Fatality rate and predictors of mortality in a large Italian cohort of hospitalized COVID-19 patients

Substantial discrepancies are evident in the clinical features and natural history of coronavirus disease 2019 (COVID-19), among different countries, so we aimed to evaluate the fatality rate and to identify predictors of mortality in a cohort of hospitalized patients. We performed a retrospective multicenter cohort study on medical records of patients admitted between 1 st March and 28 th April 2020, involving three hospitals in Northern Italy. We included 1697 patients older than 18 years of age and with a confirmed diagnosis of SARS-CoV-2 infection by reverse-transcriptase polymerase chain reaction (RT-PCR). During the study period we observed 504 deaths, with a CFR of 29.7%. We further looked for predictors of mortality in a subset of 486 patients (239 males, 59%); the median age of the study population was 71 [58-80] years. Among demographic and clinical variables considered, age, a diagnosis of cancer, obesity and current smoking independently predicted mortality. When laboratory data were added to the model, age, the diagnosis of cancer, and the baseline PaO2/FiO2 ratio were independent predictors of mortality. During the COVID-19 outbreak, the CFR of hospitalized patients in Northern Italy was high, approaching 30%. The identification of mortality predictors might contribute to better stratification of individual patient risk.