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).

在严重急性呼吸综合征冠状病毒2型（severe acute respiratory syndrome coronavirus 2, SARS-CoV-2）大流行期间，意大利是受影响最严重的欧洲国家之一。超过50%的意大利确诊病例集中在北部伦巴第大区，2020年3月至4月间当地医疗资源饱和，迫使医院依据可用资源对患者进行分诊调配。本研究团队所在医院共收治18名需要重症支持的重症2019冠状病毒病（coronavirus disease 2019, COVID-19）患者。鉴于该病的高致死性，我们对患者的临床特征进行了分析，以筛选死亡预测因素。经统计，7例患者死于多器官功能衰竭，2例死于感染性休克，2例死于肺衰竭。在医院内感染SARS-CoV-2的患者中，病死率最高。患者的不良死亡结局与以下基线特征显著相关：合并多种基础疾病（比值比[odds ratio, OR]=2.519，P=0.048）、低体质量指数（body mass index, BMI；OR=2.288，P=0.031）、低血红蛋白水平（OR=3.012，P=0.046）以及抗凝血酶Ⅲ水平异常（OR=1.172，P=0.048），同时与入院后前72小时内动脉血氧分压/吸入氧分数（partial pressure of arterial oxygen/fraction of inspired oxygen, PaO2/FiO2）比值恶化相关（OR=1.067，P=0.031）。住院期间发生合并感染与更长的重症监护时长显著相关（回归系数B=4.511，P=0.001）。本数据集被用于撰写论文《意大利大流行期间伦巴第大区重症监护病房收治的重症COVID-19患者的临床特征》，该论文于2021年发表于《Frontiers in Medicine》（《医学前沿》），DOI：10.3389/fmed.2021.582896。