Inflammation, underweight, malignancy and a marked catabolic state as predictors for worse outcomes in COVID-19 patients with moderate-to-severe disease admitted to Internal Medicine Unit.


Journal

PloS one
ISSN: 1932-6203
Titre abrégé: PLoS One
Pays: United States
ID NLM: 101285081

Informations de publication

Date de publication:
2022
Historique:
received: 08 11 2021
accepted: 29 04 2022
entrez: 18 5 2022
pubmed: 19 5 2022
medline: 21 5 2022
Statut: epublish

Résumé

During COVID-19 pandemic, Internal Medicine Units (IMUs) accounted for about 70% of patients hospitalized. Although a large body of data has been published regarding the so-called first wave of the pandemic, little is known about the characteristics and predictors of worse outcomes of patients managed in IMUs during the second wave. We prospectively assessed demographics, comorbidities, treatment and outcomes, including ventilation support (VS) and death, in patients admitted to our IMU for SARS-CoV-2 between October 13th, 2020 and January 21st, 2021. Clinical evolution and biochemical testing 1, 7 and 14 days after COVID-19 diagnosis were recorded. We studied 120 patients (M/F 56/64, age 71±14.5 years) admitted to our IMU. Most of them had at least one comorbidity (80%). Patients who died were older, more frequently underweight, affected by malignant neoplasms and on statin therapy compared to patients eventually discharged. Both worse outcome groups (VS and death) presented higher neutrophils, ferritin, IL-6 and lower total proteins levels than controls. Age was significantly associated with mortality but not with VS need. The multivariate analysis showed age and gender independent association of mortality with underweight, malignancy and antibiotics use at the admission. With regard to biochemical parameters, both unfavourable outcomes were positively associated with high WBC count, neutrophils, blood urea nitrogen and low serum total proteins. Our study identified inflammation, underweight, malignancy and a marked catabolic state as the main predictors for worse outcomes in COVID-19 patients admitted to IMU during the so-called second wave of the pandemic.

Identifiants

pubmed: 35584141
doi: 10.1371/journal.pone.0268432
pii: PONE-D-21-35509
pmc: PMC9116641
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

e0268432

Commentaires et corrections

Type : CommentIn

Déclaration de conflit d'intérêts

The authors have declared that no competing interests exist.

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Auteurs

Valeria Guglielmi (V)

Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy.
Obesity Medical Center, University Hospital Policlinico Tor Vergata, Rome, Italy.

Luca Colangeli (L)

Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy.
Obesity Medical Center, University Hospital Policlinico Tor Vergata, Rome, Italy.

Valeria Scipione (V)

Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy.

Simona Ballacci (S)

Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy.

Martina Di Stefano (M)

Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy.

Lauren Hauser (L)

Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy.

Michela Colella Bisogno (M)

Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy.

Monica D'Adamo (M)

Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy.
Obesity Medical Center, University Hospital Policlinico Tor Vergata, Rome, Italy.

Emanuela Medda (E)

Centre for Behavioural Sciences and Mental Health, Istituto Superiore Sanità, Rome, Italy.

Paolo Sbraccia (P)

Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy.
Obesity Medical Center, University Hospital Policlinico Tor Vergata, Rome, Italy.

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