Raffaele Galiero1, Pia Clara Pafundi1, Vittorio Simeon2, Luca Rinaldi1, Alessandro Perrella3, Erica Vetrano1, Alfredo Caturano1, Maria Alfano1, Domenico Beccia1, Riccardo Nevola1,4, Raffaele Marfella1, Celestino Sardu1, Carmine Coppola5, Ferdinando Scarano5, Paolo Maggi6, Pellegrino De Lucia Sposito7, Laura Vocciante8, Carolina Rescigno9, Costanza Sbreglia10, Fiorentino Fraganza11, Roberto Parrella12, Annamaria Romano13, Giosuele Calabria14, Benedetto Polverino15, Antonio Pagano16, Carolina Bologna17, Maria Amitrano18, Vincenzo Esposito19, Nicola Coppola20, Nicola Maturo21, Luigi Elio Adinolfi1, Paolo Chiodini2, Ferdinando Carlo Sasso1. 1. Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy. 2. Medical Statistics Unit, Department of Physical and Mental Health and Preventive Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy. 3. Task Force Covid-19 Regione Campania, Napoli, Italy. 4. Internal Medicine, Sant'Ottone Frangipane Hospital, Ariano Irpino, Italy. 5. COVID Center "S. Anna e SS. Madonna della Neve" Hospital, Boscotrecase, Italy. 6. U.O.C. Infectious and Tropical Diseases, S. Anna e S. Sebastiano Hospital, Caserta, Italy. 7. Covid Center-Maddaloni Hospital, Maddaloni, Italy. 8. General Medicine Unit, Loreto Mare Hospital, Naples, Italy. 9. U.O.C. Infectious Diseases and Neurology, Cotugno Hospital, Naples, Italy. 10. U.O.C. Infectious Diseases of the Elderly, Cotugno Hospital, Naples, Italy. 11. U.O.C. Anestesia and Intensive Care Unit, Cotugno Hospital, Naples, Italy. 12. U.O.C. Respiratory Infectious Diseases, Cotugno Hospital, Naples, Italy. 13. U.O.C. Pneumology, Moscati Hospital, Avellino, Italy. 14. IXth Division of Infectious Diseases and Interventional Ultrasound, Cotugno Hospital, Naples, Italy. 15. "Giovanni da Procida" Hospital, Salerno, Italy. 16. Emergency and Acceptance Unit, "Santa Maria delle Grazie" Hospital, Pozzuoli, Italy. 17. Internal Medicine Unit, Ospedale Del Mare, Naples, Italy. 18. U.O.C. Internal Medicine-Moscati Hospital, Avellino, Italy. 19. IVth Division of Immunodeficiency and Gender Infectious Diseases, Cotugno Hospital, Naples, Italy. 20. Department of Mental Health and Public Medicine, Centro COVID A.O.U. Vanvitelli, Naples, Italy. 21. U.O.S.D. Infectious Diseases Emergency and Acceptance, Cotugno Hospital, Naples, Italy.
Abstract
BACKGROUND: Italy has been the first Western country to be heavily affected by the spread of SARS-COV-2 infection and among the pioneers of the clinical management of pandemic. To improve the outcome, identification of patients at the highest risk seems mandatory. OBJECTIVES: Aim of this study is to identify comorbidities and clinical conditions upon admission associated with in-hospital mortality in several COVID Centers in Campania Region (Italy). METHODS: COVOCA is a multicentre retrospective observational cohort study, which involved 18 COVID Centers throughout Campania Region, Italy. Data were collected from patients who completed their hospitalization between March-June 2020. The endpoint was in-hospital mortality, assessed either from data at discharge or death certificate, whilst all exposure variables were collected at hospital admission. RESULTS: Among 618 COVID-19 hospitalized patients included in the study, 143 in-hospital mortality events were recorded, with a cumulative incidence of about 23%. At multivariable logistic analysis, male sex (OR 2.63, 95%CI 1.42-4.90; p = 0.001), Chronic Liver Disease (OR 5.88, 95%CI 2.39-14.46; p<0.001) and malignancies (OR 2.62, 95%CI 1.21-5.68; p = 0.015) disclosed an independent association with a poor prognosis, Glasgow Coma Scale (GCS) and Respiratory Severity Scale allowed to identify at higher mortality risk. Sensitivity analysis further enhanced these findings. CONCLUSION: Mortality of patients hospitalized for COVID-19 appears strongly affected by both clinical conditions on admission and comorbidities. Originally, we observed a very poor outcome in subjects with a chronic liver disease, alongside with an increase of hepatic damage.
