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{{ANEEtiqueta|palabrasclave=sección de la Monografía covid-19, sección II, pandemiapandemic, covid19, población absolutatotal population , densidad de poblaciónpopulation density, asentamientos ruralesrural settlement, concentración de la poblaciónhuman concentration , composición de la poblaciónpopulation structure, tercera edadold people, tamaño de los hogareshousehold size, esperanza de vidalife years, densidad de asentamientossettlement density, población en diseminadoscattered population, prevalencia de EPOCprevalence of COPD, prevalencia de obesidadprevalence of obesity, prevalencia de hipertensión arterialprevalence of hypertension, prevalencia de prevalence of diabetes, infarto de miocardioheart failure, infarto de miocardioAIDS, SIDAprevalence of chronic kidney disease|descripcion= Presentación cartográfica de la poblaciónCartographic presentation of population, poblamiento y comorbilidadsettlement and comorbidities|url=valor}}{{ANEObra|Serie=Monographs from the National Atlas of Spain|Logo=[[File:Logo Monografía.jpg|left|50x50px|link=]]|Título=The COVID-19 pandemic in Spain|Subtítulo=First wave: from the first cases to the end of June 2020|Año=2021|Contenido=New content}} {{ANENavegacionCapitulo (monografía COVID-19)|estructura temática=Thematic structure|seccion=[[La pandemia The COVID-19 en Españapandemic in Spain|The COVID-19 pandemic in Spain]]|capitulo=Population, human settlements and comorbidities}} {{ANENavegacionHermanosPrimero|siguiente=[[Resources for health services before the pandemic]]}}
This chapter focuses on some aspects that are present on a territory prior to the arrival of a disease and may favour or hinder the diffusion of the pandemic once the disease starts spreading, e.g. household overcrowding, healthy life years, age structure of the population, total amount of inhabitants per human settlement or the different types of human settlements. Population and human settlements are studied first in this chapter, whilst the text delves afterwards into a double-page devoted to comorbidities.
[[File:Logo MonografíaSpain_Total-population-and-population-density_2020_map_17746_eng.jpg|right|thumb|300px|Map: Total population and population density. 2020. Spain. [ //centrodedescargas.cnig.es/CentroDescargas/busquedaRedirigida.do?ruta=PUBLICACION_CNIG_DATOS_VARIOS/aneTematico/Spain_Total-population-and-population-density_2020_map_17746_eng.pdf PDF]. [ Datos//centrodedescargas.cnig.es/CentroDescargas/busquedaRedirigida.do?ruta=PUBLICACION_CNIG_DATOS_VARIOS/aneTematico/Spain_Total-population-and-population-density_2020_map_17746_eng.zip Data]. [ Versión interactiva//interactivo-atlasnacional.ign.es/index.php#c=indicator&i=r_3_t.r_3_t&i2=c_43_t.c_43_t&s=2020&s2=2020&t=A02&t2=A02&view=map9 Interactive version].]]
There were 47,450,795 inhabitants in Spain as of 1 January 2020. This means an average population density of 93.6 inhabitants/km2. It is the fourth State within the European Union in terms of total population and ranks seventeenth in terms of population density. The spatial distribution of the population in Spain shows at first glance a sharp contrast between a denser periphery –together with the islands– and a more empty hinterland –with the only exceptions of Madrid, Saragossa (Zaragoza) and Valladolid– (see the map on Total population and population density).
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[[File:Logo MonografíaSpain_Rural-population_2020_map_18041_eng.jpg|left|thumb|300px|Map: Rural population. 2020. Spain. [ //centrodedescargas.cnig.es/CentroDescargas/busquedaRedirigida.do?ruta=PUBLICACION_CNIG_DATOS_VARIOS/aneTematico/Spain_Rural-population_2020_map_18041_eng.pdf PDF]. [ Datos//centrodedescargas.cnig.es/CentroDescargas/busquedaRedirigida.do?ruta=PUBLICACION_CNIG_DATOS_VARIOS/aneTematico/Spain_Rural-population_2020_map_18041_eng.zip Data]. [ interactiva//interactivo-atlasnacional.ign.es/index.php#c=indicator&i=r12474.r12474&i2=c12475.c12475&t=A02&t2=A02&view=map9 Interactive version].]]
