Background

National health-system hospitals of Lombardy faced a heavy burden of admissions for acute respiratory distress syndromes associated with coronavirus disease (COVID-19). Data on patients of European origin affected by COVID-19 are limited.

Methods

All consecutive patients aged ≥18 years, coming from North-East of Milan's province and admitted at San Raffaele Hospital with COVID-19, between February 25th and March 24th, were reported, all patients were followed for at least one month. Clinical and radiological features at admission and predictors of clinical outcomes were evaluated.

Results

Of the 500 patients admitted to the Emergency Unit, 410 patients were hospitalized and analyzed: median age was 65 (IQR 56–75) years, and the majority of patients were males (72.9%). Median (IQR) days from COVID-19 symptoms onset was 8 (5–11) days. At hospital admission, fever (≥ 37.5 °C) was present in 67.5% of patients. Median oxygen saturation (SpO2) was 93% (range 60–99), with median PaO₂/FiO₂ ratio, 267 (IQR 184–314). Median Radiographic Assessment of Lung Edema (RALE) score was 9 (IQR 4–16). More than half of the patients (56.3%) had comorbidities, with hypertension, coronary heart disease, diabetes and chronic kidney failure being the most common. The probability of overall survival at day 28 was 66%. Multivariable analysis showed older age, coronary artery disease, cancer, low lymphocyte count and high RALE score as factors independently associated with an increased risk of mortality.

Conclusion

In a large cohort of COVID-19 patients of European origin, main risk factors for mortality were older age, comorbidities, low lymphocyte count and high RALE.

中文翻译：

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意大利米兰COVID-19爆发的临床预后的早期预测指标。

背景

伦巴第州的国家卫生系统医院因与冠状病毒病（COVID-19）相关的急性呼吸窘迫综合征面临着沉重的入院负担。有关受COVID-19影响的欧洲血统患者的数据有限。

方法

据报道，2月25日至3月24日之间，来自米兰省东北部且在圣拉斐尔医院以COVID-19入院的所有年龄≥18岁的连续患者，均接受了至少一个月的随访。入院时的临床和放射学特征以及临床预后的评估指标。

结果

在进入急诊室的500名患者中，有410名患者住院并进行了分析：中位年龄为65岁（IQR 56-75），大多数患者为男性（72.9％）。COVID-19症状发作的中位数（IQR）天为8（5-11）天。入院时，有67.5％的患者发烧（≥37.5°C）。氧饱和度中位数（SpO2）为93％（范围60–99），中位数PaO ₂ / FiO ₂比率267（IQR 184–314）。肺水肿的放射学评估中值（RALE）为9（IQR 4-16）。一半以上的患者（56.3％）患有合并症，其中高血压，冠心病，糖尿病和慢性肾功能衰竭最为常见。在第28天总体存活的可能性为66％。多变量分析显示年龄，冠状动脉疾病，癌症，淋巴细胞计数低和RALE评分高是与死亡风险增加独立相关的因素。

结论

在一大批来自欧洲的COVID-19患者中，死亡率的主要危险因素是年龄大，合并症，淋巴细胞计数低和RALE高。