COVID-19 infections, hospitalizations, and morality in Navarre (Spain) between February 2020 and September 2022

Background. Between February 2020 and September 2022, SARS-CoV-2 has circulated uninterruptedly throughout Spain. This study analyses COVID-19 infections, hospitalizations, and deaths in Navarre. Methods. Enhanced epidemiological surveillance and results of seroepidemiological surveys were used to analyze COVID-19 in-fections, hospitalizations, and deaths, based on the vaccination coverage and other preventive measures applied from February 2020 to September 2022. Results. A total of 295,424 COVID-19 cases were confirmed (45% of the population in Navarre); 8,594 required hospital admis-sion (1.3%), 832 were admitted to intensive care units (1.3%o) and 1,725 died (2.6%o). Over the first wave of the pandemic, there were 1,934 hospitalizations and 529 deaths from confir-med COVID-19 cases over a few weeks; these figures dropped rapidly following lockdown. Until October 2021, SARS-CoV-2 circulation was modulated by non-pharmacological preventive measures. The subsequent relaxation of these measures led to a wide circulation of the omicron variant, increasing the number of cases by three-fold. The high vaccination coverage against COVID-19 introduced decisive changes in the epidemiology of the disease, reducing to less than 2%, 0.1%, and 0.5% the cases requiring hospitalization, intensive care unit admission, or that died, respectively. Conclusions. Initial lockdown and non-pharmacological pre-ventive measures helped control SARS-CoV-2 transmission until vaccination was extended. Vaccination achieved a decisive re-duction of the COVID-19 severity and lethality.