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Baseline characteristics of COVID-19 Italian patients admitted to Desio Hospital, Lombardy: a retrospective study
Adela Sulejmani1, Elisa Galimberti1, Chiara Giacobone1
1Laboratory of Clinical Chemistry, Hospital of Desio and Monza, ASST-Monza and School of Medicine and Surgery, University of Milano-Bicocca, Milano, Italy.
Insights
Early identification of severe coronavirus disease 2019 (COVID-19) is crucial. Admission findings like older age, low oxygen levels, and elevated lab markers including C-reactive protein predict mortality risk.
Area of Science:
- Emergency Medicine
- Infectious Diseases
- Clinical Pathology
Background:
- Coronavirus disease 2019 (COVID-19) poses significant global health challenges.
- Understanding early predictors of severity and mortality in COVID-19 patients is critical for timely intervention.
Purpose of the Study:
- To investigate the correlation between initial clinical, radiological, and laboratory findings in emergency department (ED) patients and their clinical severity and mortality risk.
- To identify early risk factors for poor prognosis in hospitalized COVID-19 patients.
Main Methods:
- Retrospective study of 175 adult COVID-19 patients hospitalized in March 2020.
- Analysis of clinical, radiological, and laboratory data at admission.
- Categorization of patients based on disease severity and adverse outcomes.
Main Results:
- Most patients (79%) had comorbidities, primarily cardiovascular disease (62%).
- Severe cases showed higher absolute neutrophil count (ANC), C-reactive protein (CRP), AST, LDH, procalcitonin (PCT), and BUN.
- Mortality risk increased with older age, low PaO2/FiO2 ratio, clinical severity, elevated creatinine, and creatine kinase.
Conclusions:
- Initial clinical and laboratory findings can help identify COVID-19 patients at high risk of severe disease and mortality.
- Early identification of these risk factors allows for prompt and appropriate patient management.
Abstract:
The correlation of clinical, radiological and laboratory findings of patients at admission in the Emergency Department (ED) with clinical severity and risk of mortality was investigated. Adult coronavirus disease 2019 (COVID-19) patients hospitalized in March 2020 in Desio Hospital, Lombardy, were retrospectively included in the study, and categorized in terms of disease severity and adverse outcome. Out of the 175 patients enrolled, 79% presented one or more comorbidities, with cardiovascular disease being the most frequent (62%). More than half of the patients showed lymphocytopenia and 20% thrombocytopenia. The patients in the severe group presented higher absolute neutrophil count (ANC), C-reactive protein (CRP), AST, LDH, procalcitonin (PCT) and BUN values compared to the non-severe group (p < .05). Increased odds of mortality associated with older age (OR = 22.43; 95% CI 5.22-96.27), partial pressure of oxygen (PaO2)/fraction of inspired oxygen (FIO2) ratio < 200 (OR = 4.97; 95% CI 1.55-15.84), clinical severity (OR = 21.32; 95% CI 2.27-200.13), creatinine > 106.08 µmol/L (OR = 2.87; 95% CI 1.04-7.92) and creatine kinase > 2.90 µkat/L (OR = 3.80; 95% CI 1.31-10.9) were observed on admission (p < .05). The above findings may contribute to identify early risk factors of poor prognosis, and to select the most appropriate management for patients.