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SARS-COV-2 comorbidity network and outcome in hospitalized patients in Crema, Italy.
Gili, Tommaso; Benelli, Giampaolo; Buscarini, Elisabetta; Canetta, Ciro; La Piana, Giuseppe; Merli, Guido; Scartabellati, Alessandro; Viganò, Giovanni; Sfogliarini, Roberto; Melilli, Giovanni; Assandri, Roberto; Cazzato, Daniele; Rossi, Davide Sebastiano; Usai, Susanna; Caldarelli, Guido; Tramacere, Irene; Pellegata, Germano; Lauria, Giuseppe.
  • Gili T; IMT School for Advanced Studies, Lucca, Italy.
  • Benelli G; Radiology Unit, Ospedale Maggiore di Crema, Crema, Italy.
  • Buscarini E; Gastroenterology Unit, Ospedale Maggiore di Crema, Crema, Italy.
  • Canetta C; High Care Medical Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
  • La Piana G; Emergency Medicine Unit Ospedale Maggiore di Crema, Crema, Italy.
  • Merli G; Pneumology 2 Unit, Ospedale Maggiore di Crema, Crema, Italy.
  • Scartabellati A; Intensive Care Unit, Ospedale Maggiore di Crema, Crema, Italy.
  • Viganò G; Pneumology 1 Unit, Ospedale Maggiore di Crema, Crema, Italy.
  • Sfogliarini R; Emergency Unit, Ospedale Maggiore di Crema, Crema, Italy.
  • Melilli G; Health Directorate, Ospedale Maggiore di Crema, Crema, Italy.
  • Assandri R; Health Directorate, Ospedale Maggiore di Crema, Crema, Italy.
  • Cazzato D; Clinical Investigation Laboratory, Ospedale Maggiore di Crema, Crema, Italy.
  • Rossi DS; Department of Diagnostics and Technology, Ospedale Maggiore di Crema, Crema, Italy.
  • Usai S; Department of Diagnostics and Technology, Ospedale Maggiore di Crema, Crema, Italy.
  • Caldarelli G; Department of Clinical Neurosciences, Fondazione IRCCS Istituto Neurologico "Carlo Besta", Milan, Italy.
  • Tramacere I; DSMN Ca'Foscari University, Venice Italy and ECLT, Venice, Italy.
  • Pellegata G; ECLT, Venice, Italy.
  • Lauria G; ISC-CNR Uos "Sapienza", Rome, Italy.
PLoS One ; 16(3): e0248498, 2021.
Article in English | MEDLINE | ID: covidwho-1388907
Preprint
This scientific journal article is probably based on a previously available preprint. It has been identified through a machine matching algorithm, human confirmation is still pending.
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ABSTRACT
We report onset, course, correlations with comorbidities, and diagnostic accuracy of nasopharyngeal swab in 539 individuals suspected to carry SARS-COV-2 admitted to the hospital of Crema, Italy. All individuals underwent clinical and laboratory exams, SARS-COV-2 reverse transcriptase-polymerase chain reaction on nasopharyngeal swab, and chest X-ray and/or computed tomography (CT). Data on onset, course, comorbidities, number of drugs including angiotensin converting enzyme (ACE) inhibitors and angiotensin-II-receptor antagonists (sartans), follow-up swab, pharmacological treatments, non-invasive respiratory support, ICU admission, and deaths were recorded. Among 411 SARS-COV-2 patients (67.7% males) median age was 70.8 years (range 5-99). Chest CT was performed in 317 (77.2%) and showed interstitial pneumonia in 304 (96%). Fatality rate was 17.5% (74% males), with 6.6% in 60-69 years old, 21.1% in 70-79 years old, 38.8% in 80-89 years old, and 83.3% above 90 years. No death occurred below 60 years. Non-invasive respiratory support rate was 27.2% and ICU admission 6.8%. Charlson comorbidity index and high C-reactive protein at admission were significantly associated with death. Use of ACE inhibitors or sartans was not associated with outcomes. Among 128 swab negative patients at admission (63.3% males) median age was 67.7 years (range 1-98). Chest CT was performed in 87 (68%) and showed interstitial pneumonia in 76 (87.3%). Follow-up swab turned positive in 13 of 32 patients. Using chest CT at admission as gold standard on the entire study population of 539 patients, nasopharyngeal swab had 80% accuracy. Comorbidity network analysis revealed a more homogenous distribution 60-40 aged SARS-COV-2 patients across diseases and a crucial different interplay of diseases in the networks of deceased and survived patients. SARS-CoV-2 caused high mortality among patients older than 60 years and correlated with pre-existing multiorgan impairment.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Comorbidity / COVID-19 Type of study: Cohort study / Prognostic study Limits: Adolescent / Adult / Aged / Child / Child, preschool / Female / Humans / Male / Middle aged / Young adult Country/Region as subject: Europa Language: English Journal: PLoS One Journal subject: Science / Medicine Year: 2021 Document Type: Article Affiliation country: JOURNAL.PONE.0248498

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Comorbidity / COVID-19 Type of study: Cohort study / Prognostic study Limits: Adolescent / Adult / Aged / Child / Child, preschool / Female / Humans / Male / Middle aged / Young adult Country/Region as subject: Europa Language: English Journal: PLoS One Journal subject: Science / Medicine Year: 2021 Document Type: Article Affiliation country: JOURNAL.PONE.0248498