Fatality rate and predictors of mortality in an Italian cohort of hospitalized COVID-19 patients

Bellan, Mattia; Patti, Giuseppe; Hayden, Eyal; Azzolina, Danila; Pirisi, Mario; Acquaviva, Antonio; Aimaretti, Gianluca; Aluffi Valletti, Paolo; Angilletta, Roberto; Arioli, Roberto; Avanzi, Gian Carlo; Avino, Gianluca; Balbo, Piero Emilio; Baldon, Giulia; Baorda, Francesca; Barbero, Emanuela; Baricich, Alessio; Barini, Michela; Barone-Adesi, Francesco; Battistini, Sofia; Beltrame, Michela; Bertoli, Matteo; Bertolin, Stephanie; Bertolotti, Marinella; Betti, Marta; Bobbio, Flavio; Boffano, Paolo; Boglione, Lucio; Borrè, Silvio; Brucoli, Matteo; Calzaducca, Elisa; Cammarata, Edoardo; Cantaluppi, Vincenzo; Cantello, Roberto; Capponi, Andrea; Carriero, Alessandro; Casciaro, Francesco Giuseppe; Castello, Luigi Mario; Ceruti, Federico; Chichino, Guido; Chirico, Emilio; Cisari, Carlo; Cittone, Micol Giulia; Colombo, Crizia; Comi, Cristoforo; Croce, Eleonora; Daffara, Tommaso; Danna, Pietro; Della Corte, Francesco; De Vecchi, Simona; Dianzani, Umberto; Di Benedetto, Davide; Esposto, Elia; Faggiano, Fabrizio; Falaschi, Zeno; Ferrante, Daniela; Ferrero, Alice; Gagliardi, Ileana; Gaidano, Gianluca; Galbiati, Alessandra; Gallo, Silvia; Garavelli, Pietro Luigi; Gardino, Clara Ada; Garzaro, Massimiliano; Gastaldello, Maria Luisa; Gavelli, Francesco; Gennari, Alessandra; Giacomini, Greta Maria; Giacone, Irene; Giai Via, Valentina; Giolitti, Francesca; Gironi, Laura Cristina; Gramaglia, Carla; Grisafi, Leonardo; Inserra, Ilaria; Invernizzi, Marco; Krengli, Marco; Labella, Emanuela; Landi, Irene Cecilia; Landi, Raffaella; Leone, Ilaria; Lio, Veronica; Lorenzini, Luca; Maconi, Antonio; Malerba, Mario; Manfredi, Giulia Francesca; Martelli, Maria; Marzari, Letizia; Marzullo, Paolo; Mennuni, Marco; Montabone, Claudia; Morosini, Umberto; Mussa, Marco; Nerici, Ilaria; Nuzzo, Alessandro; Olivieri, Carlo; Padelli, Samuel Alberto; Panella, Massimiliano; Parisini, Andrea; Paschè, Alessio; Pau, Alberto; Pedrinelli, Anita Rebecca; Percivale, Ilaria; Re, Roberta; Rigamonti, Cristina; Rizzi, Eleonora; Rognoni, Andrea; Roveta, Annalisa; Salamina, Luigia; Santagostino, Matteo; Saraceno, Massimo; Savoia, Paola; Sciarra, Marco; Schimmenti, Andrea; Scotti, Lorenza; Spinoni, Enrico; Smirne, Carlo; Tarantino, Vanessa; Tillio, Paolo Amedeo; Vaschetto, Rosanna; Vassia, Veronica; Zagaria, Domenico; Zavattaro, Elisa; Zeppegno, Patrizia; Zottarelli, Francesca; Sainaghi, Pier Paolo

Clinical features and natural history of coronavirus disease 2019 (COVID-19) differ widely among different countries and during different phases of the pandemia. Here, we aimed to evaluate the case fatality rate (CFR) and to identify predictors of mortality in a cohort of COVID-19 patients admitted to three hospitals of Northern Italy between March 1 and April 28, 2020. All these patients had a confirmed diagnosis of SARS-CoV-2 infection by molecular methods. During the study period 504/1697 patients died; thus, overall CFR was 29.7%. We looked for predictors of mortality in a subgroup of 486 patients (239 males, 59%; median age 71 years) for whom sufficient clinical data were available at data cut-off. Among the demographic and clinical variables considered, age, a diagnosis of cancer, obesity and current smoking independently predicted mortality. When laboratory data were added to the model in a further subgroup of patients, age, the diagnosis of cancer, and the baseline PaO(2)/FiO(2) ratio were identified as independent predictors of mortality. In conclusion, the CFR of hospitalized patients in Northern Italy during the ascending phase of the COVID-19 pandemic approached 30%. The identification of mortality predictors might contribute to better stratification of individual patient risk.