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1. Fatality rate and predictors of mortality in an Italian cohort of hospitalized COVID-19 patients

Author

Bellan, M, Patti, G, Hayden, E, Azzolina, D, Pirisi, M, Acquaviva, A, Aimaretti, G, Aluffi Valletti, P, Angilletta, R, Arioli, R, Avanzi, G, Avino, G, Balbo, P, Baldon, G, Baorda, F, Barbero, E, Baricich, A, Barini, M, Barone-Adesi, F, Battistini, S, Beltrame, M, Bertoli, M, Bertolin, S, Bertolotti, M, Betti, M, Bobbio, F, Boffano, P, Boglione, L, Borre, S, Brucoli, M, Calzaducca, E, Cammarata, E, Cantaluppi, V, Cantello, R, Capponi, A, Carriero, A, Casciaro, F, Castello, L, Ceruti, F, Chichino, G, Chirico, E, Cisari, C, Cittone, M, Colombo, C, Comi, C, Croce, E, Daffara, T, Danna, P, Della Corte, F, De Vecchi, S, Dianzani, U, Di Benedetto, D, Esposto, E, Faggiano, F, Falaschi, Z, Ferrante, D, Ferrero, A, Gagliardi, I, Gaidano, G, Galbiati, A, Gallo, S, Garavelli, P, Gardino, C, Garzaro, M, Gastaldello, M, Gavelli, F, Gennari, A, Giacomini, G, Giacone, I, Giai Via, V, Giolitti, F, Gironi, L, Gramaglia, C, Grisafi, L, Inserra, I, Invernizzi, M, Krengli, M, Labella, E, Landi, I, Landi, R, Leone, I, Lio, V, Lorenzini, L, Maconi, A, Malerba, M, Manfredi, G, Martelli, M, Marzari, L, Marzullo, P, Mennuni, M, Montabone, C, Morosini, U, Mussa, M, Nerici, I, Nuzzo, A, Olivieri, C, Padelli, S, Panella, M, Parisini, A, Pasche, A, Pau, A, Pedrinelli, A, Percivale, I, Re, R, Rigamonti, C, Rizzi, E, Rognoni, A, Roveta, A, Salamina, L, Santagostino, M, Saraceno, M, Savoia, P, Sciarra, M, Schimmenti, A, Scotti, L, Spinoni, E, Smirne, C, Tarantino, V, Tillio, P, Vaschetto, R, Vassia, V, Zagaria, D, Zavattaro, E, Zeppegno, P, Zottarelli, F, Sainaghi, P, Bellan M., Patti G., Hayden E., Azzolina D., Pirisi M., Acquaviva A., Aimaretti G., Aluffi Valletti P., Angilletta R., Arioli R., Avanzi G. C., Avino G., Balbo P. E., Baldon G., Baorda F., Barbero E., Baricich A., Barini M., Barone-Adesi F., Battistini S., Beltrame M., Bertoli M., Bertolin S., Bertolotti M., Betti M., Bobbio F., Boffano P., Boglione L., Borre S., Brucoli M., Calzaducca E., Cammarata E., Cantaluppi V., Cantello R., Capponi A., Carriero A., Casciaro F. G., Castello L. M., Ceruti F., Chichino G., Chirico E., Cisari C., Cittone M. G., Colombo C., Comi C., Croce E., Daffara T., Danna P., Della Corte F., De Vecchi S., Dianzani U., Di Benedetto D., Esposto E., Faggiano F., Falaschi Z., Ferrante D., Ferrero A., Gagliardi I., Gaidano G., Galbiati A., Gallo S., Garavelli P. L., Gardino C. A., Garzaro M., Gastaldello M. L., Gavelli F., Gennari A., Giacomini G. M., Giacone I., Giai Via V., Giolitti F., Gironi L. C., Gramaglia C., Grisafi L., Inserra I., Invernizzi M., Krengli M., Labella E., Landi I. C., Landi R., Leone I., Lio V., Lorenzini L., Maconi A., Malerba M., Manfredi G. F., Martelli M., Marzari L., Marzullo P., Mennuni M., Montabone C., Morosini U., Mussa M., Nerici I., Nuzzo A., Olivieri C., Padelli S. A., Panella M., Parisini A., Pasche A., Pau A., Pedrinelli A. R., Percivale I., Re R., Rigamonti C., Rizzi E., Rognoni A., Roveta A., Salamina L., Santagostino M., Saraceno M., Savoia P., Sciarra M., Schimmenti A., Scotti L., Spinoni E., Smirne C., Tarantino V., Tillio P. A., Vaschetto R., Vassia