Epidemiological characteristics, clinical features and outcomes of patients with COVID-19 admitted to seven reference centers across Greece: An observational study during the fourth and fifth waves of the COVID-19 pandemic

IF 0.5 Q4 RESPIRATORY SYSTEM Pneumon Pub Date : 2023-06-21 DOI:10.18332/pne/163036

O. Papaioannou, T. Karampitsakos, P. Tsiri, Vagia Karageorgou, A. Papaioannou, M. Kallieri, M. Blizou, Stefanos Lampadakis, M. Sfika, Antonios Krouskos, Vasilis Papavasileiou, Franceska Strakosha, Kalliopi-Theoni Vandorou, Pavlos Siozos, Marina Moustaka Christodoulou, Georgia Kontonasiou, V. Apollonatou, E. Antonogiannaki, C. Kyriakopoulos, C. Aggelopoulou, C. Chronis, K. Kostikas, E. Koukaki, Z. Sotiropoulou, A. Athanasopoulou, P. Bakakos, Pinelopi Sxini, Emmanouil Alevrakis, Sotirios Poupos, Evangelia Xondrou, Dionisios Tsoukalas, Alexia Chronaiou, G. Tsoukalas, S. Koukidou, G. Hillas, K. Dimakou, K. Roukas, Ifigenia Nakou, D. Chloros, E. Fouka, S. Papiris, S. Loukides, A. Tzouvelekis

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Abstract

INTRODUCTION Epidemiological data from hospitalized patients with COVID-19 during the fourth and fifth waves of the pandemic have been published worldwide. METHODS This registry was an observational, prospective study conducted in seven reference hospitals across Greece. Maximum FiO 2 during hospitalization and Charlson comorbidity index (CCI) on admission were correlated with disease severity, as well as radiological features, parameters of complete blood count, and d-dimer. RESULTS A total of 1019 patients were included in the analysis; 55.1% and 57.2% of patients were males and never smokers, respectively, with median age of 67 years (95% CI: 65.7–69.0). Patients with increased extent of consolidation and ground glass opacities in chest CT (>10–25%) exhibited more advanced disease compared to the low extent group (<10%) as indicated by both CCI on admission (3; 95% CI: 2–3 vs 2; 95% CI: 1–2, p=0.0002) and MaxFiO 2 (0.40; 95% CI: 0.35–0.40 vs 0.28; 95% CI: 0.24–0.28, p<0.0001). Patients with high neutrophil to lymphocyte ratio (≥4.42) exhibited more severe disease as indicated by significantly increased CCI on admission (4; 95% CI: 3 to 4 vs 3; 95% CI: 2–3, p<0.0001) and MaxFiO 2 (0.35; 95% CI: 0.35–0.4 vs 0.28; 95% CI: 0.28–0.28, p<0.0001). Patients with elevated d-dimer (≥0.74 μg/mL) displayed also advanced disease compared to the low d-dimer group (<0.74 μg/mL), as assessed by both CCI on admission (4; 95% CI: 4–4 vs 2; 95% CI: 2–2, p<0.0001) and MaxFiO 2 (0.38; 95% CI: 0.35–0.40 vs 0.28; 95% CI: 0.28–0.28, p<0.0001). CONCLUSIONS We present the first observational study across Greece during the fourth and fifth waves of the COVID-19 pandemic. Extent of opacities in chest CT, neutrophil to lymphocyte ratio and d-dimer may represent reliable disease prognostic factors leading to timely therapeutic interventions.

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希腊七个参考中心收治的COVID-19患者的流行病学特征、临床特征和结局:一项在COVID-19大流行第四和第五波期间的观察性研究

在全球范围内公布了第四波和第五波COVID-19住院患者的流行病学数据。方法:本研究是一项在希腊7家参考医院进行的观察性前瞻性研究。住院期间最大FiO 2和入院时Charlson合并症指数(CCI)与疾病严重程度、影像学特征、全血细胞计数参数和d-二聚体相关。结果共纳入1019例患者;55.1%和57.2%的患者为男性，从不吸烟，中位年龄为67岁(95% CI: 65.7-69.0)。入院时两项CCI显示，胸部CT实变程度增加和磨玻璃影(bbb10 - 25%)的患者比低程度组(<10%)表现出更严重的疾病(3;95% CI: 2 - 3 vs 2;95% CI: 1-2, p=0.0002)和MaxFiO 2 (0.40;95% CI: 0.35-0.40 vs 0.28;95% CI: 0.24-0.28, p<0.0001)。中性粒细胞与淋巴细胞比值高(≥4.42)的患者入院时CCI显著升高，表明病情更为严重(4;95% CI: 3 ~ 4 vs 3;95% CI: 2 - 3, p<0.0001)和MaxFiO 2 (0.35;95% CI: 0.35-0.4 vs 0.28;95% CI: 0.28-0.28, p<0.0001)。入院时的CCI评估结果显示，与低d-二聚体组(<0.74 μg/mL)相比，d-二聚体升高(≥0.74 μg/mL)的患者也表现出疾病进展(4;95% CI: 4-4 vs 2;95% CI: 2 - 2, p<0.0001)和MaxFiO 2 (0.38;95% CI: 0.35-0.40 vs 0.28;95% CI: 0.28-0.28, p<0.0001)。结论:在2019冠状病毒病大流行的第四和第五波期间，我们在希腊进行了第一项观察性研究。胸部CT上的混浊程度、中性粒细胞与淋巴细胞的比值和d-二聚体可能是可靠的疾病预后因素，导致及时的治疗干预。

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来源期刊

Pneumon RESPIRATORY SYSTEM-

CiteScore

0.60

自引率

28.60%

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