• Antonio Vena, Daniele Roberto Giacobbe, Antonio Di Biagio, Malgorzata Mikulska, Lucia Taramasso, Andrea De Maria, Lorenzo Ball, Iole Brunetti, Maurizio Loconte, Nicolò A Patroniti, Chiara Robba, Emanuele Delfino, Chiara Dentone, Laura Magnasco, Laura Nicolini, Federica Toscanini, Martina Bavastro, Matteo Cerchiaro, Emanuela Barisione, Mauro Giacomini, Sara Mora, Federico Baldi, Elisa Balletto, Marco Berruti, Federica Briano, Chiara Sepulcri, Silvia Dettori, Laura Labate, Michele Mirabella, Federica Portunato, Rachele Pincino, Chiara Russo, Stefania Tutino, Paolo Pelosi, Matteo Bassetti, and GECOVID study group.
• Infectious Diseases Unit, Ospedale Policlinico San Martino-IRCCS, Genoa, Italy.
• Clin. Microbiol. Infect. 2020 Nov 1; 26 (11): 1537-1544.

ObjectivesTo describe clinical characteristics, management and outcome of individuals with coronavirus disease 2019 (COVID-19); and to evaluate risk factors for all-cause in-hospital mortality.MethodsThis retrospective study from a University tertiary care hospital in northern Italy, included hospitalized adult patients with a diagnosis of COVID-19 between 25 February 2020 and 25 March 2020.ResultsOverall, 317 individuals were enrolled. Their median age was 71 years and 67.2% were male (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, diarrhoea or nausea and vomiting was observed in 53/317 patients (16.7%). Hypokalaemia 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 OR 1.07; 95% 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.ConclusionsCOVID-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.Copyright © 2020 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

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