Filling the gaps in the characterization of the clinical management of COVID-19 : 30-day hospital admission and fatality rates in a cohort of 118 150 cases diagnosed in outpatient settings in Spain
© The Author(s) 2020. Published by Oxford University Press on behalf of the International Epidemiological Association..
BACKGROUND: Currently, there is a missing link in the natural history of COVID-19, from first (usually milder) symptoms to hospitalization and/or death. To fill in this gap, we characterized COVID-19 patients at the time at which they were diagnosed in outpatient settings and estimated 30-day hospital admission and fatality rates.
METHODS: This was a population-based cohort study.
Data were obtained from Information System for Research in Primary Care (SIDIAP)-a primary-care records database covering >6 million people (>80% of the population of Catalonia), linked to COVID-19 reverse transcriptase polymerase chain reaction (RT-PCR) tests and hospital emergency, inpatient and mortality registers. We included all patients in the database who were ≥15 years old and diagnosed with COVID-19 in outpatient settings between 15 March and 24 April 2020 (10 April for outcome studies). Baseline characteristics included socio-demographics, co-morbidity and previous drug use at the time of diagnosis, and polymerase chain reaction (PCR) testing and results.
Study outcomes included 30-day hospitalization for COVID-19 and all-cause fatality.
RESULTS: We identified 118 150 and 95 467 COVID-19 patients for characterization and outcome studies, respectively. Most were women (58.7%) and young-to-middle-aged (e.g. 21.1% were 45-54 years old). Of the 44 575 who were tested with PCR, 32 723 (73.4%) tested positive. In the month after diagnosis, 14.8% (14.6-15.0) were hospitalized, with a greater proportion of men and older people, peaking at age 75-84 years. Thirty-day fatality was 3.5% (95% confidence interval: 3.4% to 3.6%), higher in men, increasing with age and highest in those residing in nursing homes [24.5% (23.4% to 25.6%)].
CONCLUSION: COVID-19 infections were widespread in the community, including all age-sex strata. However, severe forms of the disease clustered in older men and nursing-home residents. Although initially managed in outpatient settings, 15% of cases required hospitalization and 4% died within a month of first symptoms. These data are instrumental for designing deconfinement strategies and will inform healthcare planning and hospital-bed allocation in current and future COVID-19 outbreaks.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2021 |
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| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:49 |
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| Enthalten in: |
International journal of epidemiology - 49(2021), 6 vom: 23. Jan., Seite 1930-1939 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Prieto-Alhambra, Daniel [VerfasserIn] |
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| Links: |
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| Themen: |
COVID-19 |
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| Anmerkungen: |
Date Completed 01.02.2021 Date Revised 10.11.2023 published: Print Citation Status MEDLINE |
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| doi: |
10.1093/ije/dyaa190 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM31686627X |
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| 245 | 1 | 0 | |a Filling the gaps in the characterization of the clinical management of COVID-19 |b 30-day hospital admission and fatality rates in a cohort of 118 150 cases diagnosed in outpatient settings in Spain |
| 264 | 1 | |c 2021 | |
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| 500 | |a Date Revised 10.11.2023 | ||
| 500 | |a published: Print | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © The Author(s) 2020. Published by Oxford University Press on behalf of the International Epidemiological Association. | ||
| 520 | |a BACKGROUND: Currently, there is a missing link in the natural history of COVID-19, from first (usually milder) symptoms to hospitalization and/or death. To fill in this gap, we characterized COVID-19 patients at the time at which they were diagnosed in outpatient settings and estimated 30-day hospital admission and fatality rates | ||
| 520 | |a METHODS: This was a population-based cohort study | ||
| 520 | |a Data were obtained from Information System for Research in Primary Care (SIDIAP)-a primary-care records database covering >6 million people (>80% of the population of Catalonia), linked to COVID-19 reverse transcriptase polymerase chain reaction (RT-PCR) tests and hospital emergency, inpatient and mortality registers. We included all patients in the database who were ≥15 years old and diagnosed with COVID-19 in outpatient settings between 15 March and 24 April 2020 (10 April for outcome studies). Baseline characteristics included socio-demographics, co-morbidity and previous drug use at the time of diagnosis, and polymerase chain reaction (PCR) testing and results | ||
| 520 | |a Study outcomes included 30-day hospitalization for COVID-19 and all-cause fatality | ||
| 520 | |a RESULTS: We identified 118 150 and 95 467 COVID-19 patients for characterization and outcome studies, respectively. Most were women (58.7%) and young-to-middle-aged (e.g. 21.1% were 45-54 years old). Of the 44 575 who were tested with PCR, 32 723 (73.4%) tested positive. In the month after diagnosis, 14.8% (14.6-15.0) were hospitalized, with a greater proportion of men and older people, peaking at age 75-84 years. Thirty-day fatality was 3.5% (95% confidence interval: 3.4% to 3.6%), higher in men, increasing with age and highest in those residing in nursing homes [24.5% (23.4% to 25.6%)] | ||
| 520 | |a CONCLUSION: COVID-19 infections were widespread in the community, including all age-sex strata. However, severe forms of the disease clustered in older men and nursing-home residents. Although initially managed in outpatient settings, 15% of cases required hospitalization and 4% died within a month of first symptoms. These data are instrumental for designing deconfinement strategies and will inform healthcare planning and hospital-bed allocation in current and future COVID-19 outbreaks | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 4 | |a COVID-19 | |
| 650 | 4 | |a coronavirus | |
| 650 | 4 | |a epidemiology | |
| 650 | 4 | |a fatality | |
| 650 | 4 | |a hospital admission | |
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| 700 | 1 | |a Coma, Ermengol |e verfasserin |4 aut | |
| 700 | 1 | |a Mora, Núria |e verfasserin |4 aut | |
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| 700 | 1 | |a Medina-Peralta, Manuel |e verfasserin |4 aut | |
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