Luca Novelli1, Federico Raimondi1,2, Arianna Ghirardi3, Dario Pellegrini4, Davide Capodanno5, Giovanni Sotgiu6, Giulio Guagliumi3, Michele Senni3, Filippo M Russo2,7, Ferdinando L Lorini7, Marco Rizzi8, Tiziano Barbui2, Alessandro Rambaldi2,9, Roberto Cosentini10, Lorenzo S Grazioli7, Gianmariano Marchesi7, Giuseppe F Sferrazza Papa2,11, Simonetta Cesa12, Michele Colledan13, Roberta Civiletti1,14, Caterina Conti1, Monica Casati12, Francesco Ferri7, Stefania Camagni13, Maria Sessa15, Arianna Masciulli2, Antonello Gavazzi2, Anna Falanga16,17, Luigi F DA Pozzo17,18, Sabrina Buoro19, Giuseppe Remuzzi20, Piero Ruggenenti21, Annapaola Callegaro22, Lorenzo D'Antiga23, Luisa Pasulo24, Fabio Pezzoli25, Andrea Gianatti26, Piercarlo Parigi1, Claudio Farina22, Antonio Bellasi27, Paolo Solidoro28, Sandro Sironi17,29, Fabiano DI Marco30,2, Stefano Fagiuoli24. 1. Unit of Pulmonary Medicine, ASST Papa Giovanni XXIII, Bergamo, Italy. 2. University of Milan, Milan, Italy. 3. FROM Research Foundation, Bergamo, Italy. 4. Cardiovascular Department, ASST Papa Giovanni XXIII, Bergamo, Italy. 5. Unit of Cardiology, Ferrarotto Hospital, University of Catania, Catania, Italy. 6. Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy. 7. Department of Emergency and Critical Care Area, ASST Papa Giovanni XXIII, Bergamo, Italy. 8. Unit of Infectious Diseases, ASST Papa Giovanni XXIII, Bergamo, Italy. 9. Department of Oncology and Hematology, ASST Papa Giovanni XXIII, Bergamo, Italy. 10. Emergency Department, ASST Papa Giovanni XXIII, Bergamo, Italy. 11. Department of Neurorehabilitation Sciences, Casa di Cura del Policlinico, Milan, Italy. 12. Department of Health and Social Care Professions, ASST Papa Giovanni XXIII, Bergamo, Italy. 13. Unit of General Surgery 3, Department of Organ Failure and Transplantation, ASST Papa Giovanni XXIII, Bergamo, Italy. 14. Federico II University, Naples, Italy. 15. Unit of Neurology, ASST Papa Giovanni XXIII, Bergamo, Italy. 16. Unit of Immunohematology and Transfusion, ASST Papa Giovanni XXIII, Bergamo, Italy. 17. University of Milano-Bicocca, Milan, Italy. 18. Unit of Urology, ASST Papa Giovanni XXIII, Bergamo, Italy. 19. Unit of Quality Management, ASST Papa Giovanni XXIII, Bergamo, Italy. 20. Mario Negri Institute for Pharmacological Research IRCCS, Anna Maria Astori Centet, Kilometro Rosso Science and Technology Park, Bergamo, Italy. 21. Unit of Nephrology and Dialysis, ASST Papa Giovanni XXIII, Bergamo, Italy. 22. Department of Laboratory Medicine, ASST Papa Giovanni XXIII, Bergamo, Italy. 23. Unit of Pediatric Hepatology Gastroenterology and Transplantation, ASST Papa Giovanni XXIII, Bergamo, Italy. 24. Unit of Gastroenterology 1, Hepatology and Transplantation, ASST Papa Giovanni XXIII, Bergamo, Italy. 25. Medical Direction, ASST Papa Giovanni XXIII, Bergamo, Italy. 26. Unit of Pathology, Department of Laboratory Medicine, ASST Papa Giovanni XXIII, Bergamo, Italy. 27. Department of Research, Innovation and Brand Reputation, ASST Papa Giovanni XXIII, Bergamo, Italy. 28. Unit of Pneumology, Department of Cardiovascular and Thoracic Surgery, Molinette Hospital, Città della Salute e della Scienza, University of Turin, Turin, Italy. 29. Department of Diagnostic Radiology, ASST Papa Giovanni XXIII, Bergamo, Italy. 30. Unit of Pulmonary Medicine, ASST Papa Giovanni XXIII, Bergamo, Italy - fabiano.dimarco@unimi.it.
