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Gasch-Illescas A, Andrade-Arroyo M, Vallejo-Vaz AJ, Praena-Fernández JM, Guerrero JA, Calderón EJ, Pollán M, Medrano FJ. The Impact of the Second Wave of the COVID-19 Pandemic on Non-COVID Hospital Care in a Tertiary Hospital in Spain. J Clin Med 2023; 12:5507. [PMID: 37685572 PMCID: PMC10487824 DOI: 10.3390/jcm12175507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Revised: 08/18/2023] [Accepted: 08/22/2023] [Indexed: 09/10/2023] Open
Abstract
In 2020, Spain ranked fourth among European countries with the highest excess mortality due to COVID-19 disease. This study evaluates the impact of the COVID-19 pandemic on non-COVID patients in a tertiary hospital during the second pandemic wave in Spain (22 June 2020-6 December 2020). Data from Virgen del Rocío University Hospital in Seville during that timeframe were compared with the data from the same period in the preceding two years (2018-2019). Between-group comparisons were performed using the Chi-squared test, Student's t-test, or Mann-Whitney U tests, as appropriate. A total of 63,137 non-COVID patients were included in this study. During the second pandemic wave, a 19% decrease was observed in the annual number of non-COVID admissions overall (18,260 vs. 22,439, p < 0.001), but a 10% increase in the proportion of emergency admissions (60.6% vs. 54.93%, p < 0.001), a higher severity level of patients (1.79 vs. 1.72, p < 0.001), a longer in-hospital stay (7.02 vs. 6.74 days, p < 0.001), a 26% increase in non-COVID mortality (4.9% vs. 3.9%, p < 0.001), and a 50% increase in global mortality (5.9 vs. 3.9, p < 0.001) were also observed. In terms of both medical and surgical diagnoses, a significant reduction in the number of admissions and an increase in in-hospital mortality were observed. These results demonstrate the significant impact of the pandemic on hospital care, similar to what was previously observed during the initial wave in the same hospital. Our findings emphasize the need to include non-COVID patients when assessing the broad impact of the pandemic on healthcare, beyond its direct effects on COVID-19 patients.
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Affiliation(s)
- Antonia Gasch-Illescas
- Service de Santé Étudiants, Campus Arras, University of Artois, 62000 Arras, France;
- Escuela Internacional de Doctorado, University of Seville, 41004 Seville, Spain
- Infectious and Immune System Diseases, Epidemiology and Public Health, Instituto de Biomedicina de Sevilla, IBIS, Hospital Universitario Virgen del Rocío, CSIC, University of Seville, 41013 Seville, Spain
| | - María Andrade-Arroyo
- Servicio de Medicina Interna, Hospital Universitario Virgen del Rocío, 41013 Sevilla, Spain;
| | - Antonio J. Vallejo-Vaz
- Department of Medicine, Faculty of Medicine, University of Seville, 41013 Seville, Spain;
- Clinical Epidemiology and Vascular Risk, Instituto de Biomedicina de Sevilla, IBIS, Hospital Universitario Virgen del Rocío, Consejo Superior de Investigaciones Científicas, CSIC, University of Seville, 41013 Seville, Spain;
| | | | - José A. Guerrero
- Servicio de Documentación Clínica, Hospital Universitario Virgen del Rocío, 41013 Seville, Spain;
| | - Enrique J. Calderón
- Clinical Epidemiology and Vascular Risk, Instituto de Biomedicina de Sevilla, IBIS, Hospital Universitario Virgen del Rocío, Consejo Superior de Investigaciones Científicas, CSIC, University of Seville, 41013 Seville, Spain;
