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.
Original language | English |
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Pages (from-to) | 1537-1544 |
Number of pages | 8 |
Journal | Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases |
Volume | 26 |
Issue number | 11 |
DOIs | |
Publication status | Published - Nov 2020 |
Keywords
- Aged
- Aged, 80 and over
- Betacoronavirus/isolation & purification
- COVID-19
- COVID-19 Testing
- Cause of Death
- Clinical Laboratory Techniques
- Coronavirus Infections/diagnosis
- Female
- Hospital Mortality
- Hospitalization
- Humans
- Italy/epidemiology
- Male
- Middle Aged
- Pandemics
- Pneumonia, Viral/diagnosis
- Retrospective Studies
- Risk Factors
- SARS-CoV-2