Clinical Characteristics of Severe COVID-19 in Italy

Italy was one of the worst affected European countries during the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic. More than 50% of Italian cases occurred in the northern region of Lombardy, where the saturation of health services between March and April 2020 forced hospitals to allocate patients according to available resources. Eighteen severe coronavirus disease 2019 (COVID-19) patients were admitted to our hospital needing intensive support. Given the disease fatality, we investigated the patients' characteristics to identify mortality predictors. We counted seven deaths from multiple organ failure, two from septic shock, and two from collapsed lungs. The maximum case fatality was observed in patients who contracted SARS-CoV-2 in hospitals. The fatal outcome was associated with the following baseline characteristics: polymorbidity (OR 2.519, p = 0.048), low body mass index (OR 2.288, p = 0.031), low hemoglobin (OR 3.012, p = 0.046), and antithrombin III (OR 1.172, p = 0.048), along with a worsening of PaO2/FiO2 ratio in the first 72 h after admission (OR 1.067, p = 0.031). The occurrence of co-infections during hospitalization was associated with a longer need for intensive care (B = 4.511, p = 0.001). The dataset was used to write the article "Clinical Characteristics of Severe COVID-19 Patients Admitted to an Intensive Care Unit in Lombardy During the Italian Pandemic", which was published by the Journal Frontiers in Medicine in 2021 (DOI:10.3389/fmed.2021.582896).

意大利在严重急性呼吸综合征冠状病毒2（SARS-CoV-2）大流行期间，是受影响最为严重的欧洲国家之一。超过50%的意大利病例发生在伦巴第大区的北部地区，2020年3月至4月期间，医疗服务资源的饱和迫使医院根据可用资源分配患者。我院接收了18名需要重症支持的严重冠状病毒疾病2019（COVID-19）患者。鉴于该疾病的死亡率，我们对患者的特征进行了调查，以识别死亡预测因子。共记录了7例因多器官功能衰竭死亡，2例因败血症休克死亡，2例因肺泡破裂死亡。最大病例死亡率见于在医院感染SARS-CoV-2的患者中。致命的结局与以下基线特征相关：多病共存（OR 2.519，p = 0.048）、低体重指数（OR 2.288，p = 0.031）、低血红蛋白（OR 3.012，p = 0.046）和抗凝血酶III（OR 1.172，p = 0.048），以及入院后前72小时内PaO2/FiO2比值恶化（OR 1.067，p = 0.031）。住院期间合并感染的发生与更长的重症监护需求相关（B = 4.511，p = 0.001）。该数据集被用于撰写文章《意大利大流行期间伦巴第重症监护室严重COVID-19患者的临床特征》，该文章发表于2021年的《医学前沿》杂志（DOI:10.3389/fmed.2021.582896）。