To describe clinical characteristics, management and outcome of COVID-19 patients; and to evaluate risk factors for all-cause in-hospital mortality.
This retrospective study from a University tertiary care hospital in northern Italy, included hospitalized adult patients with a diagnosis of COVID-19 between February 25, 2020 and March 25, 2020.
Overall, 317 patients were enrolled. Their median age 71 years and 67.2% were males (213/317). The most common underlying diseases were hypertension (149/317; 47.0%), cardiovascular disease (63/317, 19.9%) and diabetes (49/317; 15.5%). Common symptoms at the time of COVID-19 diagnosis included fever (285/317; 89.9%), shortness of breath (167/317; 52.7%) and dry cough (156/317,49.2%). An “atypical” presentation including at least one among mental confusion, diarrhea or nausea and vomiting was observed in 53/317 patients (16.7%). Hypokalemia occurred in 25.8% (78/302) and 18.5% (56/303) had acute kidney injury. During hospitalization, 111/317 patients (35.0%) received non-invasive respiratory support, 65/317 (20.5%) were admitted to the intensive care unit (ICU) and 60/317 (18.5%) required invasive mechanical ventilation. All cause in-hospital mortality, assessed in 275 patients, was 43.6% (120/275). On multivariable analysis, age (per-year increase odds ratio [OR]:1.07; 95% confidence interval [CI] 1.04-1.10, p<0.001), cardiovascular disease (OR:2.58; 95% CI 1.07-6.25; p=0.03), and C-reactive protein levels (per-point increase OR:1.009; 95% CI 1.004-1.014; p=0.001) were independent risk factors for all-cause in-hospital mortality.
COVID-19 mainly affected elderly patients with predisposing conditions and caused severe illness, frequently requiring non-invasive respiratory support or ICU admission. Despite supportive care, COVID-19 remains associated with a substantial risk of all-cause in-hospital mortality.
Copyright © 2020. Published by Elsevier Ltd.
About The Expert
Antonio Vena
Daniele Roberto Giacobbe
Antonio Di Biagio
Malgorzata Mikulska
Lucia Taramasso
Andrea De Maria
Lorenzo Ball
Iole Brunetti
Maurizio Loconte
Nicolò A Patroniti
Chiara Robba
Emanuele Delfino
Chiara Dentone
Laura Magnasco
Laura Nicolini
Federica Toscanini
Martina Bavastro
Matteo Cerchiaro
Emanuela Barisione
Mauro Giacomini
Sara Mora
Federico Baldi
Elisa Balletto
Marco Berruti
Federica Briano
Chiara Sepulcri
Silvia Dettori
Laura Labate
Michele Mirabella
Federica Portunato
Rachele Pincino
Chiara Russo
Stefania Tutino
Paolo Pelosi
Matteo Bassetti
References
PubMed