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Cubo-Romano, Pilar; Sánchez, Francisco Javier García; de Guzmán García-Monge, Mayte; Pastor-Valverde, Cruz; Villanueva-Martínez, Javier; Beato, Rubén Alonso; Gonzalo, Leyre Alonso; Narciso, Candela González San; Ibáñez, Lorena Jiménez; Núñez-Cortés, Jesús Millán; Garcia, Maria Victoria Villalba; Lorenzo-Hernández, Elizabeth; Corbella, Xavier; Homs, Narcís; Caleya, Juan Francisco López; Fernández, Francisco Arnalich; de Gea Grela, Alejandro; Iglesias, Maria Francisca García; Hernández, Maria Jesús Jaras; Saldaña, Araceli Menéndez; Peláez, Esmeralda Palmier; Pampyn, Marina Palomar; Ramos Ramos, Juan Carlos; Aseguinolaza, Martin Gericó; Laorden, Claudia Josa; Torres, Jose Jiménez; del Carmen Beceiro Abad, Maria; Castro, Sonia Molinos; Nuñez, María Pazo; Eisenhofer, Ane Andrés; Sánchez, María Jesús Citores; Prieto, Sonia García; Revilla, Beatriz García; Estéllez, Fátima Ibáñez; Olleros, Celia Rodríguez; García, Silvia Rosado; Comendador, Jose Manuel Vázquez; Cruz, Ian López; Roger, Laura Piles; Benbunan, Cynthia Chocron; González, Andrea María Vellisca; Barrio, Mónica Llorente; Vega, Marta Bustamante; de las Heras Moreno, Alicia; Marquez, Gonzalo Galvez; Caballero, Pedro Parra; Alba, Marta Sanz; Marti, Almudena Villa; Alonso, Laura Ramos; Porto, David Vieito; Casanovas, Lucía Feria; Fernández, Melani Pestaña; Navarro, Ruth Cañizares; de Miguel Campo, Borja; Ruiz, Diana Paredes; Gómez, Jennifer Fernández; Sánchez, Pablo Ramírez; Jiménez, Amalur Iza; Fernández, Marta Blanco; Saiz, María Jesús Moya; Sierra, Pilar Toledano; Ruiz, Ane Labirua-Iturburu; Huertas, Maria Franco; Reguera, Carmen Mancilla; Pérez-Aguilar, Maria; Hernández, Sara Martínez; García, Octavio Arce; Del Hoyo Cuenda, Beatriz; González, José Ignacio Martín; Bar, Marta Pose; Ballester, María Calabuig; González, Raquel Aranega; Castro, José López; Diaz, Hortensia Alvarez; Lopez, Tamara Dalama; Sambade, Dolores Suarez; del Carmen Vázquez Friol, Maria; Espartero, María Esther Guisado; de la Sierra Navas Alcántara, Maria; García, Joaquin Llorente; Hernández, Laura Torres; Torre, Fátima Espinosa; Vega, Jara Eloisa Ternero; Jiménez, Pablo Díaz; Arroyo, Raquel Monsalvo; Die, Rosario María García; Cano, Carmen Mar Sánchez; Bernal, Berta Román; Ripper, Carlos Jorge; Sevilla, Joaquín Escobar; Carlotti, Daniela Díaz; Gimeno, María José Esteve; Castellanos, M. Carmen Pacheco; López, Natalia Vicente; Fernández, Cristina Novoa; Llistosella, Mercé Blázquez; Morales, Marta Fernández; Feijoo, Maria Begoña Valle; Pérez, Manuel Jesus Soriano; Martínez, Adrián Montaño
Scientific reports, 10/2023, Volume: 13, Issue: 1Journal Article
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.