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[[File:Logo MonografíaSpain_Urban-macrocephaly_2020_map_18022_eng.jpg|left|thumb|300px|Map: Urban macrocephaly. 2020. Spain. [ //centrodedescargas.cnig.es/CentroDescargas/busquedaRedirigida.do?ruta=PUBLICACION_CNIG_DATOS_VARIOS/aneTematico/Spain_Urban-macrocephaly_2020_map_18022_eng.pdf PDF]. [ Datos//centrodedescargas.cnig.es/CentroDescargas/busquedaRedirigida.do?ruta=PUBLICACION_CNIG_DATOS_VARIOS/aneTematico/Spain_Urban-macrocephaly_2020_map_18022_eng.zip Data]. Versiones interactivas Interactive Versions [//interactivo-atlasnacional.ign.es/index.php#c=indicator&i=r12468.r12418&view=map8 1] [//interactivo-atlasnacional.ign.es/index.php#c=indicator&i=c12470.c12470&t=A02&view=map9 2] ]]
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Three noteworthy facts may be observed on the map on [[:File:Spain_Urban-macrocephaly_2020_map_18022_eng.jpg| ''Urban macrocephaly'']]. In the first place, the coast from western Andalusia (Andalucía) to Catalonia (Catalunya/Cataluña) is well traced and a moderate dominance of major towns with a large amount of inhabitants is shown in this area. To a lesser extent, the Atlantic coast in Galicia, the northern coast, the Balearic Islands and the Canary Islands are also well outlined. In the hinterland, however, only Madrid, Valladolid and Saragossa (Zaragoza) stand out. Secondly, there is a sharp contrast between the Northern Plateau and the Southern Plateau as the presence of major towns with a larger amount of inhabitants is more significant in the former. Finally, it shall be noted that the weight of the municipality with most residents on the total population of each province is more significant in the northern half of the Spanish hinterland as well as in Madrid than in the rest of the country. It is also worthy of mention that the municipality with most residents within each province is the capital town of the province except for three cases out of fifty, i.e. Pontevedra, Asturias and Cádiz, where Vigo, Gijón/Xixón and Jerez de la Frontera are the largest towns in these provinces.
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[[File:Logo MonografíaSpain_Density-of-human-settlements_2020_map_18025_eng.jpg|left|thumb|300px|Map: Density of human settlements. 2020. Spain. [//centrodedescargas.cnig.es/CentroDescargas/busquedaRedirigida.do?ruta=PUBLICACION_CNIG_DATOS_VARIOS/aneTematico/Espana_DensidadSpain_Density-deof-asentamientos_2020_mapa_18025_spahuman-settlements_2020_map_18025_eng.pdf PDF]. [//centrodedescargas.cnig.es/CentroDescargas/busquedaRedirigida.do?ruta=PUBLICACION_CNIG_DATOS_VARIOS/aneTematico/Espana_DensidadSpain_Density-deof-human-asentamientos_2020_mapa_18025_spasettlements_2020_map_18025_eng.zip DatosData]. [//interactivo-atlasnacional.ign.es/index.php#c=indicator&i=c_112_t.c_112_t&s=2020&t=A02&view=map8 Versión interactiva Interactive version].]]
