Factors Affecting Mortality in 1022 COVID-19 Patients Referred to an Emergency Department in Bergamo during the Peak of
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COVID-19
Factors Affecting Mortality in 1022 COVID-19 Patients Referred to an Emergency Department in Bergamo during the Peak of the Pandemic Orlando Goletti 1 & Chiara Nessi 2 & Amidio Testa 3 & Giovanni Albano 4 & Valter Torri 5 & Giordano Domenico Beretta 6 & Massimo Castoldi 7 & Emilio Bombardieri 8 Accepted: 6 August 2020 # The Author(s) 2020
Abstract The unexpected outbreak of COVID-19 in the area of Bergamo and the general crisis of personnel and devices has been managed as well as possible during the maximum peak of epidemic; Humanitas Gavazzeni Hospital implemented its facilities and organization in order to optimize the treatment of patients. The number of beds in the Intensive Care Unit (ICU) was doubled (from 16 to 33), and more than 220 beds were dedicated to the COVID-19 patients. This paper analyzes the factors affecting mortality in 1022 COVID-19 patients who referred to Humanitas Gavazzeni between February 25 and March 26, 2020. A total of 274 (34.9%) fatal events were registered: 202 among those admitted to the Intensive Care Unit (ICU) and COVID department and 72 among those treated in Acute Admission Unit Level II (AAUl-2) who died before hospital admission. This paper studies 274 dead cases by analyzing patient’s characteristics, physiological and laboratory parameters, symptoms, and the scores of severity of the disease. Patients who had fatal events in the AAUL-2 showed the worst parameters of risk. The most important differences regarded the Apache II score, Glasgow Coma Score (GCS), CRP (C-reactive protein), pH, creatinine, RR (respiratory rate), and asthenia. Keywords COVID-19 mortality . Risk factors . Severity . Emergency during the peak of infection
Introduction The outbreak of COVID-19 in Italy has recently become a public health emergency of international concern. Northern This article is part of the Topical Collection on COVID-19 * Emilio Bombardieri [email protected] 1
General Surgery Unit, Humanitas Gavazzeni, Bergamo, Italy
2
School of Specialization of General Surgery, University of Verona, Verona, Italy
3
Internal Medicine Unit, Humanitas Gavazzeni, Bergamo, Italy
4
Anesthesia and Intensive Care Unit, Humanitas Gavazzeni, Bergamo, Italy
5
Clinical Research Methodology Laboratory, Oncology Unit, IRCCS, Mario Negri Institute, Milan, Italy
6
Medical Oncology Unit, Humanitas Gavazzeni, Bergamo, Italy
7
Medical Direction, Humanitas Gavazzeni, Bergamo, Italy
8
Scientific Direction, Humanitas Gavazzeni, Bergamo, Italy
regions were the most affected with 67,931 positive cases and 12,579 deaths in Lombardy [1, 2]. The province of Bergamo was one of the most damaged, with a rapid increase of positive cases in a very short period [3]. Bergamo’s hospitals had to face a tremendous overload of patients in the Emergency Department. The unpredictable influx of patients determined a deep crisis in personnel, beds, and devices. The facilities were not prepared for such a dramatic event. Humanitas Gavazzeni gave its maximum effort in order to assure the best assist
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