open access

Vol 89, No 4 (2021)
Research paper
Submitted: 2021-02-24
Accepted: 2021-06-03
Published online: 2021-09-02
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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

Argyris Tzouvelekis12, Karolina Akinosoglou2, Theodoros Karampitsakos12, Vassiliki Panou3, Ioannis Tomos4, Georgios Tsoukalas5, Magdalini Stratiki5, Katerina Dimakou6, Serafeim Chrysikos6, Ourania Papaioannou16, Georgios Hillas6, Petros Bakakos3, Grigoris Stratakos3, Aris Anagnostopoulos3, Athanasios Koromilias3, Afroditi Boutou7, Ioannis Kioumis8, Diamantis Chloros9, Theodoros Kontakiotis10, Despoina Papakosta10, Spyridon Papiris4, Effrosyni Manali4, Elvira-Markela Antonogiannaki4, Nikolaos Koulouris3, Demosthenes Bouros3, Stylianos Loukides4, Charalampos Gogos2
DOI: 10.5603/ARM.a2021.0087
·
Pubmed: 34494241
·
Adv Respir Med 2021;89(4):378-385.
Affiliations
  1. Department of Respiratory Medicine, University Hospital of Patras, University of Patras, Patras, Greece, Greece
  2. Department of Internal Medicine, University Hospital of Patras, University of Patras, Patras, Greece
  3. 1st Academic Department of Respiratory Medicine, SOTIRIA General Hospital for Thoracic Diseases, National and Kapodistrian University of Athens, Athens, Greece
  4. 2nd Academic Department of Respiratory Medicine, ATTIKON General Hospital, National and Kapodistrian University of Athens, Athens, Greece
  5. 4th Department of Respiratory Medicine, SOTIRIA General Hospital, Athens, Greece
  6. 5th Department of Respiratory Medicine, SOTIRIA General Hospital, Athens, Greece
  7. Department of Respiratory Medicine, Papanikolaou General Hospital, Thessaloniki, Greece
  8. Department of Respiratory Failure, Aristotle University of Thessaloniki, Thessaloniki, Greece
  9. Department of Respiratory Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
  10. Department of Respiratory Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece

open access

Vol 89, No 4 (2021)
ORIGINAL PAPERS
Submitted: 2021-02-24
Accepted: 2021-06-03
Published online: 2021-09-02

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.

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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Keywords

COVID-19, severity, neutrophil-to-lymphocyte ratio, LDH, prognosticators

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Title

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

Journal

Advances in Respiratory Medicine

Issue

Vol 89, No 4 (2021)

Article type

Research paper

Pages

378-385

Published online

2021-09-02

DOI

10.5603/ARM.a2021.0087

Pubmed

34494241

Bibliographic record

Adv Respir Med 2021;89(4):378-385.

Keywords

COVID-19
severity
neutrophil-to-lymphocyte ratio
LDH
prognosticators

Authors

Argyris Tzouvelekis
Karolina Akinosoglou
Theodoros Karampitsakos
Vassiliki Panou
Ioannis Tomos
Georgios Tsoukalas
Magdalini Stratiki
Katerina Dimakou
Serafeim Chrysikos
Ourania Papaioannou
Georgios Hillas
Petros Bakakos
Grigoris Stratakos
Aris Anagnostopoulos
Athanasios Koromilias
Afroditi Boutou
Ioannis Kioumis
Diamantis Chloros
Theodoros Kontakiotis
Despoina Papakosta
Spyridon Papiris
Effrosyni Manali
Elvira-Markela Antonogiannaki
Nikolaos Koulouris
Demosthenes Bouros
Stylianos Loukides
Charalampos Gogos

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