Clinical factors associated with death in 3044 COVID-19 patients managed in internal medicine wards in Italy: results from the SIMI-COVID-19 study of the Italian Society of Internal Medicine (SIMI).
Clinical factors associated with death in 3044 COVID-19 patients managed in internal medicine wards in Italy: results from the SIMI-COVID-19 study of the Italian Society of Internal Medicine (SIMI).
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DOI：
10.1007/s11739-021-02742-8
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发表时间：
2021-06
影响因子：
4.6
通讯作者：
SIMI-COVID-19 Collaborators
中科院分区：
文献类型：
--
作者：
Corradini E;Ventura P;Ageno W;Cogliati CB;Muiesan ML;Girelli D;Pirisi M;Gasbarrini A;Angeli P;Querini PR;Bosi E;Tresoldi M;Vettor R;Cattaneo M;Piscaglia F;Brucato AL;Perlini S;Martelletti P;Pontremoli R;Porta M;Minuz P;Olivieri O;Sesti G;Biolo G;Rizzoni D;Serviddio G;Cipollone F;Grassi D;Manfredini R;Moreo GL;Pietrangelo A;SIMI-COVID-19 Collaborators
在2020年COVID-19疫情期间，提供了大量关于住院COVID-19患者的一般管理和结果的数据。然而，相对而言，对在内科单位（IMU）管理的患者的特征和结果知之甚少。为了弥补这一差距，意大利内科学学会开展了一项全国性队列多中心研究，研究了在IMU住院和管理的成年COVID-19患者的死亡结果。本研究评估了2020年2月3日至5月8日意大利41家转诊医院的3044名COVID-19患者。评估了人口统计学、合并症、器官功能障碍、治疗和包括死亡在内的结局。在研究期间，697例患者（22.9%）转至重症监护病房，351例患者在IMU死亡（死亡率14.9%）。入院时，与住院死亡率独立相关的因素是年龄（OR 2.46, p = 0.000）、咳痰（OR 2.04, p = 0.000）、既往存在的慢性心力衰竭（OR 1.58, p = 0.017）和慢性阻塞性肺疾病（OR 1.17, p = 0.048）、合并症数量（OR 1.34, p = 0.000）和多种药物（OR 1.20, p = 0.000）。值得注意的是，高达40%的老年患者在入院时没有报告发烧。入院时PaO2/FiO2比值降低与生存率呈显著负相关。常规补氧的使用随着已有合并症数量的增加而增加，但对于PaO2/FiO2比< 100的患者，它与更好的生存率无关。后者，明显受益于早期使用无创机械通气。我们的研究确定入院时的PaO2/FiO2比率和合并症是IMU收治的COVID-19非危重患者的临床决策和资源分配的主要预警信号。在线版本包含补充材料，可在10.1007/s11739-021-02742-8获得。
During the COVID-19 2020 outbreak, a large body of data has been provided on general management and outcomes of hospitalized COVID-19 patients. Yet, relatively little is known on characteristics and outcome of patients managed in Internal Medicine Units (IMU). To address this gap, the Italian Society of Internal Medicine has conducted a nationwide cohort multicentre study on death outcome in adult COVID-19 patients admitted and managed in IMU. This study assessed 3044 COVID-19 patients at 41 referral hospitals across Italy from February 3rd to May 8th 2020. Demographics, comorbidities, organ dysfunction, treatment, and outcomes including death were assessed. During the study period, 697 patients (22.9%) were transferred to intensive care units, and 351 died in IMU (death rate 14.9%). At admission, factors independently associated with in-hospital mortality were age (OR 2.46, p = 0.000), productive cough (OR 2.04, p = 0.000), pre-existing chronic heart failure (OR 1.58, p = 0.017) and chronic obstructive pulmonary disease (OR 1.17, p = 0.048), the number of comorbidities (OR 1.34, p = 0.000) and polypharmacy (OR 1.20, p = 0.000). Of note, up to 40% of elderly patients did not report fever at admission. Decreasing PaO2/FiO2 ratio at admission was strongly inversely associated with survival. The use of conventional oxygen supplementation increased with the number of pre-existing comorbidities, but it did not associate with better survival in patients with PaO2/FiO2 ratio < 100. The latter, significantly benefited by the early use of non-invasive mechanical ventilation. Our study identified PaO2/FiO2 ratio at admission and comorbidity as the main alert signs to inform clinical decisions and resource allocation in non-critically ill COVID-19 patients admitted to IMU. The online version contains supplementary material available at 10.1007/s11739-021-02742-8.
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影响因子：
25.4
作者：
Guaraldi, Giovanni;Meschiari, Marianna;Mussini, Cristina
通讯作者：
Mussini, Cristina
在急诊室被诊断出的310名Covid-19患者的临床特征和呼吸支持：一项单中心回顾性研究。
影响因子：
4.6
作者：
Di Domenico SL;Coen D;Bergamaschi M;Albertini V;Ghezzi L;Cazzaniga MM;Tombini V;Colombo R;Capsoni N;Coen T;Cazzola KB;Di Fiore M;Angaroni L;Strozzi MA
通讯作者：
Strozzi MA
影响因子：
4.6
作者：
Ageno W;Cogliati C;Perego M;Girelli D;Crisafulli E;Pizzolo F;Olivieri O;Cattaneo M;Benetti A;Corradini E;Bertù L;Pietrangelo A;List of contributors
通讯作者：
List of contributors
DOI：
10.1016/s2213-2600(20)30370-2
发表时间：
2020-12
期刊：
The Lancet. Respiratory medicine
影响因子：
--
作者：
Grasselli G;Tonetti T;Protti A;Langer T;Girardis M;Bellani G;Laffey J;Carrafiello G;Carsana L;Rizzuto C;Zanella A;Scaravilli V;Pizzilli G;Grieco DL;Di Meglio L;de Pascale G;Lanza E;Monteduro F;Zompatori M;Filippini C;Locatelli F;Cecconi M;Fumagalli R;Nava S;Vincent JL;Antonelli M;Slutsky AS;Pesenti A;Ranieri VM;collaborators
通讯作者：
collaborators
影响因子：
5.8
作者：
Bahat, G.
通讯作者：
Bahat, G.