ABSTRACT
Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic is known to cause a predominant respiratory disease, although extrapulmonary manifestations can also occur. One of the targets of Coronavirus disease 2019 (COVID-19) is the hepatobiliary system. The present study aims to describe the correlation between the increase of liver damage markers (i.e. alanine aminotransferase [ALT], aspartate aminotransferase [AST], total bilirubin [TB]) and COVID-19 outcomes (i.e., in-hospital mortality [IHM] and intensive care unit [ICU] transfer). Methods: All patients with confirmed SARS-CoV-2 infection admitted to the Infectious Diseases Unit of the St. Anna University-Hospital of Ferrara from March 2020 to October 2021 were retrospectively included in this single-centre study. ALT, AST and TB levels were tested in all patients and IHM or ICU transfer were considered as main outcomes. Co-morbidities were assessed using Charlson Comorbidity Index. Results: A total of 106 patients were retrieved. No hepatic marker was able to predict IHM, whereas all of them negatively predicted ICU transfer (ALT: OR 1.005, 95%CI 1.001-1.009, p= 0.011; AST: OR 1.018, 95%CI 1.006-1.030, p= 0.003; TB: OR 1.329, 95%CI 1.025-1.724, p= 0.032). Age was the only parameter significantly related to mortality. Conclusions: The present study, by correlating liver damage markers with COVID-19 outcome, showed that an increase of ALT, AST and TB predicted patients' severity, although not mortality.
ABSTRACT
Background: Since 2019, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic (COVID-19) has caused millions of deaths worldwide and is the second most serious pandemic after the Spanish flu. Despite SARS-CoV-2 infection having a dominant effect on morbidity and life-threatening outcomes, the role of bacterial co-infection in patients with COVID-19 is poorly understood. The present study aimed to verify the existence of bacterial co-infections and their possible role as cofactors worsening COVID-19-related clinical manifestations. Methods: All patients with suspected SARS-CoV-infection, hospitalised in COVID-19 wards at the Sant'Anna University Hospital of Ferrara, were retrospectively included in this single-centre study and their specific bacterial serologies were assessed. Univariate and logistic regression analyses were performed. Results: A total of 1204 individual records were retrieved. Among them, 959 were excluded because of a negative nasopharyngeal swab or missing data; of the eligible 245 patients, 51 were co-infected. Compared to patients with SARS-CoV-2 infection alone, those with Chlamydia pneumoniae or Mycoplasma pneumoniae co-infections had worse respiratory/radiological features and more intensive care unit admissions. However, the co-infection did not result in a higher mortality rate. Conclusions: The present study, comparing clinical, laboratory and radiological findings between patients with COVID-19 vs. those with co-infections (C. pneumoniae or M. pneumoniae) showed that, on admission, these features were worse in co-infected patients, although the mortality rate did not differ between the two groups.
ABSTRACT
BACKGROUND: Since 2019, the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is causing a rapidly spreading pandemic. The present study aims to compare a modified quick SOFA (MqSOFA) score with the NEWS-2 score to predict in-hospital mortality (IHM), 30-days mortality and recovery setting. METHODS: All patients admitted from March to October 2020 to the Emergency Department of St. Anna Hospital, Ferrara, Italy with clinically suspected SARS-CoV-2 infection were retrospectively included in this single-centre study and evaluated with the MqSOFA and NEWS-2 scores. Statistical and logistic regression analyses were applied to our database. RESULTS: A total of 3359 individual records were retrieved. Among them, 2716 patients were excluded because of a negative nasopharyngeal swab and 206 for lacking data; thus, 437 patients were eligible. The data showed that the MqSOFA and NEWS-2 scores equally predicted IHM (p < 0.001) and 30-days mortality (p < 0.001). Higher incidences of coronary artery disease, congestive heart failure, cerebrovascular accidents, dementia, chronic kidney disease and cancer were found in the deceased vs. survived group. CONCLUSIONS: In this study we confirmed that the MqSOFA score was non-inferior to the NEWS-2 score in predicting IHM and 30-days mortality. Furthermore, the MqSOFA score was easier to use than NEWS-2 and is more suitable for emergency settings. Neither the NEWS-2 nor the MqSOFA scores were able to predict the recovery setting.