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

被引：78

作者：

Vena, Antonio ^{[1
]}

Giacobbe, Daniele Roberto ^{[1
]}

Di Biagio, Antonio ^{[1
,2
]}

Mikulska, Malgorzata ^{[1
,2
]}

Taramasso, Lucia ^{[1
]}

De Maria, Andrea ^{[1
,2
]}

Ball, Lorenzo ^{[3
,4
]}

Brunetti, Iole ^{[4
]}

Loconte, Maurizio ^{[4
]}

Patroniti, Nicolo A. ^{[3
,4
]}

Robba, Chiara ^{[4
]}

Delfino, Emanuele ^{[1
]}

Dentone, Chiara ^{[1
]}

Magnasco, Laura ^{[1
]}

Nicolini, Laura ^{[1
]}

Toscanini, Federica ^{[1
]}

Bavastro, Martina ^{[1
]}

Cerchiaro, Matteo ^{[1
]}

Barisione, Emanuela ^{[5
]}

Giacomini, Mauro ^{[6
]}

Mora, Sara ^{[6
]}

Baldi, Federico ^{[1
]}

Balletto, Elisa ^{[1
]}

Berruti, Marco ^{[1
]}

Briano, Federica ^{[1
]}

Sepulcri, Chiara ^{[1
]}

Dettori, Silvia ^{[1
]}

Labate, Laura ^{[1
]}

Mirabella, Michele ^{[1
]}

Portunato, Federica ^{[1
,7
]}

Pincino, Rachele ^{[1
]}

Russo, Chiara ^{[1
]}

Tutino, Stefania ^{[1
]}

Pelosi, Paolo ^{[3
,4
]}

Bassetti, Matteo ^{[1
,2
]}

机构：

[1] Osped Policlin San Martino, IRCCS, Infect Dis Unit, Genoa, Italy

[2] Univ Genoa, Dept Hlth Sci DISSAL, Genoa, Italy

[3] Univ Genoa, Dept Surg Sci & Integrated Diagnost, Genoa, Italy

[4] San Martino Policlin Hosp, IRCCS Oncol & Neurosci, Anaesthesia & Intens Care, Genoa, Italy

[5] IRCCS San Martino Hosp, IST Natl Canc Res Inst, Intervent Pulmonol Unit, Genoa, Italy

[6] Univ Genoa, Dept Informat Bioengn Robot & Syst Engn, Genoa, Italy

[7] Univ Campania Luigi Vanvitelli, Infect Dis Unit, Naples, Italy

来源：

CLINICAL MICROBIOLOGY AND INFECTION | 2020年 / 26卷 / 11期

关键词：

Acute respiratory distress syndrome; Coronavirus disease 2019; Interleukin-6; Mortality; Severe acute respiratory syndrome; coronavirus; 2; COVID-19; PNEUMONIA;

D O I：

10.1016/j.cmi.2020.07.049

中图分类号：

R51 [传染病];

学科分类号：

100401 ;

摘要：

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 respi-ratory 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. (c) 2020 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

引用

页码：1537 / 1544

页数：8

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