Abstract Background Currently, there is a missing link in the natural history of COVID-19, from first (usually milder) symptoms to hospitalization and/or death. To fill in this gap, we characterized COVID-19 patients at the time at which they were diagnosed in outpatient settings and estimated 30-day hospital admission and fatality rates. Methods This was a population-based cohort study. Data were obtained from Information System for Research in Primary Care (SIDIAP)—a primary-care records database covering >6 million people (>80% of the population of Catalonia), linked to COVID-19 reverse transcriptase polymerase chain reaction (RT-PCR) tests and hospital emergency, inpatient and mortality registers. We included all patients in the database who were ≥15 years old and diagnosed with COVID-19 in outpatient settings between 15 March and 24 April 2020 (10 April for outcome studies). Baseline characteristics included socio-demographics, co-morbidity and previous drug use at the time of diagnosis, and polymerase chain reaction (PCR) testing and results. Study outcomes included 30-day hospitalization for COVID-19 and all-cause fatality. Results We identified 118 150 and 95 467 COVID-19 patients for characterization and outcome studies, respectively. Most were women (58.7%) and young-to-middle-aged (e.g. 21.1% were 45–54 years old). Of the 44 575 who were tested with PCR, 32 723 (73.4%) tested positive. In the month after diagnosis, 14.8% (14.6–15.0) were hospitalized, with a greater proportion of men and older people, peaking at age 75–84 years. Thirty-day fatality was 3.5% (95% confidence interval: 3.4% to 3.6%), higher in men, increasing with age and highest in those residing in nursing homes [24.5% (23.4% to 25.6%)]. Conclusion COVID-19 infections were widespread in the community, including all age–sex strata. However, severe forms of the disease clustered in older men and nursing-home residents. Although initially managed in outpatient settings, 15% of cases required hospitalization and 4% died within a month of first symptoms. These data are instrumental for designing deconfinement strategies and will inform healthcare planning and hospital-bed allocation in current and future COVID-19 outbreaks.
【저자키워드】 COVID-19, coronavirus, Epidemiology, Hospital admission, fatality, 【초록키워드】 Hospitalized, Mortality, Hospitalization, hospital, Diagnosis, Symptom, outcome, RT-PCR, database, Outbreaks, PCR, Characteristics, COVID-19 infection, healthcare, Patient, death, co-morbidity, Community, age, women, population-based cohort, COVID-19 patient, Older, first symptoms, positive, transcriptase, MOST, men, widespread, System, polymerase chain, peaking, Result, greater, highest, tested, died, proportion, diagnosed, the disease, required, form, characterized, diagnosed with COVID-19, 【제목키워드】 Cohort, Spain, Clinical management, Fatality rate, diagnosed, Filling,