Abstract: High in-hospital mortality due to COVID-19 in a community hospital in Spain: a prospective observational study Joan Carles Trullàs (  jctv5153@comg.cat ) Hospital d'Olot https://orcid.org/0000-0002-7380-3475 Eva Ruiz Hospital de Olot Clara Weisweiler Universitat de Girona Gemma Badosa Hospital de Olot Alba Serra Hospital de Olot Hugo Briceño Hospital de Olot Sílvia Soler Hospital de Olot Josep Bisbe Hospital de Olot Research article Keywords: COVID-19, SARS virus, severe acute respiratory syndrome, coronavirus, community hospital, hospital mortality Posted Date: July 14th, 2020 DOI: https://doi.org/10.21203/rs.3.rs-39421/v1 License:   This work is licensed under a Creative Commons Attribution 4.0 International License. Read Full License Page 1/14 Abstract Background To describe the clinical characteristics and outcome of patients with COVID-19 in a community hospital in Spain Methods Prospective, single-centre case series of the first 100 consecutive hospitalized patients with COVID-19 at a community hospital in Spain, from March 16 to April 20, 2020. Demographics, comorbidities, clinical presentation, radiologic and laboratory findings, treatment and clinical outcome were collected. Results Of the 100 patients included in the study, the median age (IQR; range) was 75 years (20; 28–96) and 52% were men. The most common comorbidities were hypertension (63%), diabetes (22%) and cardiovascular diseases (28%). The most common symptoms were fever (80%), cough (69%), fatigue (59%) and dyspnea (52%) and 64% had respiratory insufficiency. Bilateral interstitial infiltrates (65/100, 65%) and bilateral vertical “B-kerley” lines (38/46, 82.6%) were the most common imaging manifestations in chest radiographs and lung ultrasound, respectively. All patients received supplementary oxygen, 69 (69%) received medical treatment (the most common regimen being hydroxychloroquine plus azithromycin in 66 patients) and 12% were treated with glucocorticoids. During hospitalization, 26 patients (26%) died, 10 (10%) were transferred to ICU and 64 (64%) were discharged at home. Mortality or ICU admission was more frequent in advanced age and with comorbidities. Conclusions This case series provides clinical characteristics and outcome of consecutively hospitalized patients with COVID-19 admitted to a community hospital in Spain. The majority were old patients, with comorbidities and in-hospital mortality was high (26%). Background A cluster of pneumonia of unknown origin was identified in Wuhan, China, in December 2019. The disease named coronavirus disease 2019 (COVID-19) was caused by a novel coronavirus termed SARSCoV-2 and was declared an international public health emergency by the World Health Organization (WHO). In the WHO European Region, COVID-19 surveillance was implemented on January 2020 and nine European countries reported 47 cases, being France and Germany the countries with more confirmed cases. At that time only two cases from Spain were reported [1]. Since then, larger series of cases from different countries (China, United States and Italy) and different settings (from long-term care facilities to ICU) have been reported with some differences in demographics, comorbidities and mortality rates [2–4]. In this study, we describe the clinical features and outcome of the first 100 sequentially admitted patients with laboratory-confirmed COVID-19 to the Hospital de Olot i comarcal de la Garrotxa (HOCG), a community hospital in..