V., Zagaria D., Zavattaro E., Zeppegno P., Zottarelli F., Sainaghi P. P., Bellan, M, Patti, G, Hayden, E, Azzolina, D, Pirisi, M, Acquaviva, A, Aimaretti, G, Aluffi Valletti, P, Angilletta, R, Arioli, R, Avanzi, G, Avino, G, Balbo, P, Baldon, G, Baorda, F, Barbero, E, Baricich, A, Barini, M, Barone-Adesi, F, Battistini, S, Beltrame, M, Bertoli, M, Bertolin, S, Bertolotti, M, Betti, M, Bobbio, F, Boffano, P, Boglione, L, Borre, S, Brucoli, M, Calzaducca, E, Cammarata, E, Cantaluppi, V, Cantello, R, Capponi, A, Carriero, A, Casciaro, F, Castello, L, Ceruti, F, Chichino, G, Chirico, E, Cisari, C, Cittone, M, Colombo, C, Comi, C, Croce, E, Daffara, T, Danna, P, Della Corte, F, De Vecchi, S, Dianzani, U, Di Benedetto, D, Esposto, E, Faggiano, F, Falaschi, Z, Ferrante, D, Ferrero, A, Gagliardi, I, Gaidano, G, Galbiati, A, Gallo, S, Garavelli, P, Gardino, C, Garzaro, M, Gastaldello, M, Gavelli, F, Gennari, A, Giacomini, G, Giacone, I, Giai Via, V, Giolitti, F, Gironi, L, Gramaglia, C, Grisafi, L, Inserra, I, Invernizzi, M, Krengli, M, Labella, E, Landi, I, Landi, R, Leone, I, Lio, V, Lorenzini, L, Maconi, A, Malerba, M, Manfredi, G, Martelli, M, Marzari, L, Marzullo, P, Mennuni, M, Montabone, C, Morosini, U, Mussa, M, Nerici, I, Nuzzo, A, Olivieri, C, Padelli, S, Panella, M, Parisini, A, Pasche, A, Pau, A, Pedrinelli, A, Percivale, I, Re, R, Rigamonti, C, Rizzi, E, Rognoni, A, Roveta, A, Salamina, L, Santagostino, M, Saraceno, M, Savoia, P, Sciarra, M, Schimmenti, A, Scotti, L, Spinoni, E, Smirne, C, Tarantino, V, Tillio, P, Vaschetto, R, Vassia, V, Zagaria, D, Zavattaro, E, Zeppegno, P, Zottarelli, F, Sainaghi, P, Bellan M., Patti G., Hayden E., Azzolina D., Pirisi M., Acquaviva A., Aimaretti G., Aluffi Valletti P., Angilletta R., Arioli R., Avanzi G. C., Avino G., Balbo P. E., Baldon G., Baorda F., Barbero E., Baricich A., Barini M., Barone-Adesi F., Battistini S., Beltrame M., Bertoli M., Bertolin S., Bertolotti M., Betti M., Bobbio F., Boffano P., Boglione L., Borre S., Brucoli M., Calzaducca E., Cammarata E., Cantaluppi V., Cantello R., Capponi A., Carriero A., Casciaro F. G., Castello L. M., Ceruti F., Chichino G., Chirico E., Cisari C., Cittone M. G., Colombo C., Comi C., Croce E., Daffara T., Danna P., Della Corte F., De Vecchi S., Dianzani U., Di Benedetto D., Esposto E., Faggiano F., Falaschi Z., Ferrante D., Ferrero A., Gagliardi I., Gaidano G., Galbiati A., Gallo S., Garavelli P. L., Gardino C. A., Garzaro M., Gastaldello M. L., Gavelli F., Gennari A., Giacomini G. M., Giacone I., Giai Via V., Giolitti F., Gironi L. C., Gramaglia C., Grisafi L., Inserra I., Invernizzi M., Krengli M., Labella E., Landi I. C., Landi R., Leone I., Lio V., Lorenzini L., Maconi A., Malerba M., Manfredi G. F., Martelli M., Marzari L., Marzullo P., Mennuni M., Montabone C., Morosini U., Mussa M., Nerici I., Nuzzo A., Olivieri C., Padelli S. A., Panella M., Parisini A., Pasche A., Pau A., Pedrinelli A. R., Percivale I., Re R., Rigamonti C., Rizzi E., Rognoni A., Roveta A., Salamina L., Santagostino M., Saraceno M., Savoia P., Sciarra M., Schimmenti A., Scotti L., Spinoni E., Smirne C., Tarantino V., Tillio P. A., Vaschetto R., Vassia V., Zagaria D., Zavattaro E., Zeppegno P., Zottarelli F., and Sainaghi P. P.

