Publication: The first wave of the COVID-19 pandemic in Spain: characterisation of cases and risk factors for severe outcomes, as at 27 April 2020
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Publication date
2020-12
Authors
Pozo Sanchez, Francisco ISCIII
Casas Flecha, Inmaculada ISCIII
Peñalver-Argüeso, Belén ISCIII
Pampaka, Despina ISCIII
Oliva Dominguez, Jesus Angel ISCIII
Sastre García, María ISCIII
Larrauri, Amparo ISCIII
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European Centre for Disease Prevention and Control (ECDC)
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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Bibliographic citation
Euro Surveill. 2020 Dec;25(50):2001431.
Collections
Centro Nacional de Epidemiología (CNE)
Centro Nacional de Microbiología (CNM)
Escuela Nacional de Sanidad (ENS)
IBIMA-Plataforma BIONAND - Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina (Andalucía)
IdiSNA - Instituto de Investigación Sanitaria de Navarra (Navarra)
IMIB - Instituto Murciano de Investigación Biosanitaria Pascual Parrilla (Murcia)
Centro Nacional de Microbiología (CNM)
Escuela Nacional de Sanidad (ENS)
IBIMA-Plataforma BIONAND - Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina (Andalucía)
IdiSNA - Instituto de Investigación Sanitaria de Navarra (Navarra)
IMIB - Instituto Murciano de Investigación Biosanitaria Pascual Parrilla (Murcia)