Article ; Online: SARS-COV-2 comorbidity network and outcome in hospitalized patients in Crema, Italy.
PloS one
2021 Volume 16, Issue 3, Page(s) e0248498
Abstract: ... 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 ... swab in 539 individuals suspected to carry SARS-COV-2 admitted to the hospital of Crema, Italy ...
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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MeSH term(s) | Adolescent ; Adult ; Aged ; Aged, 80 and over ; Angiotensin-Converting Enzyme Inhibitors/therapeutic use ; C-Reactive Protein/analysis ; COVID-19/drug therapy ; COVID-19/mortality ; COVID-19/pathology ; COVID-19/virology ; Child ; Child, Preschool ; Comorbidity ; Female ; Hospitalization/statistics & numerical data ; Humans ; Italy ; Male ; Middle Aged ; Risk Factors ; SARS-CoV-2/isolation & purification ; Treatment Outcome ; Young Adult |
Chemical Substances | Angiotensin-Converting Enzyme Inhibitors ; C-Reactive Protein (9007-41-4) |
Language | English |
Publishing date | 2021-03-25 |
Publishing country | United States |
Document type | Journal Article ; Research Support, Non-U.S. Gov't |
ISSN | 1932-6203 |
ISSN (online) | 1932-6203 |
DOI | 10.1371/journal.pone.0248498 |
Database | MEDical Literature Analysis and Retrieval System OnLINE |
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