Analysis of prognostic factors in COVID-19 hospitalized patients: an Italian single-center case-control study

A. Concistrè, L. Petramala, C.L. Pugliano, M. Celi, F. Vinci, E. Assanto, I. Barchetta, E.P. Perrone, S. Rella, F. Iannazzo, A. Angheloni, L. Coraggio, F. Di Rienzo, D. Maggi, F. Circosta, G. Galardo, M. Muscaritoli, C. Letizia

Internal Medicine COVID-19 Unit, Policlinico “Umberto I” University Hospital, Rome, Italy. claudio.letizia@uniroma1.it

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• Infectious Diseases

OBJECTIVE: 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 to plan an early treatment and intensive follow-up. We aimed to investigate negative prognostic factors in a group of patients hospitalized for COVID-19.

PATIENTS AND METHODS: 181 patients (90 men and 91 women, mean age 66.56 ± 13.53 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, three 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).

RESULTS: The independent risk factor associated with the ICU admission were lactic dehydrogenase elevation (p=0.046), C reactive protein elevation (p=0.014) at hospital admission and direct oral anticoagulant home therapy (p=0.048); for hospital length >25 days: early corticosteroid therapy (p=0.035); for NIV treatment: ferritin elevation at hospital admission (p=0.006).

CONCLUSIONS: 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.

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