Characteristics and outcomes of a cohort of COVID-19 patients in the Province of Reggio Emilia, Italy

Rossi, Paolo Giorgi; Marino, Massimiliano; Formisano, Debora; Venturelli, Francesco; Vicentini, Massimo; Grilli, Roberto

doi:10.1371/journal.pone.0238281

Cited by 132 publications

(102 citation statements)

References 23 publications

(31 reference statements)

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“…In this study, we assessed the clinical characteristics at the admission of patients with more severe infections admitted to our hospital in the first wave of the COVID-19 pandemic. The overall proportion of deaths was 32%, much higher than that observed in China [ 4 , 5 ], similar to that reported in other areas of Spain [ 6 , 7 , 8 ] and neighboring European countries [ 9 , 10 ], and lower than that reported in United States [ 11 ], for the same age ranges. The threshold of severity required for hospitalization could explain some of these differences, as too could the incomplete follow up of patients assessed in some studies.…”

Section: Discussionsupporting

confidence: 75%

Prognostic Factors at Admission for In-Hospital Mortality from COVID-19 Infection in an Older Rural Population in Central Spain

Maestre-Muñiz

Arias

Arias-González

et al. 2021

JCM

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Background: Risk factors for in-hospital mortality from severe coronavirus disease 2019 (COVID-19) infection have been identified in studies mainly carried out in urban-based teaching hospitals. However, there is little data for rural populations attending community hospitals during the first wave of the pandemic. Methods: A retrospective, single-center cohort study was undertaken among inpatients at a rural community hospital in Spain. Electronic medical records of the 444 patients (56.5% males) admitted due to severe SARS-CoV-2 infection during 26 February 2020–31 May 2020 were reviewed. Results: Mean age was 71.2 ± 14.6 years (rank 22–98), with 69.8% over 65. At least one comorbidity was present in 410 patients (92.3%), with chronic obstructive pulmonary disease (COPD) present in 21.7%. Overall in-hospital mortality was 32%. Multivariate analysis of factors associated with death identified patients’ age (with a cumulative effect per decade), COPD as a comorbidity, and respiratory insufficiency at the point of admission. No additional comorbid conditions proved significant. Among analytical values, increased serum creatinine, LDH > 500 mg/dL, thrombocytopenia (<150 × 109/per L), and lymphopenia (<1000 cells/µL) were all independently associated with mortality during admission. Conclusions: Age remained the major determinant for COVID-19-caused mortality; COPD was the only comorbidity independently associated with in-hospital death, together with respiratory insufficiency and analytical markers at admission.

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Section: Discussionsupporting

confidence: 75%

Prognostic Factors at Admission for In-Hospital Mortality from COVID-19 Infection in an Older Rural Population in Central Spain

Maestre-Muñiz

Arias

Arias-González

et al. 2021

JCM

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“…We found a J shaped relationship with BMI. Surprisingly, although strong associations of hypertension with COVID-19 have been reported elsewhere, 5 , 6 , 7 we found that people who developed fatal or critical care unit-treated COVID-19 had slightly lower blood pressures than those who did not, and that being on antihypertensives was associated with a lower risk than not being on any. Among the specific antihypertensive drug classes, thiazides and angiotensin 2 receptor antagonists or blockers had the lowest ORs.…”

Section: Discussioncontrasting

confidence: 65%

“…Initial case series of people hospitalised with COVID-19 in several countries found over-representation of people with diabetes. 1 , 2 , 3 , 4 , 5 , 6 , 7 , 8 More than a quarter of those admitted for COVID-19 in the UK had diabetes. 9 Just four studies, three from the UK, have compared risks in defined populations with and without diabetes, all of which found increased risks in those with diabetes for in-hospital and total deaths.…”

Section: Introductionmentioning

confidence: 99%

Risks of and risk factors for COVID-19 disease in people with diabetes: a cohort study of the total population of Scotland