Abstract

Clinical features and natural history of coronavirus disease 2019 (COVID-19) differ widely among different countries and during different phases of the pandemia. Here, we aimed to evaluate the case fatality rate (CFR) and to identify predictors of mortality in a cohort of COVID-19 patients admitted to three hospitals of Northern Italy between March 1 and April 28, 2020. All these patients had a confirmed diagnosis of SARS-CoV-2 infection by molecular methods. During the study period 504/1697 patients died; thus, overall CFR was 29.7%. We looked for predictors of mortality in a subgroup of 486 patients (239 males, 59%; median age 71 years) for whom sufficient clinical data were available at data cut-off. Among the demographic and clinical variables considered, age, a diagnosis of cancer, obesity and current smoking independently predicted mortality. When laboratory data were added to the model in a further subgroup of patients, age, the diagnosis of cancer, and the baseline PaO2/FiO2 ratio were identified as independent predictors of mortality. In conclusion, the CFR of hospitalized patients in Northern Italy during the ascending phase of the COVID-19 pandemic approached 30%. The identification of mortality predictors might contribute to better stratification of individual patient risk.

Published
2020

2. Simple parameters from complete blood count predict in-hospital mortality in covid-19

Author

Bellan, M., Azzolina, D., Hayden, E., Gaidano, G., Pirisi, M., Acquaviva, A., Aimaretti, G., Valletti, P. A., Angilletta, R., Arioli, R., Avanzi, G. C., Avino, G., Balbo, P. E., Baldon, G., Baorda, F., Barbero, E., Baricich, A., Barini, M., Barone-Adesi, F., Battistini, S., Beltrame, M., Bertoli, M., Bertolin, S., Bertolotti, M., Betti, M., Bobbio, F., Boffano, P., Boglione, L., Borre, S., Brucoli, M., Calzaducca, E., Cammarata, E., Cantaluppi, V., Cantello, R., Capponi, A., Carriero, A., Casciaro, G. F., Castello, L. M., Ceruti, F., Chichino, G., Chirico, E., Cisari, C., Cittone, M. G., Colombo, C., Comi, C., Croce, E., Daffara, T., Danna, P., Corte, F. D., de Vecchi, S., Dianzani, U., Benedetto, D. D., Esposto, E., Faggiano, F., Falaschi, Z., Ferrante, D., Ferrero, A., Gagliardi, I., Galbiati, A., Gallo, S., Garavelli, P. L., Gardino, C. A., Garzaro, M., Gastaldello, M. L., Gavelli, F., Gennari, A., Giacomini, G. M., Giacone, I., Via, V. G., Giolitti, F., Gironi, L. C., Gramaglia, C., Grisafi, L., Inserra, I., Invernizzi, M., Krengli, M., Labella, E., Landi, I. C., Landi, R., Leone, I., Lio, V., Lorenzini, L., Maconi, A., Malerba, M., Manfredi, G. F., Martelli, M., Marzari, L., Marzullo, P., Mennuni, M., Montabone, C., Morosini, U., Mussa, M., Nerici, I., Nuzzo, A., Olivieri, C., Padelli, S. A., Panella, M., Parisini, A., Pasche, A., Patrucco, F., Patti, G., Pau, A., Pedrinelli, A. R., Percivale, I., Ragazzoni, L., Re, R., Rigamonti, C., Rizzi, E., Rognoni, A., Roveta, A., Salamina, L., Santagostino, M., Saraceno, M., Savoia, P., Sciarra, M., Schimmenti, A., Scotti, L., Spinoni, E., Smirne, C., Tarantino, V., Tillio, P. A., Tonello, S., Vaschetto, R., Vassia, V., Zagaria, D., Zavattaro, E., Zeppegno, P., Zottarelli, F., Sainaghi, P. P., Aiosa, G., Airoldi, A., Barco, A., Bargiacchi, O., Bazzano, S., Berni, P., Bianchi, B., Bianco, S., Biffi, S., Binda, V., Bolgeo, T., Bolla, C., Bonato, V., Bonizzoni, G., Bragantini, A., Brustia, D., Bullara, V., Burlone, M., Brustia, F., Caccia, S., Calareso, A., Cammarota, G., Cancelliere, L., Carbone, R., Cassinari, A., Ceriani, E., Cena, T., Clivati, E., Collimedaglia, L., Colombatto, A., Cornella, C., Costanzo, M., Croce, A., de Benedittis, C., Delorenzi, S., Dionisio, R., Donato, P., Esposito, M., Fangazio, S., Feggi, A., Ferrillo, S., Foci, V., Fra, G. P., Gaggino, C., Gambaro, E., Gattoni, E., Gattoni, L., Giacchero, F., Gianfreda, R., Giubertoni, A., Grecu, L., Grossi, F., Guglielmetti, G., Guido, S., Iannantuoni, G., Ingrao, S., Jona, A., Lazzarich, E., Lissandrin, R., Maduli, E., Magne, F., Mantia, E., Marangon, D., Massara, M., Matino, E., Mauri, M. G., Menegatti, M., Moglia, R., Molinari, R., Morelli, S., Morlino, P., Naldi, P., Nebbiolo, C., Omodeo, P., Palmieri, D., Panero, A., Parodi, M., Pedrazzoli, R., Pelazza, C., Penpa, S., Perucca, R., Pirovano, A., Pittau, S., Pochetti, P., Poletti, F., Polla, B., Prandi, P., Prodam, F., Prosperini, P., Puma, A., Quaglia, M., Raie, A., Rapetti, R., Ravera, S., Re, A., Reale, M., Rossati, A., Rossi, M., Rossi, P., Rostagno, R., Salomoni, G., Sama, M. T., Sarchi, E., Sarcoli, M., Sarda, C., Sguazzotti, I., Soddu, D., Sola, D., Stobbione, P., Todoerti, M., Vallese, G. C., Varrasi, C., Veia, A., Vignazia, G. L., Zanotti, I., Zecca, E., Zichittella, D., Zisa, G., and Zoppis, E.

