• Eur. J. Clin. Invest. · Sep 2021

    Prognostic parameters of in-hospital mortality in COVID-19 patients-An Italian experience.

    • Massimiliano Ruscica, Chiara Macchi, Simona Iodice, Gregorio Tersalvi, Irene Rota, Simone Ghidini, Leonardo Terranova, Luca Valenti, Francesco Amati, Stefano Aliberti, Alberto Corsini, Francesco Blasi, Stefano Carugo, Valentina Bollati, and Marco Vicenzi.
    • Department of Pharmacological and Biomolecular Sciences, Università degli Studi di Milano, Milan, Italy.
    • Eur. J. Clin. Invest. 2021 Sep 1; 51 (9): e13629.

    AbstractBackground During COVID-19 outbreak, Italy was the first country in Europe to be heavily affected with an intensive care unit mortality of 26%. In order to reduce this percentage, physicians should establish clear and objective criteria to stratify COVID-19 patients at high risk of in-hospital death. Thus, the aim has been to test a large spectrum of variables ranging from clinical evaluation to laboratory biomarkers to identify which parameter would best predict all-cause in-hospital mortality in COVID-19 patients. Design observational study. Results Multivariate Cox regression analysis showed that each 5 years of increase in age corresponded to a hazard ratio (HR) of 1.28 (95% CI 1.00-1.65, P = .050); each increment of 803 ng/L of N-terminal pro-B-type natriuretic peptide (NT-proBNP) corresponded to a HR of 1.24 (95% CI 1.11-1.39, P < .001); each increment of 58 ng/L of interleukin (IL)-6 corresponded to a HR of 1.23 (95% CI 1.09-1.40, P < .001), and each increment of 250 U/L of lactate dehydrogenase (LDH) corresponded to a HR of 1.23 (95% CI 1.10-1.37, P < .001). According to the calculated cut-points for age (≥70 years), NT-proBNP (≥803 ng/L), IL-6 (≥58 ng/L) and LDH (≥371 U/L) when 2 out of these 4 were overcome, the HR was 2.96 (95% CI 1.97-4.45, P < .001). Conclusion In COVID-19 patients, besides age, the evaluation of three biochemical parameters, available in few hours after hospital admission can predict in-hospital mortality regardless of other comorbidities.© 2021 The Authors. European Journal of Clinical Investigation published by John Wiley & Sons Ltd on behalf of Stichting European Society for Clinical Investigation Journal Foundation.

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