1. Early predictors of clinical outcomes of COVID-19 outbreak in Milan, Italy
- Author
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Maria Fazio, Giovanni Landoni, Eleonora Bossi, Stefano Franchini, Sergio Colombo, Luigi Beretta, Patrizia Rovere-Querini, Michele Carlucci, Anna Maria Scandroglio, Lorenzo Dagna, Andrea Poli, Gianvito Martino, Fabio Ciceri, Antonella Castagna, Alberto Ambrosio, Carlo Signorelli, Giacomo Monti, Caterina Conte, Massimo Clementi, Adriano Lazzarin, Francesco De Cobelli, Annalisa Ruggeri, Carlo Martinenghi, Cristina Tresoldi, Emanuele Bosi, Paolo Scarpellini, Efgeny Fominskiy, Alberto Zangrillo, Laura Galli, Moreno Tresoldi, Rebecca De Lorenzo, Massimo Locatelli, Marzia Spessot, Ciceri, F., Castagna, A., Rovere-Querini, P., De Cobelli, F., Ruggeri, A., Galli, L., Conte, C., De Lorenzo, R., Poli, A., Ambrosio, A., Signorelli, C., Bossi, E., Fazio, M., Tresoldi, C., Colombo, S., Monti, G., Fominskiy, E., Franchini, S., Spessot, M., Martinenghi, C., Carlucci, M., Beretta, L., Scandroglio, A. M., Clementi, M., Locatelli, M., Tresoldi, M., Scarpellini, P., Martino, G., Bosi, E., Dagna, L., Lazzarin, A., Landoni, G., and Zangrillo, A.
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Male ,0301 basic medicine ,ARDS ,RALE score ,Coronary Disease ,Comorbidity ,Disease ,Severe Acute Respiratory Syndrome ,Severity of Illness Index ,Infectious Disease Incubation Period ,Coronary artery disease ,0302 clinical medicine ,Risk Factors ,Immunology and Allergy ,Lymphocytes ,Age Factors ,Middle Aged ,Hospitalization ,Italy ,Hypertension ,Female ,Coronavirus Infections ,Infection ,medicine.medical_specialty ,Pneumonia, Viral ,Immunology ,Pulmonary Edema ,Article ,Betacoronavirus ,03 medical and health sciences ,Internal medicine ,Diabetes mellitus ,Severity of illness ,Diabetes Mellitus ,medicine ,Humans ,Lymphocyte Count ,Pandemics ,Survival analysis ,Aged ,SARS-CoV-2 ,business.industry ,COVID-19 ,Outbreak ,medicine.disease ,Survival Analysis ,030104 developmental biology ,Kidney Failure, Chronic ,business ,030215 immunology - Abstract
Background National health-system hospitals of Lombardy faced a heavy burden of admissions for acute respiratory distress syndromes associated with coronavirus disease (COVID-19). Data on patients of European origin affected by COVID-19 are limited. Methods All consecutive patients aged ≥18 years, coming from North-East of Milan's province and admitted at San Raffaele Hospital with COVID-19, between February 25th and March 24th, were reported, all patients were followed for at least one month. Clinical and radiological features at admission and predictors of clinical outcomes were evaluated. Results Of the 500 patients admitted to the Emergency Unit, 410 patients were hospitalized and analyzed: median age was 65 (IQR 56–75) years, and the majority of patients were males (72.9%). Median (IQR) days from COVID-19 symptoms onset was 8 (5–11) days. At hospital admission, fever (≥ 37.5 °C) was present in 67.5% of patients. Median oxygen saturation (SpO2) was 93% (range 60–99), with median PaO2/FiO2 ratio, 267 (IQR 184–314). Median Radiographic Assessment of Lung Edema (RALE) score was 9 (IQR 4–16). More than half of the patients (56.3%) had comorbidities, with hypertension, coronary heart disease, diabetes and chronic kidney failure being the most common. The probability of overall survival at day 28 was 66%. Multivariable analysis showed older age, coronary artery disease, cancer, low lymphocyte count and high RALE score as factors independently associated with an increased risk of mortality. Conclusion In a large cohort of COVID-19 patients of European origin, main risk factors for mortality were older age, comorbidities, low lymphocyte count and high RALE.
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- 2020
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