Analysis of Prognostic Factors in Covid-19 Hospitalized Patients: An Italian Single-Center Prospective Study

ABSTRACT

Introduction: COVID-19 clinical presentation ranges from asymptomatic infection to an inflammatory cytokine storm with multi-organ failure and fatal outcomes. The identification of high-risk patients for severe disease is crucial in order to plan an early treatment and intensive follow-up. Aim(s) we aimed at investigating negative prognostic factors in a group of patients hospitalized for COVID-19. Method(s) 181 patients (83 men and 98 women, age 69.50 +/- 15.75 years) were enrolled. Each patient received a work-up including medical history, clinical examination, arterial blood gas analysis, laboratory blood tests, feasible ventilatory support required during hospital stay, intensive care setting required, duration of illness and length of hospital stay (> or<25 days). For the assessment of the severity of COVID-19, four main indicators were considered (1) the intensive care unit (ICU) admission (2) the hospitalization length> 25 days;(3) the need of non-invasive ventilation (NIV);(4) death. Result(s) The independent risk factor associated with the ICU admission were male gender (p = 0.02), gamma glutamyl transpeptidase elevation (p = 0.014), C reactive protein elevation (p = 0.09) at hospital admission and direct oral anticoagulant home therapy (p = 0.048);for hospital length>25 days early corticosteroid therapy (p = 0.026) d-dimer elevation at hospital admission (p = 0.009), the presence of at least three comorbidities (p = 0.038);for NIV treatment ferritin and C reactive protein elevation at hospital admission (p = 0.006 and p = 0.008 respectively), body overweight (p<0.01) and early corticosteroid therapy (0.018);for in-hospital death body overweight (p = 0.012), age (p = 0.047), antiplatelet therapy (p = 0.03), creatinine values elevation (p = 0.025). Conclusion(s) The presence of the above factors may be useful to identify patients at high risk of developing a severe COVID-19 that need an early treatment and intensive follow-up.