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

GECOVID study group

doi:10.1016/j.cmi.2020.07.049

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

GECOVID study group

A.O.U. San Martino - IST, Istituto Nazionale Ricerca sul Cancro (GENOVA)

Research output: Contribution to journal › Article › peer-review

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
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	https://doi.org/10.1016/j.cmi.2020.07.049
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

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

In: Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases, Vol. 26, No. 11, 11.2020, p. 1537-1544.

Research output: Contribution to journal › Article › peer-review

@article{e32eb15a6b0d4746984affdfc8921b82,

title = "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.",

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",

author = "{GECOVID study group} and Antonio Vena and Giacobbe, {Daniele Roberto} and {Di Biagio}, Antonio and Malgorzata Mikulska and Lucia Taramasso and {De Maria}, Andrea and Lorenzo Ball and Iole Brunetti and Maurizio Loconte and Patroniti, {Nicol{\`o} A} and Chiara Robba and Emanuele Delfino and Chiara Dentone and Laura Magnasco and Laura Nicolini and Federica Toscanini and Martina Bavastro and Matteo Cerchiaro and Emanuela Barisione and Mauro Giacomini and Sara Mora and Federico Baldi and Elisa Balletto and Marco Berruti and Federica Briano and Chiara Sepulcri and Silvia Dettori and Laura Labate and Michele Mirabella and Federica Portunato and Rachele Pincino and Chiara Russo and Stefania Tutino and Paolo Pelosi and Matteo Bassetti",

year = "2020",

month = nov,

doi = "10.1016/j.cmi.2020.07.049",

language = "English",

volume = "26",

pages = "1537--1544",

journal = "Clinical Microbiology and Infection",

issn = "1198-743X",

publisher = "Elsevier B.V.",

number = "11",

}

TY - JOUR

T1 - Clinical characteristics, management and in-hospital mortality of patients with coronavirus disease 2019 in Genoa, Italy

AU - GECOVID study group

AU - Vena, Antonio

AU - Giacobbe, Daniele Roberto

AU - Di Biagio, Antonio

AU - Mikulska, Malgorzata

AU - Taramasso, Lucia

AU - De Maria, Andrea

AU - Ball, Lorenzo

AU - Brunetti, Iole

AU - Loconte, Maurizio

AU - Patroniti, Nicolò A

AU - Robba, Chiara

AU - Delfino, Emanuele

AU - Dentone, Chiara

AU - Magnasco, Laura

AU - Nicolini, Laura

AU - Toscanini, Federica

AU - Bavastro, Martina

AU - Cerchiaro, Matteo

AU - Barisione, Emanuela

AU - Giacomini, Mauro

AU - Mora, Sara

AU - Baldi, Federico

AU - Balletto, Elisa

AU - Berruti, Marco

AU - Briano, Federica

AU - Sepulcri, Chiara

AU - Dettori, Silvia

AU - Labate, Laura

AU - Mirabella, Michele

AU - Portunato, Federica

AU - Pincino, Rachele

AU - Russo, Chiara

AU - Tutino, Stefania

AU - Pelosi, Paolo

AU - Bassetti, Matteo

PY - 2020/11

Y1 - 2020/11

N2 - 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.

AB - 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.

KW - Aged

KW - Aged, 80 and over

KW - Betacoronavirus/isolation & purification

KW - COVID-19

KW - COVID-19 Testing

KW - Cause of Death

KW - Clinical Laboratory Techniques

KW - Coronavirus Infections/diagnosis

KW - Female

KW - Hospital Mortality

KW - Hospitalization

KW - Humans

KW - Italy/epidemiology

KW - Male

KW - Middle Aged

KW - Pandemics

KW - Pneumonia, Viral/diagnosis

KW - Retrospective Studies

KW - Risk Factors

KW - SARS-CoV-2

U2 - 10.1016/j.cmi.2020.07.049

DO - 10.1016/j.cmi.2020.07.049

M3 - Article

C2 - 32810610

VL - 26

SP - 1537

EP - 1544

JO - Clinical Microbiology and Infection

JF - Clinical Microbiology and Infection

SN - 1198-743X

IS - 11

ER -