlosInternal Medicine Department, Complejo Asistencial de SegoviaInternal Medicine Department, Complejo Hospital Universitario de BadajozInternal Medicine Department. Hospital, Universitario Miguel ServetInternal Medicine Department, Hospital Universitario de la PrincesaInternal Medicine Department, Hospital Universitario Infanta SofíaInternal Medicine Department, Complexo Hospitalario Universitario A CoruñaInternal Medicine Department, Hospital de Sant Joan Despí Moisès BroggiInternal Medicine Department, Hospital Universitari Sant Joan d’AlacantInternal Medicine Department, 12 de Octubre University HospitalAbstract In 2020, the COVID-19 pandemic followed a two-wave pattern in most countries. Hospital admission for COVID-19 in one wave or another could have affected mortality, especially among the older persons. The objective of this study was to evaluate whether the admission of older patients during the different waves, before SARS-CoV-2 vaccination was available, was associated with a different mortality. We compared the mortality rates of patients hospitalized during 2020 before (first wave) and after (second wave) July 7, 2020, included in the SEMI-COVID-19 Registry, a large, multicenter, retrospective cohort of patients admitted to 126 Spanish hospitals for COVID-19. A multivariate logistic regression analysis was performed to control for changes in either the patient or disease profile. As of December 26, 2022, 22,494 patients had been included (17,784 from the first wave and 4710 from the second one). Overall mortality was 20.4% in the first wave and 17.2% in the second wave (risk difference (RD) − 3.2%; 95% confidence interval (95% CI) − 4.4 to − 2.0). Only patients aged 70 and older (10,973 patients: 8571 in the first wave and 2386 in the second wave) had a significant reduction in mortality (RD − 7.6%; 95% CI − 9.7 to − 5.5) (unadjusted relative risk reduction: 21.6%). After adjusting for age, comorbidities, variables related to the severity of the disease, and treatment received, admission during the second wave remained a protective factor. In Spain, patients aged 70 years and older admitted during the second wave of the COVID-19 pandemic had a significantly lower risk of mortality, except in severely dependent persons in need of corticosteroid treatment. This effect is independent of patient characteristics, disease severity, or treatment received. This suggests a protective effect of a better standard of care, greater clinical expertise, or a lesser degree of healthcare system overload.https://doi.org/10.1038/s41598-023-42735-5 |
| spellingShingle | José-Manuel Casas-Rojo Juan-Miguel Antón-Santos Jesús Millán-Núñez-Cortés Ricardo Gómez-Huelgas José-Manuel Ramos-Rincón Manuel Rubio-Rivas Miguel-Ángel Corrales-González Maria-Rosa Fernández-Madera-Martínez José-Luis Beato-Pérez Francisco Arnalich-Fernández Cristina Gállego-Lezaun Pablo Pérez-Martínez Sonia Molinos-Castro Yale Tung-Chen Manuel Madrazo Manuel Méndez-Bailón Daniel Monge-Monge Gema-María García-García Rosa García-Fenoll Noemí Gilabert Rebeca Fuerte-Martínez Marta Contreras-Sánchez Nicolás Rhyman Jorge Peris-García Carlos Lumbreras-Bermejo The SEMI-COVID-19 Network Mortality reduction in older COVID-19-patients hospitalized in Spain during the second pandemic wave from the SEMI-COVID-19 Registry Scientific Reports |
| title | Mortality reduction in older COVID-19-patients hospitalized in Spain during the second pandemic wave from the SEMI-COVID-19 Registry |
| title_full | Mortality reduction in older COVID-19-patients hospitalized in Spain during the second pandemic wave from the SEMI-COVID-19 Registry |
| title_fullStr | Mortality reduction in older COVID-19-patients hospitalized in Spain during the second pandemic wave from the SEMI-COVID-19 Registry |
| title_full_unstemmed | Mortality reduction in older COVID-19-patients hospitalized in Spain during the second pandemic wave from the SEMI-COVID-19 Registry |
| title_short | Mortality reduction in older COVID-19-patients hospitalized in Spain during the second pandemic wave from the SEMI-COVID-19 Registry |
| title_sort | mortality reduction in older covid 19 patients hospitalized in spain during the second pandemic wave from the semi covid 19 registry |
| url | https://doi.org/10.1038/s41598-023-42735-5 |
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