Subjects
Adult, Male, medicine.medical_specialty, Medicine (General), Multivariate analysis, Article Subject, Clinical Decision Rules, COVID-19, Prognosis, Blood Cell Count, Hospital Mortality, Severity of Illness Index, Clinical Biochemistry, Asymptomatic, Severity of Illness Index, NO, R5-920, Internal medicine, Clinical Decision Rules, Severity of illness, Genetics, 80 and over, Medicine, Humans, Hospital Mortality, Molecular Biology, Aged, Retrospective Studies, Aged, 80 and over, medicine.diagnostic_test, business.industry, Biochemistry (medical), Complete blood count, COVID-19, Retrospective cohort study, Red blood cell distribution width, General Medicine, Odds ratio, Middle Aged, Prognosis, Female, Italy, Multivariate Analysis, Blood Cell Count, Cohort, medicine.symptom, business, Research Article
Abstract

Introduction. The clinical course of Coronavirus Disease 2019 (COVID-19) is highly heterogenous, ranging from asymptomatic to fatal forms. The identification of clinical and laboratory predictors of poor prognosis may assist clinicians in monitoring strategies and therapeutic decisions. Materials and Methods. In this study, we retrospectively assessed the prognostic value of a simple tool, the complete blood count, on a cohort of 664 patients ( F 260; 39%, median age 70 (56-81) years) hospitalized for COVID-19 in Northern Italy. We collected demographic data along with complete blood cell count; moreover, the outcome of the hospital in-stay was recorded. Results. At data cut-off, 221/664 patients (33.3%) had died and 453/664 (66.7%) had been discharged. Red cell distribution width (RDW) ( χ 2 10.4; p < 0.001 ), neutrophil-to-lymphocyte (NL) ratio ( χ 2 7.6; p = 0.006 ), and platelet count ( χ 2 5.39; p = 0.02 ), along with age ( χ 2 87.6; p < 0.001 ) and gender ( χ 2 17.3; p < 0.001 ), accurately predicted in-hospital mortality. Hemoglobin levels were not associated with mortality. We also identified the best cut-off for mortality prediction: a NL ratio > 4.68 was characterized by an odds ratio for in-hospital mortality OR = 3.40 (2.40-4.82), while the OR for a RDW > 13.7 % was 4.09 (2.87-5.83); a platelet count > 166,000 /μL was, conversely, protective (OR: 0.45 (0.32-0.63)). Conclusion. Our findings arise the opportunity of stratifying COVID-19 severity according to simple lab parameters, which may drive clinical decisions about monitoring and treatment.

Published
2021

3. Il differimento dell'effetto traslativo dal diritto civile al diritto tributario

Author

Mazzamuto, S., Labella, E., Rota, G., Nicolussi, A., Barletta, A., Mariani, C., Cervasi, C, Orsenigo, L, Albanese, A., Allena M, Bandera, L., Mazzamuto S., Allena, Marco, Allena, Marco (ORCID:0000-0002-5032-3006), Mazzamuto, S., Labella, E., Rota, G., Nicolussi, A., Barletta, A., Mariani, C., Cervasi, C, Orsenigo, L, Albanese, A., Allena M, Bandera, L., Mazzamuto S., Allena, Marco, and Allena, Marco (ORCID:0000-0002-5032-3006)

Abstract

Differimento dell'effetto traslativo dal diritto civile al diritto tributario

Published
2016

4. Rent to buy, leasing immobiliare e vendita con riserva della proprietà. Profili civilistici, processuali e tributari

Author

Albanese, Antonio (ORCID:0000-0002-3897-5810), Mazzamuto, S, Labella E, Rota G, Nicolussi A, Barletta A, Mariani C, Cervasi C, Orsenigo L, Albanese A, Allena M, Bandera L., Albanese, Antonio, Albanese, Antonio (ORCID:0000-0002-3897-5810), Mazzamuto, S, Labella E, Rota G, Nicolussi A, Barletta A, Mariani C, Cervasi C, Orsenigo L, Albanese A, Allena M, Bandera L., and Albanese, Antonio

Abstract

I saggi raccolti nel volume esaminano da una prospettiva multidisciplinare alcune figure contrattuali, che consentono ad una parte di acquisire il godimento di un bene immobile prima del pagamento integrale del prezzo, rinviando a tale momento il trasferimento della proprietà, a garanzia del creditore. Accanto alle nuove fattispecie dei contratti di godimento in funzione della successiva alienazione (c.d. rent to buy), vengono in considerazione il leasing e la vendita con rise4rva della proprietà. In questo ambito l'opera si propone di mettere a confronto, attraverso un dialogo costruttivo tra teoria e pratica, i punti di vista del diritto civile, del diritto tributario e del diritto processuale civile.

