Characteristics and outcomes in hospitalized COVID-19 patients during the first 28 days of the spring and autumn pandemic waves in Milan: An observational prospective study

Autor: Andrea Airoldi, Maurizio Rizzi, Pierachille Santus, Marica Pecis, Elisa Franceschi, Dejan Radovanovic, Stefano Pini
Jazyk: angličtina
Rok vydání: 2021
Předmět:
CRP
C reactive protein
Male
Pediatrics
WBC
white blood cells
Respiratory failure
0302 clinical medicine
PaO2
peripheral arterial oxygen partial pressure
Hospital Mortality
Prospective Studies
030212 general & internal medicine
LMWH
Low Molecular Weight Heparin
Prospective cohort study
CPAP
Continuous Positive Airway Pressure
Respiratory distress
Lopinavir
Middle Aged
Hospitalization
Survival Rate
Italy
Methylprednisolone
COVID-19
Coronavirus Disease 2019
ED
emergency department
Female
FiO2
inspired oxygen fraction
Seasons
medicine.drug
Adult
Pulmonary and Respiratory Medicine
Respiratory Therapy
medicine.medical_specialty
Short Communication
DNI
do not intubate order
Antiviral Agents
HDRU
high dependency respiratory unit
03 medical and health sciences
CPAP
PaCO2
peripheral arterial carbon dioxide partial pressure
medicine
Humans
Mortality
Survival rate
Aged
LDH
lactic acid dehydrogenase
business.industry
COVID-19
Anticoagulants
Hydroxychloroquine
Pneumonia
Length of Stay
medicine.disease
Treatment
FEU
fibrinogen equivalent unit
IMV
invasive mechanical ventilation
030228 respiratory system
PEEP
positive end expiratory pressure
SaO2
peripheral oxygen saturation
business
Hb
hemoglobin
Zdroj: Respiratory Medicine
ISSN: 0954-6111
DOI: 10.1016/j.rmed.2021.106323
Popis: Background The therapeutic approach to COVID-19 and healthcare system preparedness improved during 2020. We compared characteristics and outcomes of hospitalized COVID-19 patients during the first 28 days of the March and October pandemic waves in Milan, Italy. Material and methods A prospective, observational study enrolling adult patients hospitalized with COVID-19 pneumonia during March 7-April 4 (1st period) and October 15-November 12 (2nd period). During the 1st period hydroxychloroquine, lopinavir/ritonavir and therapeutic enoxaparin when thrombosis was confirmed were administered; systemic corticosteroids were given in case of severe pneumonia. During the 2nd period dexamethasone, methylprednisolone, remdesivir, thromboprophylaxis or anticoagulation were administered according to international recommendations. Patients with respiratory distress on oxygen masks initiated CPAP. Outcomes were: length of hospital stay, all-cause in-hospital mortality and need for intubation. Results We included 70 patients (75% males) during the 1st and 76 patients (51% males, p = 0.522) during the 2nd period. Prevalence of severe respiratory failure (30% vs. 12%, p = 0.006), and D-dimer >3000 FEU (34% vs. 15%, P = 0.012) were reduced during the 2nd period, while anticoagulation and corticosteroids were more frequently administered (both p
Highlights • We compared patients' characteristics and outcomes during the 2020 1st and 2nd epidemic waves in Milan. • The proportion of patients with severe respiratory failure was higher during the 1st period. • Timing of referral and all-cause mortality were significantly decreased during the 2nd period. • Higher social awareness and change in treatment regimens may have promoted better outcomes during the 2nd pandemic wave.
Databáze: OpenAIRE
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