Tags

Type your tag names separated by a space and hit enter

Impact of chronic liver disease upon admission on COVID-19 in-hospital mortality: Findings from COVOCA study.
PLoS One. 2020; 15(12):e0243700.Plos

Abstract

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.

Authors+Show Affiliations

Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy.Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy.Medical Statistics Unit, Department of Physical and Mental Health and Preventive Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy.Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy.Task Force Covid-19 Regione Campania, Napoli, Italy.Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy.Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy.Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy.Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy.Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy. Internal Medicine, Sant'Ottone Frangipane Hospital, Ariano Irpino, Italy.Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy.Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy.COVID Center "S. Anna e SS. Madonna della Neve" Hospital, Boscotrecase, Italy.COVID Center "S. Anna e SS. Madonna della Neve" Hospital, Boscotrecase, Italy.U.O.C. Infectious and Tropical Diseases, S. Anna e S. Sebastiano Hospital, Caserta, Italy.Covid Center-Maddaloni Hospital, Maddaloni, Italy.General Medicine Unit, Loreto Mare Hospital, Naples, Italy.U.O.C. Infectious Diseases and Neurology, Cotugno Hospital, Naples, Italy.U.O.C. Infectious Diseases of the Elderly, Cotugno Hospital, Naples, Italy.U.O.C. Anestesia and Intensive Care Unit, Cotugno Hospital, Naples, Italy.U.O.C. Respiratory Infectious Diseases, Cotugno Hospital, Naples, Italy.U.O.C. Pneumology, Moscati Hospital, Avellino, Italy.IXth Division of Infectious Diseases and Interventional Ultrasound, Cotugno Hospital, Naples, Italy."Giovanni da Procida" Hospital, Salerno, Italy.Emergency and Acceptance Unit, "Santa Maria delle Grazie" Hospital, Pozzuoli, Italy.Internal Medicine Unit, Ospedale Del Mare, Naples, Italy.U.O.C. Internal Medicine-Moscati Hospital, Avellino, Italy.IVth Division of Immunodeficiency and Gender Infectious Diseases, Cotugno Hospital, Naples, Italy.Department of Mental Health and Public Medicine, Centro COVID A.O.U. Vanvitelli, Naples, Italy.U.O.S.D. Infectious Diseases Emergency and Acceptance, Cotugno Hospital, Naples, Italy.Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy.Medical Statistics Unit, Department of Physical and Mental Health and Preventive Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy.Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy.No affiliation info available

Pub Type(s)

Journal Article
Multicenter Study
Observational Study

Language

eng

PubMed ID

33301529

Citation

Galiero, Raffaele, et al. "Impact of Chronic Liver Disease Upon Admission On COVID-19 In-hospital Mortality: Findings From COVOCA Study." PloS One, vol. 15, no. 12, 2020, pp. e0243700.
Galiero R, Pafundi PC, Simeon V, et al. Impact of chronic liver disease upon admission on COVID-19 in-hospital mortality: Findings from COVOCA study. PLoS One. 2020;15(12):e0243700.
Galiero, R., Pafundi, P. C., Simeon, V., Rinaldi, L., Perrella, A., Vetrano, E., Caturano, A., Alfano, M., Beccia, D., Nevola, R., Marfella, R., Sardu, C., Coppola, C., Scarano, F., Maggi, P., De Lucia Sposito, P., Vocciante, L., Rescigno, C., Sbreglia, C., ... Sasso, F. C. (2020). Impact of chronic liver disease upon admission on COVID-19 in-hospital mortality: Findings from COVOCA study. PloS One, 15(12), e0243700. https://doi.org/10.1371/journal.pone.0243700
Galiero R, et al. Impact of Chronic Liver Disease Upon Admission On COVID-19 In-hospital Mortality: Findings From COVOCA Study. PLoS One. 2020;15(12):e0243700. PubMed PMID: 33301529.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Impact of chronic liver disease upon admission on COVID-19 in-hospital mortality: Findings from COVOCA study. AU - Galiero,Raffaele, AU - Pafundi,Pia Clara, AU - Simeon,Vittorio, AU - Rinaldi,Luca, AU - Perrella,Alessandro, AU - Vetrano,Erica, AU - Caturano,Alfredo, AU - Alfano,Maria, AU - Beccia,Domenico, AU - Nevola,Riccardo, AU - Marfella,Raffaele, AU - Sardu,Celestino, AU - Coppola,Carmine, AU - Scarano,Ferdinando, AU - Maggi,Paolo, AU - De Lucia Sposito,Pellegrino, AU - Vocciante,Laura, AU - Rescigno,Carolina, AU - Sbreglia,Costanza, AU - Fraganza,Fiorentino, AU - Parrella,Roberto, AU - Romano,Annamaria, AU - Calabria,Giosuele, AU - Polverino,Benedetto, AU - Pagano,Antonio, AU - Bologna,Carolina, AU - Amitrano,Maria, AU - Esposito,Vincenzo, AU - Coppola,Nicola, AU - Maturo,Nicola, AU - Adinolfi,Luigi Elio, AU - Chiodini,Paolo, AU - Sasso,Ferdinando Carlo, AU - ,, Y1 - 2020/12/10/ PY - 2020/10/29/received PY - 2020/11/27/accepted PY - 2020/12/10/entrez PY - 2020/12/11/pubmed PY - 2021/1/5/medline SP - e0243700 EP - e0243700 JF - PloS one JO - PLoS One VL - 15 IS - 12 N2 - 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. SN - 1932-6203 UR - https://www.unboundmedicine.com/medline/citation/33301529/Impact_of_chronic_liver_disease_upon_admission_on_COVID_19_in_hospital_mortality:_Findings_from_COVOCA_study_ L2 - https://dx.plos.org/10.1371/journal.pone.0243700 DB - PRIME DP - Unbound Medicine ER -