TY - JOUR
T1 - Early predictors of clinical outcomes of COVID-19 outbreak in Milan, Italy
AU - Ciceri, Fabio
AU - Castagna, Antonella
AU - Rovere-Querini, Patrizia
AU - De Cobelli, Francesco
AU - Ruggeri, Annalisa
AU - Galli, Laura
AU - Conte, Caterina
AU - De Lorenzo, Rebecca
AU - Poli, Andrea
AU - Ambrosio, Alberto
AU - Signorelli, Carlo
AU - Bossi, Eleonora
AU - Fazio, Maria
AU - Tresoldi, Cristina
AU - Colombo, Sergio
AU - Monti, Giacomo
AU - Fominskiy, Efgeny
AU - Franchini, Stefano
AU - Spessot, Marzia
AU - Martinenghi, Carlo
AU - Carlucci, Michele
AU - Beretta, Luigi
AU - Scandroglio, Anna Maria
AU - Clementi, Massimo
AU - Locatelli, Massimo
AU - Tresoldi, Moreno
AU - Scarpellini, Paolo
AU - Martino, Gianvito
AU - Bosi, Emanuele
AU - Dagna, Lorenzo
AU - Lazzarin, Adriano
AU - Landoni, Giovanni
AU - Zangrillo, Alberto
N1 - Funding Information:
The authors thank the entire staff of the San Raffaele Scientific Institute, working every day to ensure the best quality of care to patients and their families. We dedicate this work to the memory of the Italian health care workers who have given their lives in the care of patients with COVID-19.
Publisher Copyright:
© 2020 The Authors
Copyright:
Copyright 2020 Elsevier B.V., All rights reserved.
PY - 2020/8
Y1 - 2020/8
N2 - Background: National health-system hospitals of Lombardy faced a heavy burden of admissions for acute respiratory distress syndromes associated with coronavirus disease (COVID-19). Data on patients of European origin affected by COVID-19 are limited. Methods: All consecutive patients aged ≥18 years, coming from North-East of Milan's province and admitted at San Raffaele Hospital with COVID-19, between February 25th and March 24th, were reported, all patients were followed for at least one month. Clinical and radiological features at admission and predictors of clinical outcomes were evaluated. Results: Of the 500 patients admitted to the Emergency Unit, 410 patients were hospitalized and analyzed: median age was 65 (IQR 56–75) years, and the majority of patients were males (72.9%). Median (IQR) days from COVID-19 symptoms onset was 8 (5–11) days. At hospital admission, fever (≥ 37.5 °C) was present in 67.5% of patients. Median oxygen saturation (SpO2) was 93% (range 60–99), with median PaO2/FiO2 ratio, 267 (IQR 184–314). Median Radiographic Assessment of Lung Edema (RALE) score was 9 (IQR 4–16). More than half of the patients (56.3%) had comorbidities, with hypertension, coronary heart disease, diabetes and chronic kidney failure being the most common. The probability of overall survival at day 28 was 66%. Multivariable analysis showed older age, coronary artery disease, cancer, low lymphocyte count and high RALE score as factors independently associated with an increased risk of mortality. Conclusion: In a large cohort of COVID-19 patients of European origin, main risk factors for mortality were older age, comorbidities, low lymphocyte count and high RALE.
AB - Background: National health-system hospitals of Lombardy faced a heavy burden of admissions for acute respiratory distress syndromes associated with coronavirus disease (COVID-19). Data on patients of European origin affected by COVID-19 are limited. Methods: All consecutive patients aged ≥18 years, coming from North-East of Milan's province and admitted at San Raffaele Hospital with COVID-19, between February 25th and March 24th, were reported, all patients were followed for at least one month. Clinical and radiological features at admission and predictors of clinical outcomes were evaluated. Results: Of the 500 patients admitted to the Emergency Unit, 410 patients were hospitalized and analyzed: median age was 65 (IQR 56–75) years, and the majority of patients were males (72.9%). Median (IQR) days from COVID-19 symptoms onset was 8 (5–11) days. At hospital admission, fever (≥ 37.5 °C) was present in 67.5% of patients. Median oxygen saturation (SpO2) was 93% (range 60–99), with median PaO2/FiO2 ratio, 267 (IQR 184–314). Median Radiographic Assessment of Lung Edema (RALE) score was 9 (IQR 4–16). More than half of the patients (56.3%) had comorbidities, with hypertension, coronary heart disease, diabetes and chronic kidney failure being the most common. The probability of overall survival at day 28 was 66%. Multivariable analysis showed older age, coronary artery disease, cancer, low lymphocyte count and high RALE score as factors independently associated with an increased risk of mortality. Conclusion: In a large cohort of COVID-19 patients of European origin, main risk factors for mortality were older age, comorbidities, low lymphocyte count and high RALE.
KW - ARDS
KW - COVID-19
KW - Infection
KW - RALE score
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U2 - 10.1016/j.clim.2020.108509
DO - 10.1016/j.clim.2020.108509
M3 - Article
C2 - 32535188
AN - SCOPUS:85086514002
VL - 217
JO - Clinical Immunology
JF - Clinical Immunology
SN - 1521-6616
M1 - 108509
ER -