Abstract: Journal of Infection and Public Health 14 (2021) 263–270 Contents lists available at ScienceDirect Journal of Infection and Public Health journal homepage: http://www.elsevier.com/locate/jiph Severe COVID-19 pneumonia in Piacenza, Italy — A cohort study of the first pandemic wave Lorenzo Guglielmetti a,b,c,∗ , Irina Kontsevaya d,e,f , Maria C. Leoni c , Patrizia Ferrante c,g , Elisa Fronti c , Laura Gerna c , Caterina Valdatta c , Alessandra Donisi h , Alberto Faggi c , Franco Paolillo c , Giovanna Ratti c , Alessandro Ruggieri c , Marta Scotti c , Daria Sacchini c , Gloria Taliani c,i,j,1 , Mauro Codeluppi c,1 , For the COVID-Piacenza Group2 a Sorbonne Université, INSERM, U1135, Centre d’Immunologie et des Maladies Infectieuses, Cimi-Paris, équipe 13, Paris, France APHP, Groupe Hospitalier Universitaire Sorbonne Université, Hôpital Pitié-Salpêtrière, Centre National de Référence des Mycobactéries et de la Résistance des Mycobactéries aux Antituberculeux, Paris, France c Infectious Diseases Unit, Piacenza Hospital, Piacenza, Italy d Research Center Borstel, Borstel, Germany e German Center for Infection Research, Hamburg-Lübeck-Borstel-Riems, Borstel, Germany f International Health/Infectious Diseases, University of Lübeck, Lübeck, Germany g Institute for Cross-Disciplinary Physics and Complex Systems IFISC (UIB-CSIC), Campus Universitat Illes Balears, E-07122 Palma de Mallorca, Spain h Migration Health Unit, Primary Health Care Department, “Guglielmo da Saliceto” Hospital, Piacenza, Italy i Infectious and Tropical Disease Unit, Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy j Anti-COVID Task Force of the Italian Civil Protection b a r t i c l e i n f o Article history: Received 11 August 2020 Received in revised form 13 November 2020 Accepted 18 November 2020 Keywords: SARS-CoV-2 Coronavirus Viral pneumonia Acute respiratory distress syndrome Mortality a b s t r a c t Background: Piacenza is the closest city to the first coronavirus disease 2019 (COVID-19) cluster in Italy and has the highest national COVID-19 death rates per population. The objective of this study is to present characteristics and outcomes of patients admitted to medical departments of the Hospital of Piacenza during the first wave of the epidemic. Methods: A total of 218 patients with confirmed or suspect COVID-19 and severe pneumonia were included from February 21st to May 15th, 2020. Routinely-collected clinical and laboratory data were retrospectively retrieved from electronic medical files. A Cox proportional-hazards model was fit to assess the association of treatment and other variables with death. Results: Median age of patients was 68 years; 150 patients (69%) had comorbidities, mainly hypertension (107, 49%). Overall, 185 (85%) patients had acute respiratory distress syndrome (ARDS) on admission, including 103 (47%) with moderate or severe ARDS. Chest computed tomography scan showed bilateral disease in 201 (98%) and extensive lung involvement in 79 (50%) patients. Most patients received antiviral treatment (187, 86%) and corticosteroids (134, 61%). All patients received respiratory support and 64 (29%) were admitted to intensive care unit. As of June 30th, 100 patients (46%) died, 109 patients (50%) were discharged, and 9 patients (4%) were still hospitalized. In multivariable Cox analysis, age above 65 years, having more than one comorbidity, severe ARDS, low platelet counts, and high LDH levels at..