Identifying risk factors for severe novel-coronavirus disease (COVID-19) is essential to ascertain which patients may benefit from advanced supportive care. The study aims to give a comparative description of COVID-19 patients who were admitted or not to the intensive (ICU) or sub-intensive cares units (SICU).
This observational study of prospectively collected data included all COVID-19 patients primarily admitted to the Infectious Diseases department of Padua between February 22 and May 20, 2020. Clinical, laboratory, radiological and treatment data were collected. The primary outcome was a composite of ICU and/or SICU admission.
303 patients were included. Median age was 62 years (IQR:50-74), 60.1% were male. 234 patients were managed in the Infectious Diseases ward (Group 1) and 69 patients (22,8%) met the primary outcome (Group 2). The mortality rate was 6.8%. Group 2 were more likely to be men, had a higher mortality (14,5%vs3,8%, p<0,01) and had more hypertension (72,4vs 44%,p<0,01) and diabetes (31,9vs21%,p=0,04). Chest X-ray at admission was positive in 63,2% and Group 2 were more likely to develop pathological findings during the hospitalization (72,7%vs17,2%,p<0,01). Group 2 presented at admission a higher neutrophil count, aspartate-transaminase and C-reactive-protein. At the 3° measurement, differences were found for white blood cell and neutrophil count, liver function tests and C-reactive-protein. Group 1 presented a shorter duration from admission to negativization of follow-up swabs (20vs35days,p<0,01).
The presence of comorbidities and the persistent observation of slightly abnormal laboratory findings should be regarded as predisposing factors for disease severity and clinical worsening.