Impact of chronic liver disease upon admission on COVID-19 in-hospital mortality: Findings from COVOCA study.

Autor: Galiero R; Department of Advanced Medical and Surgical Sciences, University of Campania 'Luigi Vanvitelli', Naples, Italy., Pafundi PC; Department of Advanced Medical and Surgical Sciences, University of Campania 'Luigi Vanvitelli', Naples, Italy., Simeon V; Medical Statistics Unit, Department of Physical and Mental Health and Preventive Medicine, University of Campania 'Luigi Vanvitelli', Naples, Italy., Rinaldi L; Department of Advanced Medical and Surgical Sciences, University of Campania 'Luigi Vanvitelli', Naples, Italy., Perrella A; Task Force Covid-19 Regione Campania, Napoli, Italy., Vetrano E; Department of Advanced Medical and Surgical Sciences, University of Campania 'Luigi Vanvitelli', Naples, Italy., Caturano A; Department of Advanced Medical and Surgical Sciences, University of Campania 'Luigi Vanvitelli', Naples, Italy., Alfano M; Department of Advanced Medical and Surgical Sciences, University of Campania 'Luigi Vanvitelli', Naples, Italy., Beccia D; Department of Advanced Medical and Surgical Sciences, University of Campania 'Luigi Vanvitelli', Naples, Italy., Nevola R; Department of Advanced Medical and Surgical Sciences, University of Campania 'Luigi Vanvitelli', Naples, Italy.; Internal Medicine, Sant'Ottone Frangipane Hospital, Ariano Irpino, Italy., Marfella R; Department of Advanced Medical and Surgical Sciences, University of Campania 'Luigi Vanvitelli', Naples, Italy., Sardu C; Department of Advanced Medical and Surgical Sciences, University of Campania 'Luigi Vanvitelli', Naples, Italy., Coppola C; COVID Center 'S. Anna e SS. Madonna della Neve' Hospital, Boscotrecase, Italy., Scarano F; COVID Center 'S. Anna e SS. Madonna della Neve' Hospital, Boscotrecase, Italy., Maggi P; U.O.C. Infectious and Tropical Diseases, S. Anna e S. Sebastiano Hospital, Caserta, Italy., De Lucia Sposito P; Covid Center-Maddaloni Hospital, Maddaloni, Italy., Vocciante L; General Medicine Unit, Loreto Mare Hospital, Naples, Italy., Rescigno C; U.O.C. Infectious Diseases and Neurology, Cotugno Hospital, Naples, Italy., Sbreglia C; U.O.C. Infectious Diseases of the Elderly, Cotugno Hospital, Naples, Italy., Fraganza F; U.O.C. Anestesia and Intensive Care Unit, Cotugno Hospital, Naples, Italy., Parrella R; U.O.C. Respiratory Infectious Diseases, Cotugno Hospital, Naples, Italy., Romano A; U.O.C. Pneumology, Moscati Hospital, Avellino, Italy., Calabria G; IXth Division of Infectious Diseases and Interventional Ultrasound, Cotugno Hospital, Naples, Italy., Polverino B; 'Giovanni da Procida' Hospital, Salerno, Italy., Pagano A; Emergency and Acceptance Unit, 'Santa Maria delle Grazie' Hospital, Pozzuoli, Italy., Bologna C; Internal Medicine Unit, Ospedale Del Mare, Naples, Italy., Amitrano M; U.O.C. Internal Medicine-Moscati Hospital, Avellino, Italy., Esposito V; IVth Division of Immunodeficiency and Gender Infectious Diseases, Cotugno Hospital, Naples, Italy., Coppola N; Department of Mental Health and Public Medicine, Centro COVID A.O.U. Vanvitelli, Naples, Italy., Maturo N; U.O.S.D. Infectious Diseases Emergency and Acceptance, Cotugno Hospital, Naples, Italy., Adinolfi LE; Department of Advanced Medical and Surgical Sciences, University of Campania 'Luigi Vanvitelli', Naples, Italy., Chiodini P; Medical Statistics Unit, Department of Physical and Mental Health and Preventive Medicine, University of Campania 'Luigi Vanvitelli', Naples, Italy., Sasso FC; Department of Advanced Medical and Surgical Sciences, University of Campania 'Luigi Vanvitelli', Naples, Italy.
Jazyk: angličtina
Zdroj: PloS one [PLoS One] 2020 Dec 10; Vol. 15 (12), pp. e0243700. Date of Electronic Publication: 2020 Dec 10 (Print Publication: 2020).
DOI: 10.1371/journal.pone.0243700
Abstrakt: Background: Italy has been the first Western country to be heavily affected by the spread of SARS-COV-2 infection and among the pioneers of the clinical management of pandemic. To improve the outcome, identification of patients at the highest risk seems mandatory.
Objectives: Aim of this study is to identify comorbidities and clinical conditions upon admission associated with in-hospital mortality in several COVID Centers in Campania Region (Italy).
Methods: COVOCA is a multicentre retrospective observational cohort study, which involved 18 COVID Centers throughout Campania Region, Italy. Data were collected from patients who completed their hospitalization between March-June 2020. The endpoint was in-hospital mortality, assessed either from data at discharge or death certificate, whilst all exposure variables were collected at hospital admission.
Results: Among 618 COVID-19 hospitalized patients included in the study, 143 in-hospital mortality events were recorded, with a cumulative incidence of about 23%. At multivariable logistic analysis, male sex (OR 2.63, 95%CI 1.42-4.90; p = 0.001), Chronic Liver Disease (OR 5.88, 95%CI 2.39-14.46; p<0.001) and malignancies (OR 2.62, 95%CI 1.21-5.68; p = 0.015) disclosed an independent association with a poor prognosis, Glasgow Coma Scale (GCS) and Respiratory Severity Scale allowed to identify at higher mortality risk. Sensitivity analysis further enhanced these findings.
Conclusion: Mortality of patients hospitalized for COVID-19 appears strongly affected by both clinical conditions on admission and comorbidities. Originally, we observed a very poor outcome in subjects with a chronic liver disease, alongside with an increase of hepatic damage.
Competing Interests: The authors have declared that no competing interests exist.
Databáze: MEDLINE
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