Background. Findings from February, 2020, indicate that the clinical spectrum of Covid-19 can be heterogeneous, probably due to theinfectious dose andviral 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. 508 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 PaO2/FiO2233 [149-281]). Mortalityrate at 28 days resulted of 33.7%(N=171).39.0% of patients were treated with continuous positive airway pressure(CPAP), 9.5%with non-invasive ventilation (NIV)and 13.6% with endotracheal intubation. 9.5%were admitted to semi-intensive respiratory care unit, and 18.9%to ICU. 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), PaO2/FiO2 <200 at presentation (3.50 [1.70-7.20], p=0.001), need for CPAP/NIVin the first 24 hours (8.38 [3.63-19.35], p <0.001), and blood urea valueat 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 mortalityin Covid-19.

At the peak of Covid-19 age and disease severity but not comorbidities are predictors of mortality. Covid-19 burden in Bergamo, Italy / L. Novelli, F. Raimondi, A. Ghirardi, D. Pellegrini, D. Capodanno, G. Sotgiu, G. Guagliumi, M. Senni, F.M. Russo, F.L. Lorini, M. Rizzi, T. Barbui, A. Rambaldi, R. Cosentini, L.S. Grazioli, G. Marchesi, G.F. Sferrazza Papa, S. Cesa, M. Colledan, R. Civiletti, C. Conti, M. Casati, F. Ferri, S. Camagni, M. Sessa, A. Masciulli, A. Gavazzi, A. Falanga, L.F. Da Pozzo, S. Buoro, G. Remuzzi, P. Ruggenenti, A. Callegaro, L. D'''''Antiga, L. Pasulo, F. Pezzoli, A. Gianatti, P. Parigi, C. Farina, A. Bellasi, P. Solidoro, S. Sironi, F. Di Marco, S. Fagiuoli. - In: PANMINERVA MEDICA. - ISSN 0031-0808. - 63:1(2021), pp. 51-61. [10.23736/S0031-0808.20.04063-X]

At the peak of Covid-19 age and disease severity but not comorbidities are predictors of mortality. Covid-19 burden in Bergamo, Italy

Russo, Filippo M;Rambaldi, Alessandro;Sferrazza Papa, Giuseppe F;Conti, Caterina;Camagni, Stefania;Remuzzi, Giuseppe;Callegaro, Annapaola;Pasulo, Luisa;Bellasi, Antonio;Di Marco, Fabiano;
2021

Abstract

Background. Findings from February, 2020, indicate that the clinical spectrum of Covid-19 can be heterogeneous, probably due to theinfectious dose andviral 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. 508 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 PaO2/FiO2233 [149-281]). Mortalityrate at 28 days resulted of 33.7%(N=171).39.0% of patients were treated with continuous positive airway pressure(CPAP), 9.5%with non-invasive ventilation (NIV)and 13.6% with endotracheal intubation. 9.5%were admitted to semi-intensive respiratory care unit, and 18.9%to ICU. 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), PaO2/FiO2 <200 at presentation (3.50 [1.70-7.20], p=0.001), need for CPAP/NIVin the first 24 hours (8.38 [3.63-19.35], p <0.001), and blood urea valueat 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 mortalityin Covid-19.
Settore MED/10 - Malattie dell'Apparato Respiratorio
27-nov-2020
PANMINERVA MEDICA
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/2434/808974
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