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[[File:Logo MonografíaSpain_Population-living-in-scattered-villages_2020_map_18024_eng.jpg|left|thumb|300px|Map: Population living in scattered villages by municipality. 2020. Spain. [//centrodedescargas.cnig.es/CentroDescargas/busquedaRedirigida.do?ruta=PUBLICACION_CNIG_DATOS_VARIOS/aneTematico/Espana_PoblacionSpain_Population-enliving-diseminadoin-porscattered-municipio_2020_mapa_18026_spavillages_2020_map_18024_eng.pdf PDF]. [//centrodedescargas.cnig.es/CentroDescargas/busquedaRedirigida.do?ruta=PUBLICACION_CNIG_DATOS_VARIOS/aneTematico/Espana_PoblacionSpain_Population-enliving-diseminadoin-porscattered-municipio_2020_mapa_18026_spavillages_2020_map_18024_eng.zip DatosData]. [//interactivo-atlasnacional.ign.es/index.php#c=indicator&i=c_113_t.c_113_t&s=2020&t=A02&view=map8 Versión interactivaInteractive version].]]
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[[File:Logo MonografíaSpain_Human-settlements_2020_map_18023_eng.jpg|left|thumb|300px|MapaMap: Human settlementessettlements. 2020. Spain. [//centrodedescargas.cnig.es/CentroDescargas/busquedaRedirigida.do?ruta=PUBLICACION_CNIG_DATOS_VARIOS/aneTematico/Espana_Entidades-deSpain_Human-poblacion_2020_mapa_18023_spasettlements_2020_map_18023_eng.pdf PDF]. [//centrodedescargas.cnig.es/CentroDescargas/busquedaRedirigida.do?ruta=PUBLICACION_CNIG_DATOS_VARIOS/aneTematico/Espana_Entidades-deSpain_Human-poblacion_2020_mapa_18023_spasettlements_2020_map_18023_eng.zip DatosData] . [//interactivo-atlasnacional.ign.es/index.php#c=indicator&i=r_109_t.r_109_t&i2=c_108_t.c_108_t&s=2020&s2=2020&t=A02&t2=A02&view=map9 Versión interactivaInteractive version].]]
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[[File:Logo MonografíaSpain_Population-living-in-scattered-villages-by-municipality_2020_map_18026_eng.jpg|left|thumb|300px|Map: Population living in scattered villages by provincemunicipality. 2020. Spain. [//centrodedescargas.cnig.es/CentroDescargas/busquedaRedirigida.do?ruta=PUBLICACION_CNIG_DATOS_VARIOS/aneTematico/Espana_PoblacionSpain_Population-living-in-scattered-villages-enby-diseminado_2020_mapa_18024_spamunicipality_2020_map_18026_eng.pdf PDF]. [//centrodedescargas.cnig.es/CentroDescargas/busquedaRedirigida.do?ruta=PUBLICACION_CNIG_DATOS_VARIOS/aneTematico/Espana_PoblacionSpain_Population-living-enin-diseminado_2020_mapa_18024_spascattered-villages-by-municipality_2020_map_18026_eng.zip DatosData]. [//interactivo-atlasnacional.ign.es/index.php#c=indicator&i=r_111_t.r_111_t&i2=c_110_t.c_110_t&s=2020&s2=2020&t=A02&t2=A02&view=map9 Versión interactivaInteractive version].]]]
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The maps showing human settlements throughout the Spanish territory seem to be very explanatory. At first glance, there is an outstanding number of human settlements in the Northwest in relation to the rest of the country (see the map on Human settlements). However, a more detailed analysis could conclude that certain differences may be observed in the rest of the country as the map on Density of human settlements, which shows a more detailed unit of anaysis as it moves from a provincial level to a municipal division, reveals areas with a significant density of human settlements such as the outskirts of the Metropolitan Area of Madrid, central and northern Catalonia (Catalunya/Cataluña), some areas in the Region of Valencia (Comunitat Valenciana), the southeast of the Region of Murcia (Región de Murcia), eastern Andalusia (Andalucía), the central area of the province of Salamanca as well as some of the Canary Islands (Canarias).
