A national population-based study of mortality and risk factors in COVID-19-hospitalized patients in Spain (2020–2021)
ObjectivesThe study aimed to analyze in-hospital mortality (IHM) among all COVID-19 patients hospitalized in Spain between March 1, 2020, and December 31, 2021, and to compare two distinct periods: the prevaccination period (March 1, 2020, to January 31, 2021) and the vaccination period (February 1,...
Saved in:
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2025-02-01
|
| Series: | Frontiers in Public Health |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fpubh.2025.1488283/full |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832542282551656448 |
|---|---|
| author | José-Manuel Ramos-Rincón José-Manuel Ramos-Rincón José Sánchez-Paya Pilar González-De-La-Aleja Juan-Carlos Rodríguez-Díaz Juan-Carlos Rodríguez-Díaz Esperanza Merino Esperanza Merino |
| author_facet | José-Manuel Ramos-Rincón José-Manuel Ramos-Rincón José Sánchez-Paya Pilar González-De-La-Aleja Juan-Carlos Rodríguez-Díaz Juan-Carlos Rodríguez-Díaz Esperanza Merino Esperanza Merino |
| author_sort | José-Manuel Ramos-Rincón |
| collection | DOAJ |
| description | ObjectivesThe study aimed to analyze in-hospital mortality (IHM) among all COVID-19 patients hospitalized in Spain between March 1, 2020, and December 31, 2021, and to compare two distinct periods: the prevaccination period (March 1, 2020, to January 31, 2021) and the vaccination period (February 1, 2021, to December 31, 2021). The objective was to assess the impact of vaccination on IHM and identify associated risk factors, using data from Spain’s national hospitalization registry.MethodsThis retrospective analysis used data from the Spanish National Surveillance System for Hospital Data. The primary outcome was in-hospital mortality (IHM). Multivariate logistic regression identified risk factors across the overall study period, as well as during the prevaccination and vaccination periods. Risk factors included age (in 20-year intervals), sex, comorbidities (e.g., hypertension, diabetes, chronic kidney failure, obesity, neurodegenerative disorders, and others), and admission to the intensive care unit.ResultsA total of 524,314 COVID-19 hospitalizations were recorded in Spain, with 329,690 during the prevaccination period and 194,624 during the vaccination period. Hospitalization rates dropped from 697/100,000 people to 411/100,000, and in-hospital mortality (IHM) decreased from 16.2 to 11.5% (adjusted odds ratio [AOR]: 0.71, 95% CI: 0.70–0.73, p < 0.001). IHM rose with age, from 0.8% in patients aged 18–39 to 31.7% in those ≥80 years (p < 0.001), but significant decreases were observed across all age groups after vaccination, especially in those ≥80 years (AOR: 0.76, 95% CI: 0.75–0.79, p < 0.001). Risk factors for IHM remained consistent, with leukemia, neoplasm, and lymphoma posing the highest risks, while female sex (AOR: 0.75, 95% CI: 0.74–0.77, p < 0.001) and dyslipidemia (AOR: 0.85, 95% CI: 0.32–0.86, p < 0.001) were protective factors.ConclusionDuring the vaccination period, the risk of in-hospital mortality (IHM) was 29% lower than in the prevaccination period, after adjusting for sex, age, and comorbidities. This reduced risk was observed across sexes, age groups, and comorbidities. The risk factors for IHM remained consistent between the two periods, with age as the main risk factor, while female sex and dyslipidemia were identified as protective factors. |
| format | Article |
| id | doaj-art-04acd2c63e9b477887b792609837f7d2 |
| institution | Kabale University |
| issn | 2296-2565 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Public Health |
| spelling | doaj-art-04acd2c63e9b477887b792609837f7d22025-02-04T06:31:48ZengFrontiers Media S.A.Frontiers in Public Health2296-25652025-02-011310.3389/fpubh.2025.14882831488283A national population-based study of mortality and risk factors in COVID-19-hospitalized patients in Spain (2020–2021)José-Manuel Ramos-Rincón0José-Manuel Ramos-Rincón1José Sánchez-Paya2Pilar González-De-La-Aleja3Juan-Carlos Rodríguez-Díaz4Juan-Carlos Rodríguez-Díaz5Esperanza Merino6Esperanza Merino7Department of Internal Medicine, Alicante Institute for Health and Biomedical Research (ISABIAL), Dr. Balmis General University Hospital, Alicante, SpainMiguel Hernández University of Elche, Alicante, SpainPreventive Service, Alicante Institute for Health and Biomedical Research (ISABIAL), Dr. Balmis General University Hospital, Alicante, SpainUnit of Infectious Diseases, Alicante Institute for Health and Biomedical Research (ISABIAL), Dr. Balmis General University Hospital, Alicante, SpainMiguel Hernández University of Elche, Alicante, SpainService of Microbiology, Alicante Institute for Health and Biomedical Research (ISABIAL), Dr. Balmis General University Hospital, Alicante, SpainMiguel Hernández University of Elche, Alicante, SpainUnit of Infectious Diseases, Alicante Institute for Health and Biomedical Research (ISABIAL), Dr. Balmis General University Hospital, Alicante, SpainObjectivesThe study aimed to analyze in-hospital mortality (IHM) among all COVID-19 patients hospitalized in Spain between March 1, 2020, and December 31, 2021, and to compare two distinct periods: the prevaccination period (March 1, 2020, to January 31, 2021) and the vaccination period (February 1, 2021, to December 31, 2021). The objective was to assess the impact of vaccination on IHM and identify