- Instituto de Biomedicina de Sevilla, IBIS, HUVR, Junta de Andalucía, Consejo Superior de Investigaciones Científicas, CSIC, University of Seville, 41013 Seville, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, 28029 Madrid, Spain;
| | - Marina Pollán
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, 28029 Madrid, Spain;
- National Center for Epidemiology, Instituto de Salud Carlos III ES, 28029 Madrid, Spain
| | - Francisco J. Medrano
- Clinical Epidemiology and Vascular Risk, Instituto de Biomedicina de Sevilla, IBIS, Hospital Universitario Virgen del Rocío, Consejo Superior de Investigaciones Científicas, CSIC, University of Seville, 41013 Seville, Spain;
- Instituto de Biomedicina de Sevilla, IBIS, HUVR, Junta de Andalucía, Consejo Superior de Investigaciones Científicas, CSIC, University of Seville, 41013 Seville, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, 28029 Madrid, Spain;
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Berenguer J, Jarrín I, Pérez-Latorre L, Hontañón V, Vivancos MJ, Navarro J, Téllez MJ, Guardiola JM, Iribarren JA, Rivero-Juárez A, Márquez M, Artero A, Morano L, Santos I, Moreno J, Fariñas MC, Galindo MJ, Hernando MA, Montero M, Cifuentes C, Domingo P, Sanz J, Domíngez L, Ferrero OL, De la Fuente B, Rodríguez C, Reus S, Hernández-Quero J, Gaspar G, Pérez-Martínez L, García C, Force L, Veloso S, Losa JE, Vilaró J, Bernal E, Arponen S, Ortí AJ, Chocarro Á, Teira R, Alonso G, Silvariño R, Vegas A, Geijo P, Bisbe J, Esteban H, González-García J. Human Immunodeficiency Virus/Hepatits C Virus Coinfection in Spain: Elimination Is Feasible, but the Burden of Residual Cirrhosis Will Be Significant. Open Forum Infect Dis 2018; 5:ofx258. [PMID: 29354658 PMCID: PMC5767960 DOI: 10.1093/ofid/ofx258] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Accepted: 12/19/2017] [Indexed: 12/13/2022] Open
Abstract
Background We assessed the prevalence of antibodies against hepatitis C virus (HCV-Abs) and active HCV infection in patients infected with human immunodeficiency virus (HIV) in Spain in 2016 and compared the results with those of similar studies performed in 2002, 2009, and 2015. Methods The study was performed in 43 centers during October-November 2016. The sample was estimated for an accuracy of 2% and selected by proportional allocation and simple random sampling. During 2016, criteria for therapy based on direct-acting antiviral agents (DAA) were at least significant liver fibrosis, severe extrahepatic manifestations of HCV, and high risk of HCV transmissibility. Results The reference population and the sample size were 38904 and 1588 patients, respectively. The prevalence of HCV-Abs in 2002, 2009, 2015, and 2016 was 60.8%, 50.2%, 37.7%, and 34.6%, respectively (P trend <.001, from 2002 to 2015). The prevalence of active HCV in 2002, 2009, 2015, and 2016 was 54.0%, 34.0%, 22.1%, and 11.7%, respectively (P trend <.001). The anti-HCV treatment uptake in 2002, 2009, 2015, and 2016 was 23.0%, 48.0%, 59.3%, and 74.7%, respectively (P trend <.001). In 2016, HCV-related cirrhosis was present in 7.6% of all HIV-infected individuals, 15.0% of patients with active HCV, and 31.5% of patients who cleared HCV after anti-HCV therapy. Conclusions Our findings suggest that with universal access to DAA-based therapy and continued efforts in prevention and screening, it will be possible to eliminate active HCV among HIV-infected individuals in Spain in the short term. However, the burden of HCV-related cirrhosis will continue to be significant among HIV-infected individuals.