Published
2016

5. Fatality rate and predictors of mortality in an Italian cohort of hospitalized COVID-19 patients

Author

Lucio Boglione, Irene Cecilia Landi, Marinella Bertolotti, Alessandra Galbiati, Luca Lorenzini, Carlo Cisari, Luigia Salamina, Matteo Brucoli, Irene Giacone, Carlo Olivieri, Flavio Bobbio, Marta Betti, Maria Martelli, Paolo Amedeo Tillio, Vanessa Tarantino, Anita R. Pedrinelli, Mario Pirisi, Pietro Luigi Garavelli, Eleonora Croce, Alessandra Gennari, Francesca Zottarelli, Pietro Danna, Marco Invernizzi, Antonio Maconi, Francesca Giolitti, Sofia Battistini, Paolo Marzullo, Roberta Re, Domenico Zagaria, Francesco Gavelli, Federico Ceruti, Ilaria Leone, Greta Maria Giacomini, Leonardo Grisafi, Andrea Parisini, Stephanie Bertolin, Elia Esposto, Vincenzo Cantaluppi, Mattia Bellan, Giuseppe Patti, Emilio Chirico, Matteo Bertoli, Paolo Boffano, Paolo Aluffi Valletti, Alessandro Carriero, Cristoforo Comi, Umberto Dianzani, Eleonora Rizzi, Massimiliano Panella, Marco Sciarra, Edoardo Cammarata, Letizia Marzari, Elisa Zavattaro, Claudia Montabone, Gian Carlo Avanzi, Samuel Alberto Padelli, Massimiliano Garzaro, Pier Paolo Sainaghi, Francesco Barone-Adesi, Carlo Smirne, Gianluca Gaidano, Michela Barini, Francesco Giuseppe Casciaro, Ilaria Inserra, Laura Cristina Gironi, Ilaria Nerici, Clara Ada Gardino, Maria Luisa Gastaldello, Micol Giulia Cittone, Marco Mussa, Umberto Morosini, Andrea Capponi, Davide Di Benedetto, Fabrizio Faggiano, Crizia Colombo, Andrea Rognoni, Elisa Calzaducca, Alessio Paschè, Annalisa Roveta, Gianluca Aimaretti, Roberto Arioli, Giulia Baldon, Roberto Cantello, Ilaria Percivale, Piero Emilio Balbo, Emanuela Barbero, Silvio Borrè, Luigi Mario Castello, Patrizia Zeppegno, Ileana Gagliardi, Emanuela Labella, Alice Ferrero, Marco Krengli, Silvia Gallo, Andrea Schimmenti, Tommaso Daffara, Raffaella Landi, Paola Savoia, Giulia Francesca Manfredi, Valentina Giai Via, Michela Beltrame, Eyal Hayden, Enrico Guido Spinoni, Francesca Baorda, Cristina Rigamonti, Alessandro Nuzzo, Mario Malerba, Carla Gramaglia, Rosanna Vaschetto, Massimo Saraceno, Gianluca Avino, Marco G. Mennuni, Daniela Ferrante, Guido Chichino, Danila Azzolina, Alessio Baricich, Veronica Lio, Veronica Vassia, Alberto Pau, Roberto Angilletta, Simona De Vecchi, Antonio Acquaviva, Lorenza Scotti, Francesco Della Corte, Matteo Santagostino, Zeno Falaschi, Bellan, M, Patti, G, Hayden, E, Azzolina, D, Pirisi, M, Acquaviva, A, Aimaretti, G, Aluffi Valletti, P, Angilletta, R, Arioli, R, Avanzi, G, Avino, G, Balbo, P, Baldon, G, Baorda, F, Barbero, E, Baricich, A, Barini, M, Barone-Adesi, F, Battistini, S, Beltrame, M, Bertoli, M, Bertolin, S, Bertolotti, M, Betti, M, Bobbio, F, Boffano, P, Boglione, L, Borre, S, Brucoli, M, Calzaducca, E, Cammarata, E, Cantaluppi, V, Cantello, R, Capponi, A, Carriero, A, Casciaro, F, Castello, L, Ceruti, F, Chichino, G, Chirico, E, Cisari, C, Cittone, M, Colombo, C, Comi, C, Croce, E, Daffara, T, Danna, P, Della Corte, F, De Vecchi, S, Dianzani, U, Di Benedetto, D, Esposto, E, Faggiano, F, Falaschi, Z, Ferrante, D, Ferrero, A, Gagliardi, I, Gaidano, G, Galbiati, A, Gallo, S, Garavelli, P, Gardino, C, Garzaro, M, Gastaldello, M, Gavelli, F, Gennari, A, Giacomini, G, Giacone, I, Giai Via, V, Giolitti, F, Gironi, L, Gramaglia, C, Grisafi, L, Inserra, I, Invernizzi, M, Krengli, M, Labella, E, Landi, I, Landi, R, Leone, I, Lio, V, Lorenzini, L, Maconi, A, Malerba, M, Manfredi, G, Martelli, M, Marzari, L, Marzullo, P, Mennuni, M, Montabone, C, Morosini, U, Mussa, M, Nerici, I, Nuzzo, A, Olivieri, C, Padelli, S, Panella, M, Parisini, A, Pasche, A, Pau, A, Pedrinelli, A, Percivale, I, Re, R, Rigamonti, C, Rizzi, E, Rognoni, A, Roveta, A, Salamina, L, Santagostino, M, Saraceno, M, Savoia, P, Sciarra, M, Schimmenti, A, Scotti, L, Spinoni, E, Smirne, C, Tarantino, V, Tillio, P, Vaschetto, R, Vassia, V, Zagaria, D, Zavattaro, E, Zeppegno, P, Zottarelli, F, and Sainaghi, P

Subjects
Male, COVID-19, Viral infection, Risk factors, lcsh:Medicine, Comorbidity, Sex Factor, 030204 cardiovascular system & hematology, 0302 clinical medicine, Retrospective Studie, Case fatality rate, Pandemic, Age Factor, 030212 general & internal medicine, lcsh:Science, clinical characteristics, Aged, 80 and over, Multidisciplinary, Reverse Transcriptase Polymerase Chain Reaction, Smoking, Age Factors, Middle Aged, Coronavirus disease, Natural history, Survival Rate, Italy, Cohort, Female, Human, medicine.medical_specialty, Article, NO, 03 medical and health sciences, Sex Factors, Internal medicine, medicine, Humans, Pandemics, Survival rate, Retrospective Studies, Aged, business.industry, SARS-CoV-2, Risk Factor, lcsh:R, Retrospective cohort study, Length of Stay, medicine.disease, Obesity, lcsh:Q, Coronavirus disease, clinical characteristics, business
Abstract

