Clinical characteristics, management and in-hospital mortality of patients with coronavirus disease 2019 in Genoa, Italy. (November 2020)

• Record Type: Journal Article
• Authors: Vena, Antonio; Giacobbe, Daniele Roberto; Di Biagio, Antonio; Mikulska, Malgorzata; Taramasso, Lucia; De Maria, Andrea; Ball, Lorenzo; Brunetti, Iole; Loconte, Maurizio; Patroniti, Nicolò A.; Robba, Chiara; Delfino, Emanuele; Dentone, Chiara; Magnasco, Laura; Nicolini, Laura; Toscanini, Federica; Bavastro, Martina; Cerchiaro, Matteo; Barisione, Emanuela; Giacomini, Mauro; Mora, Sara; Baldi, Federico; Balletto, Elisa; Berruti, Marco; Briano, Federica; Sepulcri, Chiara; Dettori, Silvia; Labate, Laura; Mirabella, Michele; Portunato, Federica; Pincino, Rachele; Russo, Chiara; Tutino, Stefania; Pelosi, Paolo; Bassetti, Matteo; Alessandrini, Anna; Camera, Marco; Delfino, Emanuele; De Maria, Andrea; Dentone, Chiara; Di Biagio, Antonio; Dodi, Ferdinando; Ferrazin, Antonio; Mazzarello, Giovanni; Mikulska, Malgorzata; Nicolini, Laura; Toscanini, Federica; Giacobbe, Daniele R.; Vena, Antonio; Taramasso, Lucia; Balletto, Elisa; Portunato, Federica; Schenone, Eva; Rosseti, Nirmala; Baldi, Federico; Berruti, Marco; Briano, Federica; Dettori, Silvia; Labate, Laura; Magnasco, Laura; Mirabella, Michele; Pincino, Rachele; russo, Chiara; Sarteschi, Giovanni; sepulcri, Chiara; Tutino, Stefania; Pontremoli, Roberto; Beccati, Valentina; Casciaro, Salvatore; Casu, Massimo; Gavaudan, Francesco; Ghinatti, Maria; Gualco, Elisa; Leoncini, Giovanna; pitto, Paola; salam, Kassem; Gratarola, Angelo; Bixio, Mattia; Amelia, Annalisa; Balestra, Andrea; Ballarino, Paola; Bardi, Nicholas; Boccafogli, Roberto; Caserza, Francesca; Calzolari, Elisa; Castelli, Marta; Cenni, Elisabetta; Cortese, Paolo; Cuttone, Giuseppe; Feltrin, Sara; Giovinazzo, Stefano; Giuntini, Patrizia; Natale, Letizia; Orsi, Davide; Pastorino, Matteo; Perazzo, Tommaso; Pescetelli, Fabio; Schenone, Federico; Serra, Maria G.; Sottano, Marco; Tallone, Roberto; Amelotti, Massimo; Majabò, Marie J.; Merlini, Massimo; Perazzo, Federica; Ahamd, Nidal; Barbera, Paolo; Bovio, Marta; Campodonico, Paola; Collidà, Andrea; Cutuli, Ombretta; Lomeo, Agnese; Fezza, Francesca; Gentilucci, Nicola; Hussein, Nadia; Malvezzi, Emanuele; Massobrio, Laura; Motta, Giula; Pastorino, Laura; Pollicardo, Nicoletta; Sartini, Stefano; Vacca, Paola; Virga, Valentina; Porto, Italo; Bezante, Giampaolo; Della Bona, Roberta; La Malfa, Giovanni; Valbusa, Alberto; Ad, Vered G.; Barisione, Emanuela; Bellotti, Michele; Teresita, Aloe'; Blanco, Alessandro; Grosso, Marco; Piroddi, Maria Grazia; Moscatelli, Paolo; Ballarino, Paola; Caiti, Matteo; Cenni, Elisabetta; Giuntini, Patrizia; Magnani, Ottavia; Sukkar, Samir; Cogorno, Ludovica; Gradaschi, Raffaella; Guiddo, Erica; Martino, Eleonora; Pisciotta, Livia; Cavagliere, Bruno; Cristina, Rossi; Francesca, Farina; Garibotto, Giacomo; Esposito, Pasquale; Bellezza, Carmen; Harusha, Emirjona; Rossi, Francesca; Arboscello, Eleonora; Arzani, Laura; De Mattei, Laura; Spadaro, Marzia; Passalacqua, Giovanni; Bagnasco, Diego; Braido, Fulvio; Riccio, Annamaria; Tagliabue, Elena; Gustavino, Claudio; Ferraiolo, Antonella; Monacelli, Fiammetta; Mahmoud, Mona; Tagliafico, Luca; Napolitano, Armando; Fiorio, Maria; Pizzonia, Monica; Giannotti, Chiara; Nencioni, Alessio; Giuffrida, Salvatore; Rosso, Nicola; Morando, Alessandra; Papalia, Riccardo; Passerini, Donata; Tiberio, Gabriella; Orengo, Giovanni; Battaglini, Alberto; Ruffoni, Silvano; Caglieris, Sergio;
• Is Part Of: Clinical microbiology and infection. Volume 26:Number 11(2020)
• Page Start: 1537
• Page End: 1544
• Publication Date: 2020-11
• Subjects: Acute respiratory distress syndrome -- Coronavirus disease 2019 -- Interleukin-6 -- Mortality -- Severe acute respiratory syndrome coronavirus 2; Medical microbiology -- Periodicals; Diagnostic microbiology -- Periodicals; Communicable diseases -- Periodicals; Infection -- Periodicals; 616.01
• DOI: 10.1016/j.cmi.2020.07.049
• Languages: English
• ISSNs: 1198-743X

Abstract

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.