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Affiliation(s)
- Juan Berenguer
- Hospital General Universitario Gregorio Marañón/Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | | | - Leire Pérez-Latorre
- Hospital General Universitario Gregorio Marañón/Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - Víctor Hontañón
- Hospital Universitario La Paz/Instituto de Investigación Sanitaria La Paz, Madrid, Spain
| | | | | | | | | | | | - Antonio Rivero-Juárez
- Hospital Universitario Reina Sofia/Instituto Maimónides de Investigación Biomédica de Córdoba, Spain
| | | | | | - Luis Morano
- Hospital Universitario Álvaro Cunqueiro, Vigo, Spain
| | | | | | - María C Fariñas
- Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | | | - María A Hernando
- Universidad Europea/Instituto de Investigación Hospital Universitario 12 de Octubre, Madrid, Spain
| | | | | | - Pere Domingo
- Hospital Universitario Arnau de Vilanova, Lleida, Spain
| | - José Sanz
- Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Spain
| | - Lourdes Domíngez
- Hospital Universitario 12 de Octubre/ Instituto de Investigación Hospital Universitario 12 de Octubre, Madrid, Spain
| | | | | | | | | | | | | | | | | | | | | | | | | | | | - Sari Arponen
- Hospital Universitario de Torrejón, Torrejón de Ardoz, Spain
| | | | | | | | | | | | - Ana Vegas
- Hospital Infanta Elena, Valdemoro, Spain
| | | | | | | | - Juan González-García
- Hospital Universitario La Paz/Instituto de Investigación Sanitaria La Paz, Madrid, Spain
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Berenguer J, Rivero A, Jarrín I, Núñez MJ, Vivancos MJ, Crespo M, Téllez MJ, Domingo P, Iribarren JA, Artero A, Márquez M, Santos I, Moreno J, Montero M, González-García J. Human Immunodeficiency Virus/Hepatitis C Virus Coinfection in Spain: Prevalence and Patient Characteristics. Open Forum Infect Dis 2016; 3:ofw059. [PMID: 27186584 PMCID: PMC4866570 DOI: 10.1093/ofid/ofw059] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2016] [Accepted: 03/09/2016] [Indexed: 02/06/2023] Open
Abstract
Background. The purpose of this study was to assess the prevalence of anti-hepatitis C virus (HCV) antibodies (Abs) and active HCV infection in human immunodeficiency virus (HIV)-infected (HIV+) patients in Spain in 2015. This was a cross-sectional study. Methods. The study was performed in 41 centers in 2015. Sample size was estimated for an accuracy of 2%, the number of patients from each hospital was determined by proportional allocation, and patients were selected using simple random sampling. Results. The reference population was 35 791 patients, and the sample size was 1867 patients. Hepatitis C virus serostatus was known in 1843 patients (98.7%). Hepatitis C virus-Abs were detected in 695 patients (37.7%), in whom the main route of HIV acquisition was injection drug use (75.4%). Of these 695 patients, 402 had HCV RNA, 170 had had a sustained viral response (SVR) after anti-HCV therapy, and 102 cleared HCV spontaneously. Hepatitis C virus-ribonucleic acid results were unknown in 21 cases. Genotype distribution (known in 367 patients) was 1a in 143 patients (39.0%), 4 in 90 (24.5%) patients, 1b in 69 (18.8%) patients, 3 in 57 (15.5%) patients, 2 in 5 (1.4%) patients, and mixed in 3 (0.8%) patients. Liver cirrhosis was present in 93 patients (23.1%) with active HCV infection and in 39 (22.9%) patients with SVR after anti-HCV therapy. Conclusions. The prevalence of HCV-Abs and active HCV infection in HIV+ patients in Spain is 37.7% and 22.1%, respectively; these figures are significantly lower than those recorded in 2002 and 2009. The predominant genotypes in patients with active HCV infection were 1a and 4. A high percentage of patients had cirrhosis. Cirrhosis is also common in patients with SVR after anti-HCV therapy.
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Affiliation(s)
- Juan Berenguer
- Hospital General Universitario Gregorio Marañón; Instituto de Investigación Sanitaria Gregorio Marañón, Madrid
| | - Antonio Rivero
- Hospital Universitario Reina Sofia, Cordoba; Instituto Maimonides de Investigacion Biomedica de Cordoba
| | | | - María J Núñez
- Hospital Universitario La Paz; Instituto de Investigación Sanitaria La Paz
| | | | | | | | - Pere Domingo
- Hospital de la Santa Creu i Sant Pau , Barcelona
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