Clinical characteristics, management and in-hospital mortality of patients with COVID-19 In Genoa, Italy

Objectives To describe clinical characteristics, management and outcome of COVID-19 patients;and to evaluate risk factors for all-cause in-hospital mortality Methods This retrospective study from a University tertiary care hospital in northern Italy, included hospitalized adult patients with a diagnosis of COVID-19 between February 25th, 2020 and March 25th, 2020 Results Overall, 317 patients were enrolled Their median age 71 years and 67 2% were males (213/317) The most common underlying diseases were hypertension (149/317;47 0%), cardiovascular disease (63/317, 19 9%) and diabetes (49/317;15 5%) Common symptoms at the time of COVID-19 diagnosis included fever (285/317;89 9%), shortness of breath (167/317;52 7%) and dry cough (156/317,49 2%) An “atypical” presentation including at least one among mental confusion, diarrhea or nausea and vomiting was observed in 53/317 patients (16 7%) Hypokalemia occurred in 25 8% (78/302) and 18 5% (56/303) had acute kidney injury During hospitalization, 111/317 patients (35 0%) received non-invasive respiratory support, 65/317 (20 5%) were admitted to the intensive care unit (ICU) and 60/317 (18 5%) required invasive mechanical ventilation All cause in-hospital mortality, assessed in 275 patients, was 43 6% (120/275) On multivariable analysis, age (per-year increase odds ratio [OR]:1 07;95% confidence interval [CI] 1 04-1 10, p<0 001), cardiovascular disease (OR:2 58;95% CI 1 07-6 25;p=0 03), and C-reactive protein levels (per-point increase OR:1 009;95% CI 1 004-1 014;p=0 001) were independent risk factors for all-cause in-hospital mortality Conclusions COVID-19 mainly affected elderly patients with predisposing conditions and caused severe illness, frequently requiring non-invasive respiratory support or ICU admission Despite supportive care, COVID-19 remains associated with a substantial risk of all-cause in-hospital mortality