Prognostic Factors at Admission for In-Hospital Mortality from COVID-19 Infection in an Older Rural Population in Central Spain

• Published in: Journal of clinical medicine Vol. 10; no. 2; p. 318
• Main Authors: Maestre-Muñiz, Modesto M., Arias, Ángel, Arias-González, Laura, Angulo-Lara, Basilio, Lucendo, Alfredo J.
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 16.01.2021; MDPI
• Subjects: Clinical medicine; Coronaviruses; COVID-19; Emergency medical care; Mortality; Spain; COVID-19; predictors; mortality; risk factors; Spain
• ISSN: 2077-0383; 2077-0383
• DOI: 10.3390/jcm10020318

Background: Risk factors for in-hospital mortality from severe coronavirus disease 2019 (COVID-19) infection have been identified in studies mainly carried out in urban-based teaching hospitals. However, there is little data for rural populations attending community hospitals during the first wave of the pandemic. Methods: A retrospective, single-center cohort study was undertaken among inpatients at a rural community hospital in Spain. Electronic medical records of the 444 patients (56.5% males) admitted due to severe SARS-CoV-2 infection during 26 February 2020–31 May 2020 were reviewed. Results: Mean age was 71.2 ± 14.6 years (rank 22–98), with 69.8% over 65. At least one comorbidity was present in 410 patients (92.3%), with chronic obstructive pulmonary disease (COPD) present in 21.7%. Overall in-hospital mortality was 32%. Multivariate analysis of factors associated with death identified patients’ age (with a cumulative effect per decade), COPD as a comorbidity, and respiratory insufficiency at the point of admission. No additional comorbid conditions proved significant. Among analytical values, increased serum creatinine, LDH > 500 mg/dL, thrombocytopenia (<150 × 109/per L), and lymphopenia (<1000 cells/µL) were all independently associated with mortality during admission. Conclusions: Age remained the major determinant for COVID-19-caused mortality; COPD was the only comorbidity independently associated with in-hospital death, together with respiratory insufficiency and analytical markers at admission.