Clinical factors associated with death in 3044 COVID-19 patients managed in internal medicine wards in Italy: results from the SIMI-COVID-19 study of the Italian Society of Internal Medicine (SIMI)
Corradini et al.
, Clinical factors associated with death in 3044 COVID-19 patients managed in internal medicine wards in Italy:..
, Internal and Emergency Medicine, doi:10.1007/s11739-021-02742-8
Retrospective 3,044 hospitalized COVID-19 patients in Italy, showing HCQ significantly associated with survival in light, mild, and moderate cases in multivariable analysis, but not in severe cases.
risk of death, 70.2% lower, OR 0.30, p < 0.001, treatment 1,439, control 274, adjusted per study, Table S6, all patients, multivariable, RR approximated with OR.
risk of death, 67.4% lower, OR 0.33, p = 0.01, treatment 641, control 102, adjusted per study, Table S6, light condition patients, multivariable, RR approximated with OR, early treatment result.
risk of death, 76.8% lower, OR 0.23, p < 0.001, treatment 546, control 71, adjusted per study, Table S6, mild condition patients, multivariable, RR approximated with OR.
risk of death, 84.2% lower, OR 0.16, p < 0.001, treatment 184, control 64, adjusted per study, Table S6, moderate condition patients, multivariable, RR approximated with OR.
risk of death, 29.0% higher, OR 1.29, p = 0.73, treatment 68, control 37, adjusted per study, Table S6, severe condition patients, multivariable, RR approximated with OR.
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Corradini et al., 24 Apr 2021, retrospective, Italy, peer-reviewed, 60 authors, dosage not specified.
Abstract: Internal and Emergency Medicine (2021) 16:1005–1015
IM - ORIGINAL
Clinical factors associated with death in 3044 COVID‑19
patients managed in internal medicine wards in Italy: results
from the SIMI‑COVID‑19 study of the Italian Society of Internal
Elena Corradini1 · Paolo Ventura1 · Walter Ageno2 · Chiara Beatrice Cogliati3 · Maria Lorenza Muiesan4 ·
Domenico Girelli5 · Mario Pirisi6 · Antonio Gasbarrini7 · Paolo Angeli8 · Patrizia Rovere Querini9 · Emanuele Bosi9 ·
Moreno Tresoldi9 · Roberto Vettor10 · Marco Cattaneo11 · Fabio Piscaglia12 · Antonio Luca Brucato13 ·
Stefano Perlini14 · Paolo Martelletti15 · Roberto Pontremoli16 · Massimo Porta17 · Pietro Minuz18 · Oliviero Olivieri19 ·
Giorgio Sesti20 · Gianni Biolo21 · Damiano Rizzoni22 · Gaetano Serviddio23 · Francesco Cipollone24 · Davide Grassi25 ·
Roberto Manfredini26 · Guido Luigi Moreo27 · Antonello Pietrangelo1 · SIMI-COVID-19 Collaborators
Received: 19 February 2021 / Accepted: 9 April 2021 / Published online: 24 April 2021
© Società Italiana di Medicina Interna (SIMI) 2021
During the COVID-19 2020 outbreak, a large body of data has been provided on general management and outcomes of hospitalized COVID-19 patients. Yet, relatively little is known on characteristics and outcome of patients managed in Internal
Medicine Units (IMU). To address this gap, the Italian Society of Internal Medicine has conducted a nationwide cohort
multicentre study on death outcome in adult COVID-19 patients admitted and managed in IMU. This study assessed 3044
COVID-19 patients at 41 referral hospitals across Italy from February 3rd to May 8th 2020. Demographics, comorbidities,
organ dysfunction, treatment, and outcomes including death were assessed. During the study period, 697 patients (22.9%)
were transferred to intensive care units, and 351 died in IMU (death rate 14.9%). At admission, factors independently
associated with in-hospital mortality were age (OR 2.46, p = 0.000), productive cough (OR 2.04, p = 0.000), pre-existing
chronic heart failure (OR 1.58, p = 0.017) and chronic obstructive pulmonary disease (OR 1.17, p = 0.048), the number of
comorbidities (OR 1.34, p = 0.000) and polypharmacy (OR 1.20, p = 0.000). Of note, up to 40% of elderly patients did not
report fever at admission. Decreasing P
aO2/FiO2 ratio at admission was strongly inversely associated with survival. The use
of conventional oxygen supplementation increased with the number of pre-existing comorbidities, but it did not associate
with better survival in patients with PaO2/FiO2 ratio < 100. The latter, significantly benefited by the early use of non-invasive
mechanical ventilation. Our study identified PaO2/FiO2 ratio at admission and comorbidity as the main alert signs to inform
clinical decisions and resource allocation in non-critically ill COVID-19 patients admitted to IMU.
Keywords SARS-CoV-2 · Mortality from COVID-19 · Comorbidity · Polypharmacy · Internal medicine
ACE Angiotensin-converting enzyme
CHF Chronic heart failure
Elena Corradini and Paolo Ventura contributed equally to the
Members of the SIMI COVID-19 Collaborators are listed in the
Acknowledgement section at the end of the article.
* Antonello Pietrangelo
CKD Chronic kidney disease
COPD Chronic obstructive pulmonary disease
COVID-19 Coronavirus disease 2019
CPAP Continuous positive air pressure
CRF Case report..
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