Silvestri Caterina, Stasi Cristina, Profili Francesco, Bartolacci Simone, Sessa Emiliano, Tacconi Danilo, Villari Liliana, Carrozzi Laura, Dotta Francesco, Bargagli Elena, Donnini Sandra, Masotti Luca, Rasero Laura, Lavorini Federico, Pistelli Francesco, Chimera Davide, Sorano Alessandra, Pacifici Martina, Milli Caterina, Voller Fabio
Epidemiology Unit, Regional Health Agency of Tuscany, 50141 Florence, Italy.
Department of Medicine, Surgery and Neuroscience, University of Siena, 53100 Siena, Italy.
J Clin Med. 2024 Aug 7;13(16):4626. doi: 10.3390/jcm13164626.
A few months after the COVID-19 pandemic onset, knowledge of SARS-CoV-2 infection and outcomes and treatments blew up. This paper aimed to evaluate the features of a Tuscany COVID-19 hospitalized cohort and to identify risk factors for COVID-19 severity. This retrospective observational COVID-19 cohort study (1 March 2020-1 March 2021) was conducted on patients ≥ 18 years old, admitted to Tuscany Hospital, and subjected to follow-up within 12 months after discharge. Patients were enrolled at Pisana, Senese and Careggi University Hospitals, and South East, North West, and Center Local Hospitals. : 2888 patients (M = 58.5%, mean age = 66.2 years) were enrolled, of whom 14.3% (N = 413) were admitted to an intensive care unit. Smokers were 25%, and overweight and obese 65%. The most used drugs were corticosteroids, antacids, antibiotics, and antithrombotics, all antiviral drugs, with slight differences between 2020 and 2021. A strong association was found between outcomes of evolution towards critical COVID-19 (non-invasive mechanical ventilation (NIV) and/or admission to intensive care) and smoking (RR = 4.91), ex-smoking (RR = 3.48), overweight (RR = 1.30), obese subjects (RR = 1.62), comorbidities (aRR = 1.38). The alteration of liver enzymes (aspartate aminotransferase, alanine aminotransferase, or gamma-glutamyl transpeptidase) was associated with NIV (aOR = 2.28). Our cohort, characterized by patients with a mean age of 66.2 years, showed 65% of patients were overweight and obese. Smoking/ex-smoking, overweight/obesity, and other comorbidities were associated with COVID-19 adverse outcomes. The findings also demonstrated that alterations in liver enzymes were associated with worse outcomes.
在新冠疫情爆发后的几个月里，关于严重急性呼吸综合征冠状病毒2（SARS-CoV-2）感染、预后及治疗的知识迅速增加。本文旨在评估托斯卡纳地区新冠住院患者队列的特征，并确定新冠严重程度的风险因素。这项回顾性观察性新冠队列研究（2020年3月1日至2021年3月1日）针对的是年龄≥18岁、入住托斯卡纳医院且出院后12个月内接受随访的患者。患者入组于比萨纳、塞内塞和卡雷吉大学医院以及东南部、西北部和中部地方医院。共纳入2888例患者（男性占58.5%，平均年龄66.2岁），其中14.3%（n = 413）入住重症监护病房。吸烟者占25%，超重和肥胖者占65%。最常用的药物是皮质类固醇、抗酸剂、抗生素和抗血栓药物，所有抗病毒药物在2020年和2021年之间略有差异。研究发现，发展为重症新冠（无创机械通气（NIV）和/或入住重症监护病房）的预后与吸烟（相对风险（RR）= 4.91）、既往吸烟（RR = 3.48）、超重（RR = 1.30）、肥胖受试者（RR = 1.62）、合并症（调整后RR（aRR）= 1.38）之间存在强烈关联。肝酶（天冬氨酸转氨酶、丙氨酸转氨酶或γ-谷氨酰转肽酶）的改变与无创机械通气相关（调整后比值比（aOR）= 2.28）。我们的队列以平均年龄66.2岁的患者为特征，65%的患者超重和肥胖。吸烟/既往吸烟、超重/肥胖以及其他合并症与新冠不良预后相关。研究结果还表明，肝酶改变与更差的预后相关。
