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High mortality in COVID‐19 patients with mild respiratory disease
Author(s) -
Masetti Chiara,
Generali Elena,
Colapietro Francesca,
Voza Antonio,
Cecconi Maurizio,
Messina Antonio,
Omodei Paolo,
Angelini Claudio,
Ciccarelli Michele,
Badalamenti Salvatore,
Caica G. Walter,
Lleo Ana,
Aghemo Alessio
Publication year - 2020
Publication title -
european journal of clinical investigation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.164
H-Index - 107
eISSN - 1365-2362
pISSN - 0014-2972
DOI - 10.1111/eci.13314
Subject(s) - medicine , comorbidity , intensive care unit , diabetes mellitus , pneumonia , mechanical ventilation , univariate analysis , logistic regression , cohort , severity of illness , pediatrics , multivariate analysis , endocrinology
Severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) has infected 189 000 people in Italy, with more than 25 000 deaths. Several predictive factors of mortality have been identified; however, none has been validated in patients presenting with mild disease. Methods Patients with a diagnosis of interstitial pneumonia caused by SARS‐CoV‐2, presenting with mild symptoms, and requiring hospitalization in a non‐intensive care unit with known discharge status were prospectively collected and retrospectively analysed. Demographical, clinical and biochemical parameters were recorded, as need for non‐invasive mechanical ventilation and admission in intensive care unit. Univariate and multivariate logistic regression analyses were used to identify independent predictors of death. Results Between 28 February and 10 April 2020, 229 consecutive patients were included in the study cohort; the majority were males with a mean age of 60 years. 54% of patients had at least one comorbidity, with hypertension being the most commonly represented, followed by diabetes mellitus. 196 patients were discharged after a mean of 9 days, while 14.4% died during hospitalization because of respiratory failure. Age higher than 75 years, low platelet count (<150 × 10 3 /mm 3 ) and higher ferritin levels (>750 ng/mL) were independent predictors of death. Comorbidities were not independently associated with in‐hospital mortality. Conclusions In‐hospital mortality of patients with COVID‐19 presenting with mild symptoms is high and is associated with older age, platelet count and ferritin levels. Identifying early predictors of outcome can be useful in the clinical practice to better stratify and manage patients with COVID‐19.

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