Besides, the maps showing the Population population living in scattered villages ([[:File:Spain_Population-living-in-scattered-villages_2020_map_18024_eng.jpg| ''by province '']] and [[:File:Spain_Population-living-in-scattered-villages-by-municipality_2020_map_18026_eng.jpg| ''by municipality'']] ), i.e. villages different to the capital town of the municipality, reveal a sharp contrast between the periphery [especially Galicia, western Asturias, the Basque Country (Euskadi/País Vasco), northwestern Navarre (Navarra), the district called Maestrazgo/Maestrat between the regions of Aragón and Valencia, as well as a long strip that goes from Alicante/Alacant to Cádiz], where more people live in scattered villages, and the Spanish hinterland, where lower figures are shown on both maps since more people live in the capital town of the municipality. In short, population distribution is more scattered along the coast, whether for geographical, historical or functional reasons. In the hinterland, by contrast, a greater concentration in terms of human settlements may be observed, yet certain differences shall be pointed out, i.e. human settlements are closer to each other although smaller in size in the Northern Plateau, whereas a smaller number of settlements that are more distant from each other and which have municipalities larger in size may be observed in the Southern Plateau.
Certain features of population distribution and human concentration have been described so far. Three further aspects are analysed in the following paragraphs, i.e. age structure, levels of household overcrowding and healthy life years.
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[[File:Logo MonografíaSpain_Population-under-60-years-of-age_2020_map_17748_eng.jpg|left|thumb|300px|Map: Population under 60 years of age. 2020. Spain. [//centrodedescargas.cnig.es/CentroDescargas/busquedaRedirigida.do?ruta=PUBLICACION_CNIG_DATOS_VARIOS/aneTematico/Espana_PoblacionSpain_Population-under-menor60-deyears-60of-anos_2020_mapa_17748_spaage_2020_map_17748_eng.pdf PDF]. [ Datos//centrodedescargas.cnig.es/CentroDescargas/busquedaRedirigida.do?ruta=PUBLICACION_CNIG_DATOS_VARIOS/aneTematico/Spain_Population-under-60-years-of-age_2020_map_17748_eng.zip Data]. [ Versión interactiva//interactivo-atlasnacional.ign.es/index.php#c=indicator&i=r12111.r12111&i2=c12112.v12112&t=A03&t2=A03&view=map9 Interactive version].]]
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<li style="display: inline-block">[[File:Logo MonografíaSpain_Population-from-60-to-85-years-of-age_2020_map_17749_eng.jpg|right|thumb|300px|Map: Population from 60 to 85 years of age. 2020. Spain. [//centrodedescargas.cnig.es/CentroDescargas/busquedaRedirigida.do?ruta=PUBLICACION_CNIG_DATOS_VARIOS/aneTematico/Espana_PoblacionSpain_Population-entrefrom-60-yto-85-anos_2020_mapa_17749_spayears-of-age_2020_map_17749_eng.pdf PDF]. [//centrodedescargas.cnig.es/CentroDescargas/busquedaRedirigida.do?ruta=PUBLICACION_CNIG_DATOS_VARIOS/aneTematico/Espana_PoblacionSpain_Population-entrefrom-60-yto-85-anos_2020_mapa_17749_spayears-of-age_2020_map_17749_eng.zip DatosData]. [//interactivo-atlasnacional.ign.es/index.php#c=indicator&i=r12124.v12124&i2=c12125.c12125&t=A02&t2=A02&view=map9 Versión interactivaInteractive version].]]