BACKGROUND: Italy has been the first Western country to be heavily affected by the spread of SARS-COV-2 infection and among the pioneers of the clinical management of pandemic. To improve the outcome, identification of patients at the highest risk seems mandatory. OBJECTIVES: Aim of this study is to identify comorbidities and clinical conditions upon admission associated with in-hospital mortality in several COVID Centers in Campania Region (Italy). METHODS: COVOCA is a multicentre retrospective observational cohort study, which involved 18 COVID Centers throughout Campania Region, Italy. Data were collected from patients who completed their hospitalization between March-June 2020. The endpoint was in-hospital mortality, assessed either from data at discharge or death certificate, whilst all exposure variables were collected at hospital admission. RESULTS: Among 618 COVID-19 hospitalized patients included in the study, 143 in-hospital mortality events were recorded, with a cumulative incidence of about 23%. At multivariable logistic analysis, male sex (OR 2.63, 95%CI 1.42-4.90; p = 0.001), Chronic Liver Disease (OR 5.88, 95%CI 2.39-14.46; p<0.001) and malignancies (OR 2.62, 95%CI 1.21-5.68; p = 0.015) disclosed an independent association with a poor prognosis, Glasgow Coma Scale (GCS) and Respiratory Severity Scale allowed to identify at higher mortality risk. Sensitivity analysis further enhanced these findings. CONCLUSION:Mortality of patients hospitalized for COVID-19 appears strongly affected by both clinical conditions on admission and comorbidities. Originally, we observed a very poor outcome in subjects with a chronic liver disease, alongside with an increase of hepatic damage.
Authors: Urszula Tokarczyk; Krzysztof Kaliszewski; Anna Kopszak; Łukasz Nowak; Karolina Sutkowska-Stępień; Maciej Sroczyński; Monika Sępek; Agata Dudek; Dorota Diakowska; Małgorzata Trocha; Damian Gajecki; Jakub Gawryś; Tomasz Matys; Justyna Maciejiczek; Valeriia Kozub; Roman Szalast; Marcin Madziarski; Anna Zubkiewicz-Zarębska; Krzysztof Letachowicz; Katarzyna Kiliś-Pstrusińska; Agnieszka Matera-Witkiewicz; Michał Pomorski; Marcin Protasiewicz; Janusz Sokołowski; Barbara Adamik; Krzysztof Kujawa; Adrian Doroszko; Katarzyna Madziarska; Ewa Anita Jankowska Journal: J Clin Med Date: 2022-08-01 Impact factor: 4.964
Authors: Abhishek Bhurwal; Carlos D Minacapelli; Evan Orosz; Kapil Gupta; Christopher Tait; Ishita Dalal; Clark Zhang; Eric Zhao; Vinod K Rustgi Journal: World J Gastroenterol Date: 2021-12-14 Impact factor: 5.742
Authors: Shimaa Afify; Basem Eysa; Fatma Abdel Hamid; Omnia M Abo-Elazm; Mohamed A Edris; Rabab Maher; Ahmed Abdelhalim; Muhammad Mostafa Abdel Ghaffar; Dalia A Omran; Hend Ibrahim Shousha Journal: World J Gastroenterol Date: 2021-11-14 Impact factor: 5.742