Clinical features and natural history of coronavirus disease 2019 (COVID-19) differ widely among different countries and during different phases of the pandemia. Here, we aimed to evaluate the case fatality rate (CFR) and to identify predictors of mortality in a cohort of COVID-19 patients admitted to three hospitals of Northern Italy between March 1 and April 28, 2020. All these patients had a confirmed diagnosis of SARS-CoV-2 infection by molecular methods. During the study period 504/1697 patients died; thus, overall CFR was 29.7%. We looked for predictors of mortality in a subgroup of 486 patients (239 males, 59%; median age 71 years) for whom sufficient clinical data were available at data cut-off. Among the demographic and clinical variables considered, age, a diagnosis of cancer, obesity and current smoking independently predicted mortality. When laboratory data were added to the model in a further subgroup of patients, age, the diagnosis of cancer, and the baseline PaO2/FiO2 ratio were identified as independent predictors of mortality. In conclusion, the CFR of hospitalized patients in Northern Italy during the ascending phase of the COVID-19 pandemic approached 30%. The identification of mortality predictors might contribute to better stratification of individual patient risk.

Published
2020

6. An Optofluidic Young Interferometer for Electrokinetic Transport-Coupled Biosensing.

Author

Labella E and Gupta R

Abstract

Label-free optical biosensors, such as interferometers, can provide a comparable limit of detection to widely used enzyme-linked immunosorbent assays while minimizing the number of steps and reducing false positives/negatives. In 2020, the authors reported on a novel optofluidic Young interferometer (YI) that could provide real-time spatial information on refractive index changes occurring along the length of the sensor and reference channels. Herein, we exploit these features of the YI to study interactions of biomolecules with recognition elements immobilized in selected regions of agarose gel in the sensor channel. We show that the YI is well suited for the biosensing of an exemplar biomolecule, streptavidin, in the absence and presence of the bovine serum albumin interferent. Equally, we couple the YI with electrokinetic transport to reduce the time needed for biosensing.

Published
2024
Full Text
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7. Pattern of Emergency Department referral during the COVID-19 outbreak in Italy.

Author

Bellan M, Gavelli F, Hayden E, Patrucco F, Soddu D, Pedrinelli AR, Cittone MG, Rizzi E, Casciaro GF, Vassia V, Landi R, Menegatti M, Gastaldello ML, Beltrame M, Labella E, Tonello S, Avanzi GC, Pirisi M, Castello LM, and Sainaghi PP

Subjects
Adolescent, Adult, Aged, Aged, 80 and over, Emergency Service, Hospital trends, Female, Health Services Accessibility, Humans, Italy epidemiology, Male, Middle Aged, Pandemics, Referral and Consultation trends, Retrospective Studies, SARS-CoV-2, COVID-19 epidemiology, Disease Outbreaks, Emergency Service, Hospital statistics & numerical data, Referral and Consultation statistics & numerical data
Abstract

Background: The Coronavirus disease (COVID-19) outbreak is putting the European National Health Systems under pressure. Interestingly, Emergency Department (ED) referrals for other reasons than COVID-19 seem to have declined steeply. In the present paper, we aimed to verify how the COVID-19 outbreak changed ED referral pattern., Methods: We retrospectively reviewed the clinical records of patients referred to the ED of a University Hospital in Northern Italy from 1 March to 13 April 2020. We compared the following data with those belonging to the same period in 2019: number of EDs accesses, rate of hospital admission, frequencies of the most common causes of ED referral, priority codes of access., Results: The number of ED referrals during the COVID-19 outbreak was markedly reduced when compared to the same period in 2019 (3059 vs. 5691; -46.3%). Conversely, the rate of hospital admission raised from 16.9% to 35.4% (P<0.0001), with a shift toward higher priority codes of ED admission. In 2020, we observed both a reduction of the number of patients referred for both traumatic (513, 16.8% vs. 1544, 27.1%; χ 2 =118.7, P<0.0001) and non-traumatic (4147 vs. 2546) conditions. Among the latter, suspected COVID-19 accounted for 1101 (43.2%) accesses., Conclusions: The COVID-19 pandemic completely changed the pattern of ED referral in Italy, with a marked reduction of the accesses to the hospitals. This could be related to a limited exposure to traumas and to a common fear of being infected during EDs in-stay. This may limit the misuse of EDs for non-urgent conditions but may also delay proper referrals for urgent conditions.

Published
2021
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8. Simple Parameters from Complete Blood Count Predict In-Hospital Mortality in COVID-19.