associated risk factors, using data from Spain’s national hospitalization registry.MethodsThis retrospective analysis used data from the Spanish National Surveillance System for Hospital Data. The primary outcome was in-hospital mortality (IHM). Multivariate logistic regression identified risk factors across the overall study period, as well as during the prevaccination and vaccination periods. Risk factors included age (in 20-year intervals), sex, comorbidities (e.g., hypertension, diabetes, chronic kidney failure, obesity, neurodegenerative disorders, and others), and admission to the intensive care unit.ResultsA total of 524,314 COVID-19 hospitalizations were recorded in Spain, with 329,690 during the prevaccination period and 194,624 during the vaccination period. Hospitalization rates dropped from 697/100,000 people to 411/100,000, and in-hospital mortality (IHM) decreased from 16.2 to 11.5% (adjusted odds ratio [AOR]: 0.71, 95% CI: 0.70–0.73, p < 0.001). IHM rose with age, from 0.8% in patients aged 18–39 to 31.7% in those ≥80 years (p < 0.001), but significant decreases were observed across all age groups after vaccination, especially in those ≥80 years (AOR: 0.76, 95% CI: 0.75–0.79, p < 0.001). Risk factors for IHM remained consistent, with leukemia, neoplasm, and lymphoma posing the highest risks, while female sex (AOR: 0.75, 95% CI: 0.74–0.77, p < 0.001) and dyslipidemia (AOR: 0.85, 95% CI: 0.32–0.86, p < 0.001) were protective factors.ConclusionDuring the vaccination period, the risk of in-hospital mortality (IHM) was 29% lower than in the prevaccination period, after adjusting for sex, age, and comorbidities. This reduced risk was observed across sexes, age groups, and comorbidities. The risk factors for IHM remained consistent between the two periods, with age as the main risk factor, while female sex and dyslipidemia were identified as protective factors.https://www.frontiersin.org/articles/10.3389/fpubh.2025.1488283/fullCOVID-19SARS-CoV-2Spainhospitalizationrisk factor mortalityin-hospital mortality |
| spellingShingle | José-Manuel Ramos-Rincón José-Manuel Ramos-Rincón José Sánchez-Paya Pilar González-De-La-Aleja Juan-Carlos Rodríguez-Díaz Juan-Carlos Rodríguez-Díaz Esperanza Merino Esperanza Merino A national population-based study of mortality and risk factors in COVID-19-hospitalized patients in Spain (2020–2021) Frontiers in Public Health COVID-19 SARS-CoV-2 Spain hospitalization risk factor mortality in-hospital mortality |
| title | A national population-based study of mortality and risk factors in COVID-19-hospitalized patients in Spain (2020–2021) |
| title_full | A national population-based study of mortality and risk factors in COVID-19-hospitalized patients in Spain (2020–2021) |
| title_fullStr | A national population-based study of mortality and risk factors in COVID-19-hospitalized patients in Spain (2020–2021) |
| title_full_unstemmed | A national population-based study of mortality and risk factors in COVID-19-hospitalized patients in Spain (2020–2021) |
| title_short | A national population-based study of mortality and risk factors in COVID-19-hospitalized patients in Spain (2020–2021) |
| title_sort | national population based study of mortality and risk factors in covid 19 hospitalized patients in spain 2020 2021 |
| topic | COVID-19 SARS-CoV-2 Spain hospitalization risk factor mortality in-hospital mortality |
| url | https://www.frontiersin.org/articles/10.3389/fpubh.2025.1488283/full |
| work_keys_str_mv | AT josemanuelramosrincon anationalpopulationbasedstudyofmortalityandriskfactorsincovid19hospitalizedpatientsinspain20202021 AT josemanuelramosrincon anationalpopulationbasedstudyofmortalityandriskfactorsincovid19hospitalizedpatientsinspain20202021 AT josesanchezpaya anationalpopulationbasedstudyofmortalityandriskfactorsincovid19hospitalizedpatientsinspain20202021 AT pilargonzalezdelaaleja anationalpopulationbasedstudyofmortalityandriskfactorsincovid19hospitalizedpatientsinspain20202021 AT juancarlosrodriguezdiaz anationalpopulationbasedstudyofmortalityandriskfactorsincovid19hospitalizedpatientsinspain20202021 AT juancarlosrodriguezdiaz anationalpopulationbasedstudyofmortalityandriskfactorsincovid19hospitalizedpatientsinspain20202021 AT esperanzamerino anationalpopulationbasedstudyofmortalityandriskfactorsincovid19hospitalizedpatientsinspain20202021 AT esperanzamerino anationalpopulationbasedstudyofmortalityandriskfactorsincovid19hospitalizedpatientsinspain20202021 AT josemanuelramosrincon nationalpopulationbasedstudyofmortalityandriskfactorsincovid19hospitalizedpatientsinspain20202021 AT josemanuelramosrincon nationalpopulationbasedstudyofmortalityandriskfactorsincovid19hospitalizedpatientsinspain20202021 AT josesanchezpaya nationalpopulationbasedstudyofmortalityandriskfactorsincovid19hospitalizedpatientsinspain20202021 AT pilargonzalezdelaaleja nationalpopulationbasedstudyofmortalityandriskfactorsincovid19hospitalizedpatientsinspain20202021 AT juancarlosrodriguezdiaz nationalpopulationbasedstudyofmortalityandriskfactorsincovid19hospitalizedpatientsinspain20202021 AT juancarlosrodriguezdiaz nationalpopulationbasedstudyofmortalityandriskfactorsincovid19hospitalizedpatientsinspain20202021 AT esperanzamerino nationalpopulationbasedstudyofmortalityandriskfactorsincovid19hospitalizedpatientsinspain20202021 AT esperanzamerino nationalpopulationbasedstudyofmortalityandriskfactorsincovid19hospitalizedpatientsinspain20202021 |