Analysis of prognostic factors in COVID-19 hospitalized patients. an italian single-center case-control study

OBJECTIVE: COVID-19 clinical presentation ranges from asymptomatic infec-tion to an inflammatory cytokine storm with multi-organ failure and fatal outcomes. The identification of high-risk patients for severe disease is crucial to plan an early treatment and intensive follow-up. We aimed to investi-gate negative prognostic factors in a group of patients hospitalized for COVID-19. PATIENTS AND METHODS: 181 patients (90 men and 91 women, mean age 66.56 +/- 13.53 years) were enrolled. Each patient received a work-up in-cluding medical history, clinical examination, arte-rial blood gas analysis, laboratory blood tests, fea-sible ventilatory support required during hospital stay, intensive care setting required, duration of illness and length of hospital stay (> or < 25 days). For the assessment of the severity of COVID-19, three main indicators were considered: 1) the in-tensive care unit (ICU) admission 2) the hospital-ization length > 25 days; 3) the need of non-inva-sive ventilation (NIV). RESULTS: The independent risk factor associ-ated with the ICU admission were lactic dehydro-genase elevation (p=0.046), C reactive protein elevation (p=0.014) at hospital admission and di-rect oral anticoagulant home therapy (p=0.048); for hospital length > 25 days: early corticosteroid therapy (p=0.035); for NIV treatment: ferritin ele-vation at hospital admission (p=0.006). CONCLUSIONS: The presence of the above factors may be useful to identify patients at high risk of developing a severe COVID-19 that need an early treatment and intensive follow-up.