At the peak of COVID-19 age and disease severity but not comorbidities are predictors of mortality: COVID-19 burden in Bergamo, Italy

• DOI: 10.23736/s0031-0808.20.04063-x
• Publication Date: 2021-02-05T08:48:59Z
• Authors: Luca NOVELLI; ; Federico RAIMONDI; Arianna GHIRARDI; Dario PELLEGRINI; Davide CAPODANNO; Giovanni SOTGIU; Giulio GUAGLIUMI; Michele SENNI; Filippo M. RUSSO; Ferdinando L. LORINI; Marco RIZZI; Tiziano BARBUI; Alessandro RAMBALDI; Roberto COSENTINI; Lorenzo S. GRAZIOLI; Gianmariano MARCHESI; Giuseppe F. SFERR...; Simonetta CESA; Michele COLLEDAN; Roberta CIVILETTI; Caterina CONTI; Monica CASATI; Francesco FERRI; Stefania CAMAGNI; Maria SESSA; Arianna MASCIULLI; Antonello GAVAZZI; Anna FALANGA; Luigi F. DA POZZO; Sabrina BUORO; Giuseppe REMUZZI; Piero RUGGENENTI; Annapaola CALLEGARO; Lorenzo D’ANTIGA; Luisa PASULO; Fabio PEZZOLI; Andrea GIANATTI; Piercarlo PARIGI; Claudio FARINA; Antonio BELLASI; Paolo SOLIDORO; Sandro SIRONI; Fabiano DI MARCO; Stefano FAGIUOLI
• Keywords: Adult; Aged, 80 and over; Male; SARS-CoV-2; Age Factors; COVID-19; Middle Aged; Severity of Illness Index; 3. Good health; 03 medical and health sciences; 0302 clinical medicine; Italy; Humans; Female; Aged; Retrospective Studies

Background.Findings from February, 2020, indicate that the clinical spectrum of Covid-19 can be heterogeneous, probably due to infectious dose and viral load SARS-CoV-2 within first weeks outbreak.The aim this study was investigate predictors overall 28-day mortality at peak Italian outbreak.Methods.Retrospective observational all patients admitted main hospital Bergamo, February 23 March, 14, 2020.Results.508 were hospitalized , predominantly male (72.4%), mean age 66±15 years; 49.2% older than 70 years.Most presented with severe respiratory failure (median value [IQR] PaO2/FiO2 233 [149-281]).Mortality rate 28 days resulted 33.7% (N=171).39.0% treated continuous positive airway pressure (CPAP), 9.5% non-invasive ventilation (NIV) 13.6% endotracheal intubation.9.5% semi-intensive care unit, 18.9% ICU.Risk factors independently associated advanced (≥78 years: odds ratio, OR, 95% confidence interval [CI] 38.91 [10.67-141.93],p<0.001; 70-77 17.30 [5.40-55.38],p<0.001; 60-69 3.20 [1.00-10.20],p=0.049),PaO2/FiO2 <200 presentation (3.50 [1.70-7.20],p=0.001), need for CPAP/NIV in 24 hours (8.38 [3.63-19.35],p <0.001), blood urea admission (1.01 [1.00-1.02],p=0.015).Conclusions.At outbreak, a probable high load, age, severity renal impairment presentation, but not comorbidities, are Covid-19.