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[[File:Logo MonografíaSpain_Population-over-85-years-of-age_2020_map_17750_eng.jpg|rightleft|thumb|300px|Map: Population over 85 years of age. 2020. Spain. [//centrodedescargas.cnig.es/CentroDescargas/busquedaRedirigida.do?ruta=PUBLICACION_CNIG_DATOS_VARIOS/aneTematico/Espana_PoblacionSpain_Population-over-mayor85-deyears-85of-anos_2020_mapa_17750_spaage_2020_map_17750_eng.pdf PDF]. [ Datos//centrodedescargas.cnig.es/CentroDescargas/busquedaRedirigida.do?ruta=PUBLICACION_CNIG_DATOS_VARIOS/aneTematico/Spain_Population-over-85-years-of-age_2020_map_17750_eng.zip Data]. [ Versión interactiva//interactivo-atlasnacional.ign.es/index.php#c=indicator&i=r12114.r12114&i2=c12115.c12115&t=A02&t2=A02&view=map9 Interactive version].]]
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[[File:Logo MonografíaSpain_Households-with-5-or-more-members_2019_map_17763_eng.jpg|left|thumb|300px|Map: Households with 5 or more members. 2019. Spain. [//centrodedescargas.cnig.es/CentroDescargas/busquedaRedirigida.do?ruta=PUBLICACION_CNIG_DATOS_VARIOS/aneTematico/Espana_HogaresSpain_Households-conwith-cinco5-oor-masmore-personas_2019_mapa_17763_spamembers_2019_map_17763_eng.pdf PDF]. [//centrodedescargas.cnig.es/CentroDescargas/busquedaRedirigida.do?ruta=PUBLICACION_CNIG_DATOS_VARIOS/aneTematico/Espana_HogaresSpain_Households-conwith-cinco5-oor-masmore-personas_2019_mapa_17763_spamembers_2019_map_17763_eng.zip DatosData]. [//interactivo-atlasnacional.ign.es/index.php#c=indicator&i=s17763.s17763&i2=c12131.c12131&t=A01&t2=A01&view=map9 Versión interactivaInteractive version].]]
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[[File:Logo MonografíaSpain_Healthy-life-years_2007-2018_map_18147_eng.jpg|left|thumb|300px|Map: Healthy life years. 2007-2018. Spain. [//centrodedescargas.cnig.es/CentroDescargas/busquedaRedirigida.do?ruta=PUBLICACION_CNIG_DATOS_VARIOS/aneTematico/Espana_EsperanzaSpain_Healthy-de-vida-enlife-buenayears_2007-salud_2007-2018_mapa_18147_spa2018_map_18147_eng.pdf PDF]. [//centrodedescargas.cnig.es/CentroDescargas/busquedaRedirigida.do?ruta=PUBLICACION_CNIG_DATOS_VARIOS/aneTematico/Espana_EsperanzaSpain_Healthy-de-vida-en-buenalife-salud_2007years_2007-2018_mapa_18147_spa2018_map_18147_eng.zip DatosData]. [//interactivo-atlasnacional.ign.es/index.php#c=indicator&i=c12628.c12628&t=A02&view=map10 Versión interactivaInteractive version].]]
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The national average of households with five or more members out of the total amount of households lies by 5.7% (see the map on [[:File:Spain_Households-with-5-or-more-members_2019_map_17763_eng.jpg| ''Households with 5 or more members'']]). The provinces of Almería and Murcia stand out as their figures rise to around 9%, whilst on the other end of the scale some provinces on the Northern Plateau, next to the Portuguese border as well as Asturias fall to around 4%. Figures in the rest of the country are similar to the national average.
The region is used as spatial unit of analysis on the map on [[:File:Spain_Healthy-life-years_2007-2018_map_18147_eng.jpg| ''Healthy life years'']]. A double point of view is taken into account, i.e. healthy life years at birth and at the age of 65. In the first case, a graph shows the evolution from 2007 to 2018 with very contrasting profiles that do not allow deducing well-defined spatial behaviours. In the second case, however, a larger extension of healthy life at the age of 65 seems to be detected in the northern hinterland as well as in Galicia, the Basque Country (Euskadi/País Vasco) and the Balearic Islands (Illes Balears).
