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

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.

SUBMITTER: Vena A

PROVIDER: S-EPMC7428680 | biostudies-literature | 2020 Aug

REPOSITORIES: biostudies-literature

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

Vena Antonio A Giacobbe Daniele Roberto DR Di Biagio Antonio A Mikulska Malgorzata M Taramasso Lucia L De Maria Andrea A Ball Lorenzo L Brunetti Iole I Loconte Maurizio M Patroniti Nicolò A NA Robba Chiara C Delfino Emanuele E Dentone Chiara C Magnasco Laura L Nicolini Laura L Toscanini Federica F Bavastro Martina M Cerchiaro Matteo M Barisione Emanuela E Giacomini Mauro M Mora Sara S Baldi Federico F Balletto Elisa E Berruti Marco M Briano Federica F Sepulcri Chiara C Dettori Silvia S Labate Laura L Mirabella Michele M Portunato Federica F Pincino Rachele R Russo Chiara C Tutino Stefania S Pelosi Paolo P Bassetti Matteo M

Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases 20200815 11

<h4>Objectives</h4>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.<h4>Methods</h4>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.<h4>Results</h4>Overall, 317 individuals were enrolled. Their median age was 71 years an ...[more]

PMID: 32810610

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Project description:BackgroundThe epidemic of Coronavirus Disease 2019 (COVID-19) has become a global health emergency, but the clinical characteristics of COVID-19 are not fully described. We aimed to describe the clinical characteristics of COVID-19 outside of Wuhan city; and to develop a multivariate model to predict the risk of prolonged length of stay in hospital (ProLOS).MethodsThe study was conducted in a tertiary care hospital in Zhejiang province from January to February 20, 2020. Medical records of all confirmed cases of COVID-19 were retrospectively reviewed. Patients were categorized into the ProLOS and non-ProLOS groups by hospital length of stay greater and less than 14 days, respectively. Conventional descriptive statistics were applied. Multivariate regression model was built to predict the risk of ProLOS, with variables selected using stepwise approach.ResultsA total of 75 patients with confirmed COVID-19 were included for quantitative analysis, including 25 (33%) patients in the ProLOS group. ProLOS patients were more likely to have history of traveling to Wuhan (68% vs. 28%; P=0.002). Patients in the ProLOS group showed lower neutrophil counts [median (IQR): 2.50 (1.77–3.23) ×109/L vs. 2.90 (2.21–4.19) ×109/L; P=0.048], higher partial thrombin time (PT) (13.42±0.63 vs. 13.10±0.48 s; P=0.029), lower D-Dimer [0.26 (0.22–0.46) vs. 0.44 (0.32–0.84) mg/L; P=0.012]. There was no patient died and no severe case in our cohort. The overall LOS was 11 days (IQR, 5–15 days). The median cost for a hospital stay was 7,388.19 RMB (IQR, 5,085.39–11,145.44). The prediction model included five variables of procalcitonin, heart rate, epidemiological history, lymphocyte count and cough. The discrimination of the model was 84.8% (95% CI: 75.3% to 94.4%).ConclusionsOur study described clinical characteristics of COVID-19 outside of Wuhan city and found that the illness was less severe than that in the core epidemic region. A multivariate model was developed to predict ProLOS, which showed good discrimination.

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Dataset Information

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

Publications

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

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