30-day mortality in patients hospitalized with COVID-19 during the first wave of the Italian epidemic: A prospective cohort study

Abstract

The clinical characteristics of all the COVID-19 patients hospitalised in the early days of the epidemic (21 February-19 March 2020) were recorded upon admission, and the time-dependent probability of death was evaluated using the Kaplan-Meier method (censored as of 20 April 2020). Cox proportional hazard models were used to assess the factors independently associated with the risk of death. Forty-eight (20.6 %) of the 233 patients followed up for a median of 40 days (interquartile range 33-47) died during the follow-up. Most were males (69.1 %) and their median age was 61 years (IQR 50-72). The timedependent probability of death was 19.7 % (95 % CI 14.6-24.9 %) 30 days after hospital admission. Age (adjusted hazard ratio [aHR] 2.08, 95 % CI 1.48−2.92 per ten years more) and obesity (aHR 3.04, 95 % CI 1.42−6.49) were independently associated with an increased risk of death, which was also associated with critical disease (aHR 8.26, 95 % CI 1.41−48.29), C-reactive protein levels (aHR 1.17, 95 % CI 1.02−1.35 per 50 mg/L more) and creatinine kinase levels above 185 U/L (aHR 2.58, 95 % CI 1.37−4.87) upon admission. Case-fatality rate of patients hospitalized with COVID-19 in the early days of the Italian epidemic was about 20 %. Our study adds evidence to the notion that older age, obesity and more advanced illness are factors associated to an increased risk of death among patients hospitalized with COVID-19.

High versus standard doses of corticosteroids in severe COVID-19: a retrospective cohort study

“…Although some differences in baseline characteristics were detected (male gender, older age, and comorbidities were significantly more common among the HD group), appropriate adjustments were performed, concomitant treatments during admission were equally administered, and sensitivity analyses reinforced the robustness of our results. In addition, despite all patients had a severe COVID-19, overall mortality (24.8%) was consistent with that reported from previous studies in the early stages of the pandemics in Europe among hospitalized subjects [38,39], suggesting a lower risk of selection bias.…”

Anemia and iron metabolism in COVID-19: a systematic review and meta-analysis

“…In a study by Cen et al [25] hemoglobin levels below 110 g/L were linked with disease progression in patients with COVID-19; univariable hazard ratio was 3.91 (95% CI 2.99-5.10). In addition, Giacomelli et al [26] reported anemia (defined as hemoglobin levels below 125 g/L) was more prevalent…”

COVID-19 outbreak in Brazil: Adherence to national preventive measures and impact on people’s lives

“…Regarding this vulnerable group, 29.4% stated to have underlying diseases in our survey. This is a concern, as older age and the presence of (an) underlying health condition(s) are associated with increased COVID-19 related mortality [28,29] On the other hand, Brazilian respondents with underlying diseases adhered better to the containment measures.…”

“…From that moment on, there was a relaxation of quarantine measures, opening of part of the trade, and consequently less physical distancing. This increased the number of COVID-19 cases and associated deaths [28,31]. At the end of April, the COVID-19 death toll in Brazil had already exceeded that of China [3] (more than 5,000 deaths) and this scenario is getting worse, not reaching the attening of the curve and overloading the Brazilian health system [32].…”