1. Clinical characteristics, management and in-hospital mortality of patients with coronavirus disease 2019 in Genoa, Italy.
- Author
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Vena A, Giacobbe DR, Di Biagio A, Mikulska M, Taramasso L, De Maria A, Ball L, Brunetti I, Loconte M, Patroniti NA, Robba C, Delfino E, Dentone C, Magnasco L, Nicolini L, Toscanini F, Bavastro M, Cerchiaro M, Barisione E, Giacomini M, Mora S, Baldi F, Balletto E, Berruti M, Briano F, Sepulcri C, Dettori S, Labate L, Mirabella M, Portunato F, Pincino R, Russo C, Tutino S, Pelosi P, and Bassetti M
- Subjects
- Aged, Aged, 80 and over, Betacoronavirus isolation & purification, COVID-19, COVID-19 Testing, Cause of Death, Clinical Laboratory Techniques, Coronavirus Infections drug therapy, Coronavirus Infections epidemiology, Coronavirus Infections therapy, Female, Hospital Mortality, Hospitalization, Humans, Italy epidemiology, Male, Middle Aged, Pandemics, Pneumonia, Viral epidemiology, Pneumonia, Viral therapy, Retrospective Studies, Risk Factors, SARS-CoV-2, COVID-19 Drug Treatment, Coronavirus Infections diagnosis, Coronavirus Infections mortality, Pneumonia, Viral diagnosis, Pneumonia, Viral mortality
- Abstract
Objectives: To describe clinical characteristics, management and outcome of individuals with coronavirus disease 2019 (COVID-19); and to evaluate risk factors for all-cause in-hospital mortality., Methods: This retrospective study from a University tertiary care hospital in northern Italy, included hospitalized adult patients with a diagnosis of COVID-19 between 25 February 2020 and 25 March 2020., Results: Overall, 317 individuals were enrolled. Their median age was 71 years and 67.2% were male (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, diarrhoea or nausea and vomiting was observed in 53/317 patients (16.7%). Hypokalaemia 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 OR 1.07; 95% 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., Conclusions: 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 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.)
- Published
- 2020
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