Baseline clinical characteristics and prognostic factors in hospitalized COVID-19 patients aged ≤ 65 years: A retrospective observational study

• Published in: PloS one 2021-03, Vol.16 (3), p.e0248829-e0248829
• Main Authors: Betti, Marta, Bertolotti, Marinella, Ferrante, Daniela, Roveta, Annalisa, Pelazza, Carolina, Giacchero, Fabio, Penpa, Serena, Massarino, Costanza, Bolgeo, Tatiana, Cassinari, Antonella, Mussa, Marco, Chichino, Guido, Maconi, Antonio
• Format: Article
• Language: English
• Subjects: Acidosis; Adult; Age; Anosmia; Antibiotics; Antifungal agents; Antiviral agents; Biochemistry; Biology and Life Sciences; Blood coagulation; Blood pressure; C-Reactive Protein - analysis; Cancer; Chronic obstructive pulmonary disease; Coagulation; Comorbidity; Complications; Congestive heart failure; Conjunctivitis; Connective tissue diseases; Coronaviridae; Coronaviruses; Corticoids; Corticosteroids; COVID-19; COVID-19 - epidemiology; COVID-19 - transmission; Dementia disorders; Demographic aspects; Demographic variables; Diabetes; Diabetes mellitus; Embolisms; Epidemiology; Female; Fever; Heart failure; Heart rate; Hematology; Hemorrhage; Hospital patients; Hospitalization; Hospitalization - trends; Hospitals; Humans; Illnesses; Immunoglobulins; Infectious diseases; Inflammation; Italy - epidemiology; Kidney diseases; Kidneys; Laboratories; Leukemia; Liver; Liver diseases; Lung diseases; Lymphoma; Male; Mechanical ventilation; Medical prognosis; Medical records; Medicine and Health Sciences; Metastasis; Methodology; Middle Aged; Muscles; Myocardial infarction; Nausea; Nucleic acids; Observational studies; Opacity; Oxygen; Oxygen saturation; Oxygenation; Pain; Patients; Physical Sciences; Platelet Count - trends; Pneumonia; Prognosis; Prophylaxis; Public health; Pulmonary embolisms; Research and Analysis Methods; Respiration; Respiratory diseases; Respiratory distress syndrome; Retrospective Studies; Risk Factors; SARS-CoV-2 - pathogenicity; Severe acute respiratory syndrome; Severe acute respiratory syndrome coronavirus 2; Severity of Illness Index; Signs and symptoms; Statistical analysis; Thromboembolism; Thrombosis; Vascular diseases; Veins; Ventilation; Ventilators; Viral diseases; Vomiting
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0248829

Individual differences in susceptibility to SARS-CoV-2 infection, symptomatology and clinical manifestation of COVID-19 have thus far been observed but little is known about the prognostic factors of young patients. A retrospective observational study was conducted on 171 patients aged ≤ 65 years hospitalized in Alessandria's Hospital from 1st March to 30th April 2020 with laboratory confirmed COVID-19. Epidemiological data, symptoms at onset, clinical manifestations, Charlson Comorbidity Index, laboratory parameters, radiological findings and complications were considered. Patients were divided into two groups on the basis of COVID-19 severity. Multivariable logistic regression analysis was used to establish factors associated with the development of a moderate or severe disease. A total of 171 patients (89 with mild/moderate disease, 82 with severe/critical disease), of which 61% males and a mean age (± SD) of 53.6 (± 9.7) were included. The multivariable logistic model identified age (50-65 vs 18-49; OR = 3.23 CI95% 1.42-7.37), platelet count (per 100 units of increase OR = 0.61 CI95% 0.42-0.89), c-reactive protein (CPR) (per unit of increase OR = 1.12 CI95% 1.06-1.20) as risk factors for severe or critical disease. The multivariable logistic model showed a good discriminating capacity with a C-index value of 0.76. Patients aged ≥ 50 years with low platelet count and high CRP are more likely to develop severe or critical illness. These findings might contribute to improved clinical management.