Abstract
BACKGROUND: Findings from February 2020, indicate that the clinical spectrum of COVID-19 can be heterogeneous, probably due to the infectious dose and viral load of SARS-CoV-2 within the first weeks of the outbreak. The aim of this study was to investigate predictors of overall 28-day mortality at the peak of the Italian outbreak. METHODS: Retrospective observational study of all COVID-19 patients admitted to the main hospital of Bergamo, from February 23 to March 14, 2020. RESULTS: Five hundred and eight patients were hospitalized, predominantly male (72.4%), mean age of 66±15 years; 49.2% were older than 70 years. Most of patients presented with severe respiratory failure (median value [IQR] of PaO<inf>2</inf>/FiO<inf>2</inf>: 233 [149-281]). Mortality rate at 28 days resulted of 33.7% (N.=171). Thirty-nine percent of patients were treated with continuous positive airway pressure (CPAP), 9.5% with noninvasive ventilation (NIV) and 13.6% with endotracheal intubation. 9.5% were admitted to Semi-Intensive Respiratory Care Unit, and 18.9% to Intensive Care Unit. Risk factors independently associated with 28-day mortality were advanced age (≥78 years: odds ratio [OR], 95% confidence interval [CI]: 38.91 [10.67-141.93], P<0.001; 70-77 years: 17.30 [5.40-55.38], P<0.001; 60-69 years: 3.20 [1.00-10.20], P=0.049), PaO<inf>2</inf>/FiO<inf>2</inf><200 at presentation (3.50 [1.70-7.20], P=0.001), need for CPAP/NIV in the first 24 hours (8.38 [3.63-19.35], P<0.001), and blood urea value at admission (1.01 [1.00-1.02], P=0.015). CONCLUSIONS: At the peak of the outbreak, with a probable high infectious dose and viral load, older age, the severity of respiratory failure and renal impairment at presentation, but not comorbidities, are predictors of 28-day mortality in COVID-19.
BACKGROUND: Findings from February 2020, indicate that the clinical spectrum of COVID-19 can be heterogeneous, probably due to the infectious dose and viral load of SARS-CoV-2 within the first weeks of the outbreak. The aim of this study was to investigate predictors of overall 28-day mortality at the peak of the Italian outbreak. METHODS: Retrospective observational study of all COVID-19patients admitted to the main hospital of Bergamo, from February 23 to March 14, 2020. RESULTS: Five hundred and eight patients were hospitalized, predominantly male (72.4%), mean age of 66±15 years; 49.2% were older than 70 years. Most of patients presented with severe respiratory failure (median value [IQR] of PaO<inf>2</inf>/FiO<inf>2</inf>: 233 [149-281]). Mortality rate at 28 days resulted of 33.7% (N.=171). Thirty-nine percent of patients were treated with continuous positive airway pressure (CPAP), 9.5% with noninvasive ventilation (NIV) and 13.6% with endotracheal intubation. 9.5% were admitted to Semi-Intensive Respiratory Care Unit, and 18.9% to Intensive Care Unit. Risk factors independently associated with 28-day mortality were advanced age (≥78 years: odds ratio [OR], 95% confidence interval [CI]: 38.91 [10.67-141.93], P<0.001; 70-77 years: 17.30 [5.40-55.38], P<0.001; 60-69 years: 3.20 [1.00-10.20], P=0.049), PaO<inf>2</inf>/FiO<inf>2</inf><200 at presentation (3.50 [1.70-7.20], P=0.001), need for CPAP/NIV in the first 24 hours (8.38 [3.63-19.35], P<0.001), and blood urea value at admission (1.01 [1.00-1.02], P=0.015). CONCLUSIONS: At the peak of the outbreak, with a probable high infectious dose and viral load, older age, the severity of respiratory failure and renal impairment at presentation, but not comorbidities, are predictors of 28-day mortality in COVID-19.
Authors: Gábor Bánfai; Péter Kanizsai; Csaba Csontos; Szilárd Kun; Ágnes Lakatos; Anikó Lajtai; Vanessza Lelovics; Sándor Szukits; Péter Bogner; Attila Miseta; István Wittmann; Gergő A Molnár Journal: Metabolites Date: 2022-05-27
Authors: Lan Yao; Minghui Li; Jim Y Wan; Scott C Howard; James E Bailey; Joyce Carolyn Graff Journal: Environ Sci Pollut Res Int Date: 2021-09-07 Impact factor: 5.190
Authors: Marco Ranucci; Gianfranco Parati; Umberto Di Dedda; Maurizio Bussotti; Eustachio Agricola; Lorenzo Menicanti; Sara Bombace; Fabiana De Martino; Stefano Giovinazzo; Antonella Zambon; Roberto Menè; Maria Teresa La Rovere Journal: J Clin Med Date: 2022-07-15 Impact factor: 4.964