Author

Bellan M, Azzolina D, Hayden E, Gaidano G, Pirisi M, Acquaviva A, Aimaretti G, Aluffi Valletti P, Angilletta R, Arioli R, Avanzi GC, Avino G, Balbo PE, Baldon G, Baorda F, Barbero E, Baricich A, Barini M, Barone-Adesi F, Battistini S, Beltrame M, Bertoli M, Bertolin S, Bertolotti M, Betti M, Bobbio F, Boffano P, Boglione L, Borrè S, Brucoli M, Calzaducca E, Cammarata E, Cantaluppi V, Cantello R, Capponi A, Carriero A, Casciaro GF, Castello LM, Ceruti F, Chichino G, Chirico E, Cisari C, Cittone MG, Colombo C, Comi C, Croce E, Daffara T, Danna P, Della Corte F, De Vecchi S, Dianzani U, Di Benedetto D, Esposto E, Faggiano F, Falaschi Z, Ferrante D, Ferrero A, Gagliardi I, Galbiati A, Gallo S, Garavelli PL, Gardino CA, Garzaro M, Gastaldello ML, Gavelli F, Gennari A, Giacomini GM, Giacone I, Giai Via V, Giolitti F, Gironi LC, Gramaglia C, Grisafi L, Inserra I, Invernizzi M, Krengli M, Labella E, Landi IC, Landi R, Leone I, Lio V, Lorenzini L, Maconi A, Malerba M, Manfredi GF, Martelli M, Marzari L, Marzullo P, Mennuni M, Montabone C, Morosini U, Mussa M, Nerici I, Nuzzo A, Olivieri C, Padelli SA, Panella M, Parisini A, Paschè A, Patrucco F, Patti G, Pau A, Pedrinelli AR, Percivale I, Ragazzoni L, Re R, Rigamonti C, Rizzi E, Rognoni A, Roveta A, Salamina L, Santagostino M, Saraceno M, Savoia P, Sciarra M, Schimmenti A, Scotti L, Spinoni E, Smirne C, Tarantino V, Tillio PA, Tonello S, Vaschetto R, Vassia V, Zagaria D, Zavattaro E, Zeppegno P, Zottarelli F, and Sainaghi PP

Subjects
Adult, Aged, Aged, 80 and over, COVID-19 diagnosis, Female, Humans, Italy epidemiology, Male, Middle Aged, Multivariate Analysis, Prognosis, Retrospective Studies, Blood Cell Count, COVID-19 blood, COVID-19 mortality, Clinical Decision Rules, Hospital Mortality, Severity of Illness Index
Abstract

Introduction: The clinical course of Coronavirus Disease 2019 (COVID-19) is highly heterogenous, ranging from asymptomatic to fatal forms. The identification of clinical and laboratory predictors of poor prognosis may assist clinicians in monitoring strategies and therapeutic decisions., Materials and Methods: In this study, we retrospectively assessed the prognostic value of a simple tool, the complete blood count, on a cohort of 664 patients ( F 260; 39%, median age 70 (56-81) years) hospitalized for COVID-19 in Northern Italy. We collected demographic data along with complete blood cell count; moreover, the outcome of the hospital in-stay was recorded., Results: At data cut-off, 221/664 patients (33.3%) had died and 453/664 (66.7%) had been discharged. Red cell distribution width (RDW) ( χ 2 10.4; p < 0.001), neutrophil-to-lymphocyte (NL) ratio ( χ 2 7.6; p = 0.006), and platelet count ( χ 2 5.39; p = 0.02), along with age ( χ 2 87.6; p < 0.001) and gender ( χ 2 17.3; p < 0.001), accurately predicted in-hospital mortality. Hemoglobin levels were not associated with mortality. We also identified the best cut-off for mortality prediction: a NL ratio > 4.68 was characterized by an odds ratio for in-hospital mortality (OR) = 3.40 (2.40-4.82), while the OR for a RDW > 13.7% was 4.09 (2.87-5.83); a platelet count > 166,000/ μ L was, conversely, protective (OR: 0.45 (0.32-0.63))., Conclusion: Our findings arise the opportunity of stratifying COVID-19 severity according to simple lab parameters, which may drive clinical decisions about monitoring and treatment., Competing Interests: The authors have no conflict of interest to declare., (Copyright © 2021 Mattia Bellan et al.)

Published
2021
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9. Keeping Nurses Engaged in Nursing Professional Governance During the COVID-19 Pandemic:: Nursing Professional Governance Structure at Yale New Haven Hospital.

Author

Baron K, LaBella E, Parkosewich JA, and Hahn JM

Abstract

In 2020, during the COVID-19 pandemic, nursing professional governance (NPG) clinical nurse leaders at Yale New Haven Hospital developed an innovative way to engage nurses in their practice. Utilizing an electronic platform, NPG leaders established a way to harvest best practices, innovations, and resources from clinical nurses and reputable sources to share with all nurses in every practice area. Support for NPG leaders to have dedicated time for this work accelerated the process and allowed them to engage with nursing leaders to enhance communication and support clinical nurses. This work demonstrated the value of NPG during a time of crisis., (2020 by Elsevier Inc. All rights reserved.)

Published
2021
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10. Clinical stability and in-hospital mortality prediction in COVID-19 patients presenting to the Emergency Department.

Author

Gavelli F, Castello LM, Bellan M, Azzolina D, Hayden E, Beltrame M, Galbiati A, Gardino CA, Gastaldello ML, Giolitti F, Labella E, Patrucco F, Sainaghi PP, and Avanzi GC

Subjects
Adult, Age Factors, Aged, Aged, 80 and over, COVID-19 classification, COVID-19 physiopathology, Clinical Deterioration, Comorbidity, Female, Humans, Intensive Care Units, Logistic Models, Male, Middle Aged, Oxygen Consumption, Patient Readmission statistics & numerical data, Proportional Hazards Models, Reproducibility of Results, Respiratory Rate, Retrospective Studies, Sex Factors, Triage methods, COVID-19 mortality, Emergency Service, Hospital statistics & numerical data, Hospital Mortality, Hospitalization statistics & numerical data, SARS-CoV-2, Severity of Illness Index
Abstract