McGurnaghan

Weir

Bishop

et al. 2021

The Lancet Diabetes & Endocrinology

281

258

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Background We aimed to ascertain the cumulative risk of fatal or critical care unit-treated COVID-19 in people with diabetes and compare it with that of people without diabetes, and to investigate risk factors for and build a crossvalidated predictive model of fatal or critical care unit-treated COVID-19 among people with diabetes. MethodsIn this cohort study, we captured the data encompassing the first wave of the pandemic in Scotland, from March 1, 2020, when the first case was identified, to July 31, 2020, when infection rates had dropped sufficiently that shielding measures were officially terminated. The participants were the total population of Scotland, including all people with diabetes who were alive 3 weeks before the start of the pandemic in Scotland (estimated Feb 7, 2020). We ascertained how many people developed fatal or critical care unit-treated COVID-19 in this period from the Electronic Communication of Surveillance in Scotland database (on virology), the RAPID database of daily hospitalisations, the Scottish Morbidity Records-01 of hospital discharges, the National Records of Scotland death registrations data, and the Scottish Intensive Care Society and Audit Group database (on critical care). Among people with fatal or critical care unit-treated COVID-19, diabetes status was ascertained by linkage to the national diabetes register, Scottish Care Information Diabetes. We compared the cumulative incidence of fatal or critical care unit-treated COVID-19 in people with and without diabetes using logistic regression. For people with diabetes, we obtained data on potential risk factors for fatal or critical care unit-treated COVID-19 from the national diabetes register and other linked health administrative databases. We tested the association of these factors with fatal or critical care unit-treated COVID-19 in people with diabetes, and constructed a prediction model using stepwise regression and 20-fold cross-validation. Findings Of the total Scottish population onMarch 1, 2020 (n=5 463 300), the population with diabetes was 319 349 (5•8%), 1082 (0•3%) of whom developed fatal or critical care unit-treated COVID-19 by July 31, 2020, of whom 972 (89•8%) were aged 60 years or older. In the population without diabetes, 4081 (0•1%) of 5 143 951 people developed fatal or critical care unit-treated COVID-19. As of July 31, the overall odds ratio (OR) for diabetes, adjusted for age and sex, was 1•395 (95% CI 1•304-1•494; p<0•0001, compared with the risk in those without diabetes. The OR was 2•396 (1•815-3•163; p<0•0001) in type 1 diabetes and 1•369 (1•276-1•468; p<0•0001) in type 2 diabetes. Among people with diabetes, adjusted for age, sex, and diabetes duration and type, those who developed fatal or critical care unit-treated COVID-19 were more likely to be male, live in residential care or a more deprived area, have a COVID-19 risk condition, retinopathy, reduced renal function, or worse glycaemic control, have had a diabetic ketoacidosis or hypoglycaemia hospitalisation in the past 5 years, be on more...

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“…Lymphopenia, elevated D-dimer and other analytical signs of systemic inflammatory response syndrome (SIRS) has been observed [ 4 , 9 ]. In severe cases, individuals present severe bilateral interstitial pneumonia, commonly requiring admission in intensive care units (ICU) and mechanical ventilation [ 3 , 4 , 11 , 12 , 13 ]. Furthermore, SARS-CoV-2, like other coronaviruses, not only affects the respiratory tract but also the digestive tract, liver and heart [ 14 ].…”

Section: Introductionmentioning

confidence: 99%

Clinical Profile, Treatment and Predictors during the First COVID-19 Wave: A Population-Based Registry Analysis from Castile and Leon Hospitals

Gutiérrez-Abejón

Tamayo

Martín-García

et al. 2020

IJERPH

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The first wave of the COVID-19 pandemic collapsed the hospitals in Castile and Leon (Spain). An analysis of the clinical characteristics, drug therapies and principal outcome predictors in the COVID-19 hospitalized patients from 1 March to 31 May 2020 is presented through a population-based registry study. Hospital stay variables, ventilation mode data and clinical outcomes were observed. In Castile and Leon hospitals, 7307 COVID-19 patients were admitted, with 57.05% being male and a median of 76 years. The mortality rate was 24.43%, with a high incidence of severe acute respiratory syndrome (SARS) (14.03%) and acute kidney injury (AKI) (10.87%). The most used medicines were antibiotics (90.83%), antimalarials (42.63%), steroids (44.37%) and antivirals, such as lopinavir/ritonavir (42.63%). The use of tocilizumab (9.37%) and anti-SIRS (systemic inflammatory response syndrome) medicines (7.34%) were remarkable. Fundamentally, death occurred more likely over 65 years of age (OR: 9.05). In addition, the need for ventilation was associated with a higher probability of death (OR: 3.59), SARS (OR: 5.14) and AKI (OR: 2.31). The drug-use pattern had been modified throughout the COVID-19 first wave. Multiple factors, such as age, gender and the need for mechanical ventilation, were related to the worst evolution prognosis of the disease.

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Characteristics and outcomes of a cohort of COVID-19 patients in the Province of Reggio Emilia, Italy

Abstract: ¶ Membership of the Reggio Emilia COVID-19 Working Group is provided in the Acknowledgments.

Cited by 132 publications

References 23 publications

Prognostic Factors at Admission for In-Hospital Mortality from COVID-19 Infection in an Older Rural Population in Central Spain

Prognostic Factors at Admission for In-Hospital Mortality from COVID-19 Infection in an Older Rural Population in Central Spain

Risks of and risk factors for COVID-19 disease in people with diabetes: a cohort study of the total population of Scotland

Clinical Profile, Treatment and Predictors during the First COVID-19 Wave: A Population-Based Registry Analysis from Castile and Leon Hospitals

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