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'''COPD'''[[File:Logo MonografíaSpain_Reported-prevalence-of-COPD-in-the-population-over-15-years-of-age_2017_map_17860_eng.jpg|left|thumb|300px|Map: Reportered Reported prevalence of COPD in the population over 15 years of age. 2017. Spain . [//centrodedescargas.cnig.es/CentroDescargas/busquedaRedirigida.do?ruta=PUBLICACION_CNIG_DATOS_VARIOS/aneTematico/Espana_PrevalenciaSpain_Reported-prevalence-of-deCOPD-obesidadin-enthe-lapopulation-poblacionover-mayor15-deyears-18of-anos_2017_mapa_17861_spaage_2017_map_17860_eng.pdf PDF]. [//centrodedescargas.cnig.es/CentroDescargas/busquedaRedirigida.do?ruta=PUBLICACION_CNIG_DATOS_VARIOS/aneTematico/Espana_PrevalenciaSpain_Reported-deprevalence-obesidadof-enCOPD-in-the-lapopulation-poblacionover-mayor15-deyears-18of-anos_2017_mapa_17861_spaage_2017_map_17860_eng.zip Data]. Interactive versions [//interactivo-atlasnacional.ign.es/index.php#c=indicator&i=r_122_tc12329.r_122_tc12329&st=TotalA02&view=map10 1] [//interactivo-atlasnacional.ign.es/index.php#c=indicator&i=c12328.c12328&t=A02&view=map10 Versión interactiva2] [//interactivo-atlasnacional.ign. es/index.php#c=indicator&i=c12327.c12327&t=A02&view=map10 3]. ]]
Chronic Obstructive Pulmonary Disease (COPD) does not appear to be a predisposing factor for SARS-CoV-2 infection. However, once infection occurs and the disease develops, there is an increased risk of hospital admission, admission to intensive care unit (ICU) and death. Furthermore, the respiratory symptoms of COVID-19 may sometimes be confused with COPD exacerbations, which may delay diagnosis and affect the clinical course. The underlying pathophysiological mechanism would be an increased expression of ACE2 receptors (to which the virus binds to penetrate the cell) in the bronchial epithelium, amongst others.
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'''HYPERTENSION'''[[File:Logo MonografíaSpain_Reported-prevalence-of-hypertension-in-the-population-over-15-years-of-age_2017_map_17862_eng.jpg|left|thumb|300px|Map: Reportered Reported prevalence of hypertension in the population over 15 yearsof age. 2017. Spain. [ //centrodedescargas.cnig.es/CentroDescargas/busquedaRedirigida.do?ruta=PUBLICACION_CNIG_DATOS_VARIOS/aneTematico/Spain_Reported-prevalence-of-hypertension-in-the-population-over-15-years-of-age_2017_map_17862_eng.pdf PDF]. [/ /centrodedescargas.cnig.es/CentroDescargas/busquedaRedirigida.do?ruta=PUBLICACION_CNIG_DATOS_VARIOS/aneTematico/Spain_Reported-prevalence-of-hypertension-in-the-population-over-15-years-of-age_2017_map_17862_eng.zip Data]. Interactive versions [//interactivo-atlasnacional.ign.es/index.php#c=indicator&i=r_123_tc12332.r_123_tc12332&st=TotalA02&view=map10 1] [//interactivo-atlasnacional.ign.es/index.php#c=indicator&i=c12331.c12331&t=A02&view=map10 Versión interactiva2] [//interactivo-atlasnacional.ign.es/index.php#c=indicator&i=c12333. c12333&t=A02&view=map10 3]. ]]
Hypertension is an important risk factor that has been discovered in 19% of patients with COVID-19 in Spain. The biological concept is based on its effect on the renin-angiotensin-aldosterone system and on angiotensin-converting enzyme 2 (ACE-2) overexpression.