Background: The Novara-COVID score was developed to help the emergency physician to decide which Coronavirus disease (COVID) patient required hospitalization at Emergency Department (ED) presentation and to which intensity of care. We aimed at evaluating its prognostic role., Methods: We retrospectively collected data of COVID patients admitted to our ED between March 16 and April 22, 2020. The Novara-COVID score was systematically applied to all COVID patients since its introduction in clinical practice and adopted to decide patients' destination. The ability of the Novara-COVID score to predict in-hospital clinical stability and in-hospital mortality were evaluated through multivariable logistic regression and cox regression hazard models, respectively., Results: Among the 480 COVID patients admitted to the ED, 338 were hospitalized: the Novara-COVID score was 0-1 in 49.7%, 2 in 24.6%, 3 in 15.4% and 4-5 in 10.3% of patients. Novara-COVID score values of 3 and 4-5 were associated with lower clinical stability with adjusted odds ratios of 0.28 (0.13-0.59) and 0.03 (0.01-0.12), respectively. When in-hospital mortality was evaluated, a significant difference emerged between scores of 0-1 and 2 vs. 3 and 4-5. In particular, the death adjusted hazard ratio for Novara-COVID scores of 3 and 4-5 were 2.6 (1.4-4.8) and 8.4 (4.7-15.2), respectively., Conclusions: The Novara-COVID score reliably predicts in-hospital clinical instability and mortality of COVID patients at ED presentation. This tool allows the emergency physician to detect patients at higher risk of clinical deterioration, suggesting a more aggressive therapeutic management from the beginning.

Published
2021
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11. Fatality rate and predictors of mortality in an Italian cohort of hospitalized COVID-19 patients.

Author

Bellan M, Patti G, Hayden E, Azzolina D, Pirisi M, Acquaviva A, Aimaretti G, Aluffi Valletti P, Angilletta R, Arioli R, Avanzi GC, Avino G, Balbo PE, Baldon G, Baorda F, Barbero E, Baricich A, Barini M, Barone-Adesi F, Battistini S, Beltrame M, Bertoli M, Bertolin S, Bertolotti M, Betti M, Bobbio F, Boffano P, Boglione L, Borrè S, Brucoli M, Calzaducca E, Cammarata E, Cantaluppi V, Cantello R, Capponi A, Carriero A, Casciaro FG, Castello LM, Ceruti F, Chichino G, Chirico E, Cisari C, Cittone MG, Colombo C, Comi C, Croce E, Daffara T, Danna P, Della Corte F, De Vecchi S, Dianzani U, Di Benedetto D, Esposto E, Faggiano F, Falaschi Z, Ferrante D, Ferrero A, Gagliardi I, Gaidano G, Galbiati A, Gallo S, Garavelli PL, Gardino CA, Garzaro M, Gastaldello ML, Gavelli F, Gennari A, Giacomini GM, Giacone I, Giai Via V, Giolitti F, Gironi LC, Gramaglia C, Grisafi L, Inserra I, Invernizzi M, Krengli M, Labella E, Landi IC, Landi R, Leone I, Lio V, Lorenzini L, Maconi A, Malerba M, Manfredi GF, Martelli M, Marzari L, Marzullo P, Mennuni M, Montabone C, Morosini U, Mussa M, Nerici I, Nuzzo A, Olivieri C, Padelli SA, Panella M, Parisini A, Paschè A, Pau A, Pedrinelli AR, Percivale I, Re R, Rigamonti C, Rizzi E, Rognoni A, Roveta A, Salamina L, Santagostino M, Saraceno M, Savoia P, Sciarra M, Schimmenti A, Scotti L, Spinoni E, Smirne C, Tarantino V, Tillio PA, Vaschetto R, Vassia V, Zagaria D, Zavattaro E, Zeppegno P, Zottarelli F, and Sainaghi PP

Subjects
Age Factors, Aged, Aged, 80 and over, COVID-19 virology, Comorbidity, Female, Humans, Italy epidemiology, Length of Stay, Male, Middle Aged, Retrospective Studies, Reverse Transcriptase Polymerase Chain Reaction, Risk Factors, Sex Factors, Smoking, Survival Rate, COVID-19 epidemiology, COVID-19 mortality, Pandemics, SARS-CoV-2 genetics
Abstract

Clinical features and natural history of coronavirus disease 2019 (COVID-19) differ widely among different countries and during different phases of the pandemia. Here, we aimed to evaluate the case fatality rate (CFR) and to identify predictors of mortality in a cohort of COVID-19 patients admitted to three hospitals of Northern Italy between March 1 and April 28, 2020. All these patients had a confirmed diagnosis of SARS-CoV-2 infection by molecular methods. During the study period 504/1697 patients died; thus, overall CFR was 29.7%. We looked for predictors of mortality in a subgroup of 486 patients (239 males, 59%; median age 71 years) for whom sufficient clinical data were available at data cut-off. Among the demographic and clinical variables considered, age, a diagnosis of cancer, obesity and current smoking independently predicted mortality. When laboratory data were added to the model in a further subgroup of patients, age, the diagnosis of cancer, and the baseline PaO 2 /FiO 2 ratio were identified as independent predictors of mortality. In conclusion, the CFR of hospitalized patients in Northern Italy during the ascending phase of the COVID-19 pandemic approached 30%. The identification of mortality predictors might contribute to better stratification of individual patient risk.

Published
2020
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