Evolution of in-hospital patient characteristics and predictors of death in the COVID-19 pandemic across four waves: are they moving targets with implications for patient care?

Autor:	Trecarichi EM; Department of Medical and Surgical Sciences, 'Magna Graecia' University, Catanzaro, Italy.; Infectious and Tropical Disease Unit, 'Renato Dulbecco' Teaching Hospital, Catanzaro, Italy., Olivadese V; Department of Medical and Surgical Sciences, 'Magna Graecia' University, Catanzaro, Italy., Davoli C; Department of Medical and Surgical Sciences, 'Magna Graecia' University, Catanzaro, Italy.; Infectious and Tropical Disease Unit, 'Renato Dulbecco' Teaching Hospital, Catanzaro, Italy., Rotundo S; Department of Medical and Surgical Sciences, 'Magna Graecia' University, Catanzaro, Italy., Serapide F; Infectious and Tropical Disease Unit, 'Renato Dulbecco' Teaching Hospital, Catanzaro, Italy., Lionello R; Infectious and Tropical Disease Unit, 'Renato Dulbecco' Teaching Hospital, Catanzaro, Italy., Tassone B; Infectious and Tropical Disease Unit, 'Renato Dulbecco' Teaching Hospital, Catanzaro, Italy., La Gamba V; Department of Medical and Surgical Sciences, 'Magna Graecia' University, Catanzaro, Italy.; Infectious and Tropical Disease Unit, 'Renato Dulbecco' Teaching Hospital, Catanzaro, Italy., Fusco P; Department of Medical and Surgical Sciences, 'Magna Graecia' University, Catanzaro, Italy.; Infectious and Tropical Disease Unit, 'Renato Dulbecco' Teaching Hospital, Catanzaro, Italy., Russo A; Department of Medical and Surgical Sciences, 'Magna Graecia' University, Catanzaro, Italy.; Infectious and Tropical Disease Unit, 'Renato Dulbecco' Teaching Hospital, Catanzaro, Italy., Borelli M; UMG School of PhD Programmes 'Life Sciences and Technologies', 'Magna Graecia' University, Catanzaro, Italy., Torti C; Dipartimento di Scienze di Laboratorio e Infettivologiche, Fondazione Policlinico Universitario 'A. Gemelli' IRCCS, Rome, Italy.; Dipartimento di Sicurezza e Bioetica, Università Cattolica del Sacro Cuore, Rome, Italy.
Jazyk:	angličtina
Zdroj:	Frontiers in public health [Front Public Health] 2024 Jan 08; Vol. 11, pp. 1280835. Date of Electronic Publication: 2024 Jan 08 (Print Publication: 2023).
DOI:	10.3389/fpubh.2023.1280835
Abstrakt:	Objectives: The aim of this work was to study characteristics, outcomes and predictors of all-cause death in inpatients with SARS-CoV-2 infection across the pandemic waves in one large teaching hospital in Italy to optimize disease management. Methods: All patients with SARS-CoV-2 infection admitted to our center from March 2020 to June 2022 were included in this retrospective observational cohort study. Both descriptive and regression tree analyses were applied to identify factors influencing all-cause mortality. Results: 527 patients were included in the study (65.3% with moderate and 34.7% with severe COVID-19). Significant evolutions of patient characteristics were found, and mortality increased in the last wave with respect to the third wave notwithstanding vaccination. Regression tree analysis showed that in-patients with severe COVID-19 had the greatest mortality across all waves, especially the older adults, while prognosis depended on the pandemic waves in patients with moderate COVID-19: during the first wave, dyspnea was the main predictor, while chronic kidney disease emerged as determinant factor afterwards. Conclusion: Patients with severe COVID-19, especially the older adults during all waves, as well as those with moderate COVID-19 and concomitant chronic kidney disease during the most recent waves require more attention for monitoring and care. Therefore, our study drives attention towards the importance of co-morbidities and their clinical impact in patients with COVID-19 admitted to hospital, indicating that the healthcare system should adapt to the evolving features of the epidemic. Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. (Copyright © 2024 Trecarichi, Olivadese, Davoli, Rotundo, Serapide, Lionello, Tassone, La Gamba, Fusco, Russo, Borelli, Torti and the IDTM UMG COVID-19 Group.)
Databáze:	MEDLINE
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