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'''OBESITY'''[[File:Logo MonografíaSpain_Prevalence-of-obesity-in-the-population-over-18-years-of-age_2017_map_17861_eng.jpg|left|thumb|300px|Map: Prevalence of obesity in the population over 18 years of age. 2017. Spain. [ //centrodedescargas.cnig.es/CentroDescargas/busquedaRedirigida.do?ruta=PUBLICACION_CNIG_DATOS_VARIOS/aneTematico/Spain_Prevalence-of-obesity-in-the-population-over-18-years-of-age_2017_map_17861_eng.pdf PDF]. [/ /centrodedescargas.cnig.es/CentroDescargas/busquedaRedirigida.do?ruta=PUBLICACION_CNIG_DATOS_VARIOS/aneTematico/Spain_Prevalence-of-obesity-in-the-population-over-18-years-of-age_2017_map_17861_eng.zip Data]. Interactive versions [//interactivo-atlasnacional.ign.es/index.php#c=indicator&i=r_123_tc12363.r_123_tc12363&t=A02&view=map10 1] [//interactivo-atlasnacional.ign.es/index.php#c=indicator&si=Totalc12362.c12362&t=A02&view=map10 Versión interactiva2] [//interactivo-atlasnacional. ign.es/index.php#c=indicator&i=c12364.c12364&t=A02&view=map10 3].]]
Obesity is considered the epidemic of the 21st century, as its numbers are increasing in the adult population and, what is more worrying, in children. Being overweight/obese has been identified in numerous studies as a predictor of hospital admission and admission to the ICU, especially in patients under 65 years of age. The SEMI-COVID-19 registry shows its presence in 21% of patients.
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'''DIABETES'''[[File:Logo MonografíaSpain_Reported-prevalence-of-diabetes-in-the-population-over-15-years-of-age_2017_map_17863_eng.jpg|left|thumb|300px|Map: Reportered Reported prevalence of diabetes in the population over 15 yearsof age. 2017. Spain. [ //centrodedescargas.cnig.es/CentroDescargas/busquedaRedirigida.do?ruta=PUBLICACION_CNIG_DATOS_VARIOS/aneTematico/Spain_Reported-prevalence-of-diabetes-in-the-population-over-15-years-of-age_2017_map_17863_eng.pdf PDF]. [ //centrodedescargas.cnig.es/CentroDescargas/busquedaRedirigida.do?ruta=PUBLICACION_CNIG_DATOS_VARIOS/aneTematico/Spain_Reported-prevalence-of-diabetes-in-the-population-over-15-years-of-age_2017_map_17863_eng.zip Data]. Interactive versions [//interactivo-atlasnacional.ign.es/index.php#c=indicator&i=r_123_tc12369.r_123_tc12369&t=A02&view=map10 1] [//interactivo-atlasnacional.ign.es/index.php#c=indicator&si=Totalc12368.c12368&t=A02&view=map10 Versión interactiva2] [//interactivo-atlasnacional. ign.es/index.php#c=indicator&i=c12370.c12370&t=A02&view=map10 3].]]
This risk factor has been identified in 17% of the cases reported (8.9% of hospital admissions in Spain). It is clearly a higher risk factor for hospital admission, admission to the ICU and death. The biological mechanism on which this risk factor is based is that described for hypertension.
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'''HEART FAILURE'''[[File:Logo MonografíaSpain_Prevalence-of-heart-failure_2017_map_17868_eng.jpg|left|thumb|300px|Map: Prevalence of heart failure. 2017. Spain. [ //centrodedescargas.cnig.es/CentroDescargas/busquedaRedirigida.do?ruta=PUBLICACION_CNIG_DATOS_VARIOS/aneTematico/Spain_Prevalence-of-heart-failure_2017_map_17868_eng.pdf PDF]. [/ /centrodedescargas.cnig.es/CentroDescargas/busquedaRedirigida.do?ruta=PUBLICACION_CNIG_DATOS_VARIOS/aneTematico/Spain_Prevalence-of-heart-failure_2017_map_17868_eng.zip Data]. Interactive versions [//interactivo-atlasnacional.ign.es/index.php#c=indicator&i=r_123_tc12546.c12546&t=A02&view=map10 1] [//interactivo-atlasnacional.r_123_tign.es/index.php#c=indicator&si=Totalc12545.c12545&t=A02&view=map10 Versión interactiva2] [//interactivo-atlasnacional. ign.es/index.php#c=indicator&i=c12547.c12547&t=A02&view=map10 3].]]
