@Article{info:doi/10.2196/25452,
author="Mayer, Miguel Angel
and Vidal-Alaball, Josep
and Puigdell{\'i}vol-S{\'a}nchez, Anna
and Mar{\'i}n Gomez, Francesc X
and Leis, Angela
and Mendioroz Pe{\~{n}}a, Jacobo",
title="Clinical Characterization of Patients With COVID-19 in Primary Care in Catalonia: Retrospective Observational Study",
journal="JMIR Public Health Surveill",
year="2021",
month="Feb",
day="8",
volume="7",
number="2",
pages="e25452",
keywords="COVID-19; risk factors; primary health care; angiotensin-converting enzyme inhibitors; angiotensin II type 2 receptor blockers; risk; characteristic; retrospective; observational; Spain; mortality",
abstract="Background: The country of Spain has one of the highest incidences of COVID-19, with more than 1,000,000 cases as of the end of October 2020. Patients with a history of chronic conditions, obesity, and cancer are at greater risk from COVID-19; moreover, concerns surrounding the use of angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin type II receptor blockers (ARBs) and its relationship to COVID-19 susceptibility have increased since the beginning of the pandemic. Objective: The objectives of this study were to compare the characteristics of patients diagnosed with COVID-19 to those of patients without COVID-19 in primary care; to determine the risk factors associated with the outcome of mortality; and to determine the potential influence of certain medications, such as ACEIs and ARBs, on the mortality of patients with COVID-19. Methods: An observational retrospective study of patients diagnosed with COVID-19 in the Catalan Central Region of Spain between March 1 and August 17, 2020, was conducted. The data were obtained from the Primary Care Services Information Technologies System of the Catalan Institute of Health in Barcelona, Spain. Results: The study population included 348,596 patients (aged >15 years) registered in the Primary Care Services Information Technologies System of the Catalan Central Region. The mean age of the patients was 49.53 years (SD 19.42), and 31.17{\%} of the patients were aged ≥60 years. 175,484/348,596 patients (50.34{\%}) were women. A total of 23,844/348,596 patients (6.84{\%}) in the population studied were diagnosed with COVID-19 during the study period, and the most common clinical conditions of these patients were hypertension (5267 patients, 22.1{\%}) and obesity (5181 patients, 21.7{\%}). Overall, 2680/348,596 patients in the study population (0.77{\%}) died during the study period. The number of deaths among patients without COVID-19 was 1825/324,752 (0.56{\%}; mean age 80.6 years, SD 13.3), while among patients diagnosed with COVID-19, the number of deaths was 855/23,844 (3.58{\%}; mean age 83.0 years, SD 10.80) with an OR of 6.58 (95{\%} CI 6.06-7.15). Conclusions: We observed that women were more likely to contract COVID-19 than men. In addition, our study did not show that hypertension, obesity, or being treated with ACEIs or ARBs was linked to an increase in mortality in patients with COVID-19. Age is the main factor associated with mortality in patients infected with SARS-CoV-2. ",
issn="2369-2960",
doi="10.2196/25452",
url="http://publichealth.jmir.org/2021/2/e25452/",
url="https://doi.org/10.2196/25452",
url="http://www.ncbi.nlm.nih.gov/pubmed/33496668"
}