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Minerva Medica 2021 Apr 29

DOI: 10.23736/S0026-4806.21.07187-1


language: English

Role of comorbidities on the mortality in patients with SARS-CoV-2 infection: an Italian cohort study

Pasquale VERGARA 1 , Luca ROSSI 2, Andrea BIAGI 2, Giulio FALASCONI 1, Luigi PANNONE 1, Alessia ZANNI 2, Concetta STICOZZI 2, Greta COMASTRI 2, Stefano GANDOLFI 3, Cosmo GODINO 4, Alessandro MALAGOLI 5, Giovanni Q. VILLANI

1 Arrhythmia Unit and Electrophysiology Laboratories, San Raffaele Hospital, Milano, Italy; 2 Division of Cardiology, Cardiovascular and Emergency Department, Guglielmo da Saliceto Hospital, Piacenza, Italy; 3 Health Management, Guglielmo da Saliceto Hospital, ASL Piacenza, Piacenza, Italy; 4 Cardiovascular Department, San Raffaele Scientific Institute, Milan, Italy; 5 Division of Cardiology, Nephro-Cardiovascular Department, S. Agostino-Estense Public Hospital, University of Modena and Reggio Emilia, Modena, Italy


BACKGROUND: Cardiovascular comorbidities are a common cause of death in COVID-19 and the aim of this study is to evaluate the effect of comorbidities on mortality in COVID-19 patients.
METHODS: In this retrospective observational study we enrolled 1049 patients hospitalized with confirmed SARS-CoV-2 infection in a single Italian Center from 21 February to 20 March 2020 Evaluated risk factors (RFs) were: advanced age, gender, hypertension, diabetes, atrial fibrillation, hyperlipidemia, chronic kidney disease, thyroid disease, chronic obstructive pulmonary disease, malignancy, stroke, cardiovascular disease, and peripheral vascular disease. Endpoint of the study was death from any cause. A multivariate logistic regression model was built using covariates that showed as statistically significant at univariate regression analysis.
RESULTS: Median age at presentation was 71.1 years (IQR: 59.1-80.5); 244 (72.2%) were males. Primary outcome occurred in 338 patients (32.2%). In decedents, median survival from Hospitalization was 6 (IQR: 3-10) days. 264 decedents had 1 RF, 120 had 2 RFs and 39 had ≥3 RFs. At multivariate logistic regression model, variables associated with primary outcome were: age class (64-69 years) (OR 3.03, CI 1.75-5.31, p<0.001), age class (70-88 years) (OR 10.08, CI 6.67-15.72, p<0.001), age class (≥ 88 years) (OR 23.99, CI 13.21-44.82, p<0.001), male gender (OR 1.88, CI 1.36-2.62, p<0.001), diabetes (OR 1.56, CI 1.07-2.26, p=0.02), stroke (OR 3.41, CI 1.33-9.91, p=0.015).
CONCLUSIONS: Age, male gender, presence of diabetes and stroke appeared as independent predictors of mortality in COVID-19 patients. A table for risk of 30 days-mortality in SARS-CoV-2 infection was built, based on odds ratios derived from multivariate regression analysis.

KEY WORDS: COVID-19; Mortality; Diabetes; Stroke; Cardiovascular risk factors

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