Heart failure has been described, either under this term or as a cardiovascular disease, as the most prevalent risk factor in the population diagnosed with COVID-19 (up to 30%) and is present in more than 50% of COVID-19 patients admitted to the ICU in Spain, according to several studies. Its mechanism of action is the same as for diabetes and hypertension.
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'''CHRONIC KIDNEY DISEASE'''[[File:Logo MonografíaSpain_Prevalence-of-chronic-kidney-disease_2019_map_18373_eng.jpg|left|thumb|300px|Map: Prevalence of chronic kidney disease. 2019. Spain. [ //centrodedescargas.cnig.es/CentroDescargas/busquedaRedirigida.do?ruta=PUBLICACION_CNIG_DATOS_VARIOS/aneTematico/Spain_Prevalence-of-chronic-kidney-disease_2019_map_18373_eng.pdf PDF]. [/ /centrodedescargas.cnig.es/CentroDescargas/busquedaRedirigida.do?ruta=PUBLICACION_CNIG_DATOS_VARIOS/aneTematico/Spain_Prevalence-of-chronic-kidney-disease_2019_map_18373_eng.zip Data]. Interactive version [//interactivo-atlasnacional.ign.es/index.php#c=indicator&i=r_123_tc12867.c12867&t=A02&view=map10 1] [//interactivo-atlasnacional.ign.es/index.r_123_tphp#c=indicator&si=Totalc12866.c12866&t=A02&view=map10 Versión interactiva2] [//interactivo-atlasnacional.ign.es/index.php#c=indicator&i=c12868. c12868&t=A02&view=map10 3].]]
Chronic Kidney Disease (CKD) is included in the range of comorbidities that are associated with worse COVID-19 outcomes. Kidneys have ACE-2 receptors and are primarily involved in the renin-angiotensin-aldosterone system that regulates blood pressure. These are usually patients with added comorbidities, such as diabetes and hypertension, who have a weakened immune system.
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'''HIV-AIDS'''[[File:Logo MonografíaSpain_Prevalence-of-HIV-and-AIDS_2017_map_17869_eng.jpg|left|thumb|300px|Map: Prevalence of HIV and AIDS. 2017. Spain. [ //centrodedescargas.cnig.es/CentroDescargas/busquedaRedirigida.do?ruta=PUBLICACION_CNIG_DATOS_VARIOS/aneTematico/Spain_Prevalence-of-HIV-and-AIDS_2017_map_17869_eng.pdf PDF]. [/ /centrodedescargas.cnig.es/CentroDescargas/busquedaRedirigida.do?ruta=PUBLICACION_CNIG_DATOS_VARIOS/aneTematico/Spain_Prevalence-of-HIV-and-AIDS_2017_map_17869_eng.zip Data]. Interactive versions [//interactivo-atlasnacional.ign.es/index.php#c=indicator&i=r_123_tc12549.c12549&t=A02&view=map10 1] [//interactivo-atlasnacional.ign.es/index.r_123_tphp#c=indicator&si=Totalc12548.c12548&t=A02&view=map10 Versión interactiva2] [//interactivo-atlasnacional.ign.es/index.php#c=indicator&i=c12550. c12550&t=A02&view=map10 3].]]
HIV infection and AIDS diagnosis is not usually listed as a risk factor in most studies as such; immunodeficiency is. However, this term is very broad and difficult to define. So a pathology like VIH-AIDS, with a well-established information system and a clear impact on the immune system, especially cell-mediated immunity, was opted for in this study.
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