Characteristics and outcomes of a cohort of COVID-19 patients in the Province of Reggio Emilia, Italy

• Published in: PloS one Vol. 15; no. 8; p. e0238281
• Main Authors: Giorgi Rossi, Paolo, Marino, Massimiliano, Formisano, Debora, Venturelli, Francesco, Vicentini, Massimo, Grilli, Roberto
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 27.08.2020; Public Library of Science (PLoS)
• Subjects: Age; Age Distribution; Aged; Aged, 80 and over; Arrhythmia; Betacoronavirus; Biology and life sciences; Cardiovascular diseases; Chronic obstructive pulmonary disease; Clinical decision making; Comorbidity; Complications and side effects; Confidence intervals; Congestive heart failure; Coronary artery disease; Coronavirus Infections - epidemiology; Coronavirus Infections - mortality; COVID-19; Death; Decision making; Dementia disorders; Demographic aspects; Diabetes; Diabetes mellitus; Emigrants and Immigrants - statistics & numerical data; Epidemiology; Fatalities; Female; Health planning; Health risks; Heart diseases; Hospital patients; Hospitalization - statistics & numerical data; Humans; Hypertension; Immigrants; Incidence; Italy - epidemiology; Male; Medical prognosis; Medicine and Health Sciences; Men; Middle Aged; Mortality; Pandemics; Patient outcomes; Pneumonia, Viral - epidemiology; Pneumonia, Viral - mortality; Population studies; Proportional Hazards Models; Prospective Studies; Public health; Risk; Risk Factors; SARS-CoV-2; Severe acute respiratory syndrome coronavirus 2; Sex Distribution; Viral diseases; Italy
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0238281

This is a population-based prospective cohort study on archive data describing the age- and sex-specific prevalence of COVID-19 and its prognostic factors. All 2653 symptomatic patients tested positive for SARS-CoV-2 from February 27 to April 2, 2020 in the Reggio Emilia province, Italy, were included. COVID-19 cumulative incidence, hospitalization and death rates, and adjusted hazard ratios (HR) with 95% confidence interval (95% CI) were calculated according to sociodemographic and clinical characteristics. Females had higher prevalence of infection than males below age 50 (2.61 vs. 1.84 ‰), but lower in older ages (16.49 vs. 20.86 ‰ over age 80). Case fatality rate reached 20.7% in cases with more than 4 weeks follow up. After adjusting for age and comorbidities, men had a higher risk of hospitalization (HR 1.4 95% CI 1.2 to 1.6) and of death (HR 1.6, 95% CI 1.2 to 2.1). Patients over age 80 compared to age < 50 had HR 7.1 (95% CI 5.4 to 9.3) and HR 27.8 (95% CI 12.5 to 61.7) for hospitalization and death, respectively. Immigrants had a higher risk of hospitalization (HR 1.3, 95% CI 0.99 to 1.81) than Italians and a similar risk of death. Risk of hospitalization and of death were higher in patients with heart failure, arrhythmia, dementia, coronary heart disease, diabetes, and hypertension, while COPD increased the risk of hospitalization (HR 1.9, 95% CI 1.4 to 2.5) but not of death (HR 1.1, 95% CI 0.7 to 1.7). Previous use of ACE inhibitors had no effect on risk of death (HR 0.97, 95% CI 0.69 to 1.34). Identified susceptible populations and fragile patients should be considered when setting priorities in public health planning and clinical decision making.