The first wave of the COVID-19 pandemic in Spain: characterisation of cases and risk factors for severe outcomes, as at 27 April 2020

BackgroundThe 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.AimTo describe reported cases and the impact of national lockdown, and to identify disease severity risk...

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Published in:	Euro surveillance : bulletin européen sur les maladies transmissibles Vol. 25; no. 50; p. 15
Main Authors:	Redondo-Bravo, Lidia, Sierra Moros, María José, Martínez Sánchez, Elena Vanessa, Lorusso, Nicola, Carmona Ubago, Alberto, Gallardo García, Virtudes, Sánchez Villanueva, Pilar, Puy Azón, Adela, Guimbao Bescós, Joaquín, Boone, An LD, Fernández Ibáñez, Ana, Álvarez Fernández, Blanca, Nicolau Riutort, Antonio, Salom Castell, Magdalena, Giménez Duran, Jaume, Núñez Gallo, Domingo, Rojo Moreno, Magdalena Lucia, Blasco de la Fuente, Aniceto, Viloria Raymundo, Luis Javier, Hernández Pereña, Marcos, Chico Mena, Matilde, Humanes Aparicio, Sonia, Illescas Fernández, Maria Soledad, Fernández Arribas, Socorro, Marcos Rodríguez, Mª del Henar, Martínez-Pino, Isabel, Jané, Mireia, Martínez, Ana, Ciruela, Pilar, Villatoro Bongiorno, Katja, March Yagüe, Aina, Pérez Panadés, Jordi, López-Tercero Torvisco, María del Mar, Gordillo Romero, Cecilia, Caleya Olivas, Beatriz, De Miguel García, Sara, Córdoba Deorador, Esther, Gil Montalbán, Elisa, del Valle Arrojo, Manuel, Abraira García, Luisa, Boullosa Cortés, Antonio, García-Fulgueiras, Ana, Chirlaque, Mª Dolores, Barranco, Mª Isabel, Casado, Itziar, Castilla, Jesús, García-Cenoz, Manuel, Gonzalez Carril, Fernando, Soraluce Olañeta, Amaia, Lázaro-Carrasco de la Fuente, Mª Jesús, Martínez Ochoa, Eva, Carmen Ibáñez Pérez, Ana, Blanco Martínez, Ángela, Isabel Rivas Pérez, Ana, Ramos Marín, Violeta, Medina Vinuesa, Margarita, Castrillejo Pérez, Daniel, Alfonso Gómez Anés, Atanasio, Pozo, Francisco, Casas, Inmaculada, Peñalver-Argüeso, Belén, Pampaka, Despina, Oliva Domínguez, Jesús A., Sastre García, María, Larrauri, Amparo
Format:	Journal Article
Language:	English
Published:	Sweden Centre Europeen pour la Surveillance Epidemiologique du SIDA (European Centre for the Epidemiological Monitoring of AIDS) 17-12-2020 European Centre for Disease Prevention and Control (ECDC)
Subjects:	Adolescent Adult Aged Aged, 80 and over Algorithms Child Child, Preschool Communicable Disease Control - methods Comorbidity COVID-19 COVID-19 - epidemiology COVID-19 - prevention & control Data Collection Female Geography, Medical Health Personnel - statistics & numerical data Hospitalization Humans Infant Intensive care Male Middle Aged Pandemics Patient admissions Physical Distancing Population Surveillance Quarantine Registries Risk Factors SARS-CoV-2 Shelter in place Spain - epidemiology Surveillance Young Adult Spain COVID-19 SARS-CoV-2 risk factors surveillance pandemic Spain
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Summary:	BackgroundThe 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.AimTo describe reported cases and the impact of national lockdown, and to identify disease severity risk factors.MethodsNational 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.ResultsThe 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).ConclusionsCOVID-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.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 Correspondence: Amparo Larrauri (alarrauri@isciii.es)
ISSN:	1560-7917 1025-496X 1560-7917
DOI:	10.2807/1560-7917.ES.2020.25.50.2001431