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Clinical characteristics, management and in-hospital mortality of patients with coronavirus disease 2019 in Genoa, Italy

2020; Elsevier BV; Volume: 26; Issue: 11 Linguagem: Inglês

10.1016/j.cmi.2020.07.049

1469-0691

Antonio Vena, Daniele Roberto Giacobbe, Antonio Di Biagio, Małgorzata Mikulska, Lucia Taramasso, Andrea De Maria, Lorenzo Ball, Iole Brunetti, Maurizio Loconte, Nicoló Patroniti, Chiara Robba, Emanuele Delfino, Chiara Dentone, Laura Magnasco, Laura Ambra 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, A. Alessandrini, M. La Camera, Emanuele Delfino, Andrea De Maria, Chiara Dentone, Antonio Di Biagio, Ferdinando Dodi, Antonio Ferrazin, Giovanni Mazzarello, Małgorzata Mikulska, Laura Ambra Nicolini, Federica Toscanini, Daniele Roberto Giacobbe, Antonio Vena, Lucia Taramasso, Elisa Balletto, Federica Portunato, Eva Schenone, Nirmala Rosseti, Federico Baldi, Marco Berruti, Federica Briano, Silvia Dettori, Laura Labate, Laura Magnasco, Michele Mirabella, Rachele Pincino, Chiara Russo, Giovanni Sarteschi, Chiara Sepulcri, Stefania Tutino, Roberto Pontremoli, Valentina Beccati, Salvatore Casciaro, Massimo Casu, Francesco Gavaudan, Maria Ghinatti, Elisa Gualco, Giovanna Leoncini, Paola Pitto, Kassem Salam, Angelo Gratarola, Mattia Bixio, Annalisa Amelia, Andrea Balestra, Paola Ballarino, Nicholas Bardi, Roberto Boccafogli, Francesca Caserza, Elisa Calzolari, Marta Castelli, E. Cenni, Paolo Cortese, Giuseppe Cuttone, Sara Feltrin, Stefano Giovinazzo, Patrizia Giuntini, Letizia Natale, Davide Orsi, Matteo Pastorino, Tommaso Perazzo, Fabio Pescetelli, F Schenone, Maria Serra, Marco Sottano, Roberto Tallone, Massimo Amelotti, Marie Jeanne Majabò, Massimo Merlini, Federica Perazzo, Nidal Ahamd, Paolo Barbera, Marta Bovio, Paola B. Campodónico, Andrea Collidà, Ombretta Cutuli, A. Lomeo, Francesca Fezza, Nicola Gentilucci, Nadia Hussein, Emanuele Malvezzi, Laura Massobrio, Giula Motta, Laura Pastorino, N. Pollicardo, Stefano Sartini, Paola Vacca, Valentina Virga, Italo Porto, Giampaolo Bezante, Roberta Della Bona, Giovanni La Malfa, Alberto Valbusa, V Gil Ad, Emanuela Barisione, Michele Bellotti, Aloe’ Teresita, Alessandro Blanco, Marco Grosso, Maria Grazia Piroddi, P Moscatelli, Paola Ballarino, Matteo Caiti, E. Cenni, Patrizia Giuntini, Ottavia Magnani, Samir Giuseppe Sukkar, Ludovica Cogorno, Raffaella Gradaschi, Erica Guiddo, Eleonora Martino, Livia Pisciotta, Bruno Cavagliere, Cristina Rossi, Farina Francesca, Giacomo Garibotto, Pasquale Esposito, Carmen Bellezza, Harusha Emirjona, Francesca Rossi, Eleonora Arboscello, L. Arzani, Laura De Mattei, Marzia Spadaro, Giovanni Passalacqua, Diego Bagnasco, Fulvio Braido, A Riccio, Elena Tagliabue, Claudio Gustavino, Antonella Ferraiolo, Fiammetta Monacelli, Mona Hanafy Mahmoud, Luca Tagliafico, Armando Napolitano, M. Fiorio, Monica Pizzonia, Chiara Giannotti, Alessio Nencioni, Salvatore Giuffrida, Nicola Rosso, Alessandra Morando, Riccardo Papalia, Donata Passerini, Gabriella Tiberio, Giovanni Orengo, Alberto Battaglini, S Ruffoni, Sergio Caglieris,

COVID-19 and healthcare impacts

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.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.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.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.