Epidemiological Characteristics and Outcomes from 187 Patients with COVID-19 Admitted to 6 Reference Centers in Greece: An Observational Study during the First Wave of the COVID-19 Pandemic

Αrgyris Τzouvelekis(University of Patras), Karolina Akinosoglou(University of Patras), Τheodoros Karampitsakos(University of Patras), Vassiliki Panou(National and Kapodistrian University of Athens), Ioannis Tomos(National and Kapodistrian University of Athens), Georgios Tsoukalas(Sotiria General Hospital), Magdalini Stratiki(Sotiria General Hospital), Katerina Dimakou(Sotiria General Hospital), Serafeim Chrysikos(Sotiria General Hospital), Ουρανία Παπαϊωάννου(University of Patras), Georgios Hillas(Sotiria General Hospital), Petros Bakakos(National and Kapodistrian University of Athens), Grigoris Stratakos(National and Kapodistrian University of Athens), Aris Anagnostopoulos(National and Kapodistrian University of Athens), Athanasios Koromilias(National and Kapodistrian University of Athens), Afroditi Boutou(G. Papanikolaou General Hospital), Ioannis Kioumis(Aristotle University of Thessaloniki), Diamantis Chloros(Aristotle University of Thessaloniki), Theodoros Kontakiotis(Aristotle University of Thessaloniki), Despoina Papakosta(Aristotle University of Thessaloniki), Spyridon Papiris(National and Kapodistrian University of Athens), Effrosyni D. Manali(National and Kapodistrian University of Athens), Elvira-Markela Antonogiannaki(National and Kapodistrian University of Athens), Νikolaos Koulouris(National and Kapodistrian University of Athens), Demosthenes Bouros(National and Kapodistrian University of Athens), Stylianos Loukides(National and Kapodistrian University of Athens), Charalampos Gogos(University of Patras)
Advances in respiratory medicine
September 2, 2021
Cited by 5Open Access
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Abstract

INTRODUCTION: Epidemiological data from patients with COVID-19 has been recently published in several countries. Nationwide data of hospitalized patients with COVID-19 in Greece remain scarce. MATERIAL AND METHODS: This was an observational, retrospective study from 6 reference centers between February 26 and May 15, 2020. RESULTS: The patients were mostly males (65.7%) and never smokers (57.2%) of median age 60 (95% CI: 57.6-64) years. The majority of the subjects (98%) were treated with the standard-of-care therapeutic regimen at that time, including hydroxychlo-roquine and azithromycin. Median time of hospitalization was 10 days (95% CI: 10-12). Twenty-five (13.3%) individuals were intubated and 8 died (4.2%). The patients with high neutrophil-to-lymphocyte ratio (NLR) ( > 3.58) exhibited more severe disease as indicated by significantly increased World Health Organization (WHO) R&D ordinal scale (4; 95% CI: 4-4 vs 3; 95% CI: 3-4, p = 0.0001) and MaxFiO2% (50; 95% CI: 38.2-50 vs 29.5; 95% CI: 21-31, p < 0.0001). The patients with increased lactate dehydrogenase (LDH) levels ( > 270 IU/ml) also exhibited more advanced disease compared to the low LDH group ( < 270 IU/ml) as indicated by both WHO R&D ordinal scale (4; 95% CI: 4-4 vs 4; 95% CI: 3-4, p = 0.0001) and MaxFiO2% (50; 95% CI: 35-60 vs 28; 95% CI: 21-31, p < 0.0001). CONCLUSION: We present the first epidemiological report from a low-incidence and mortality COVID-19 country. NLR and LDH may represent reliable disease prognosticators leading to timely treatment decisions.


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