1.Twenty-four-hour serum creatinine variation is associated with poor outcome in the novel coronavirus disease 2019 (COVID-19) patients
Gaetano ALFANO ; Annachiara FERRARI ; Francesco FONTANA ; Giacomo MORI ; Giulia LIGABUE ; Silvia GIOVANELLA ; Riccardo MAGISTRONI ; Marianna MESCHIARI ; Erica FRANCESCHINI ; Marianna MENOZZI ; Gianluca CUOMO ; Gabriella ORLANDO ; Antonella SANTORO ; Margherita DI GAETANO ; Cinzia PUZZOLANTE ; Federica CARLI ; Andrea BEDINI ; Jovana MILIC ; Cristina MUSSINI ; Gianni CAPPELLI ; Giovanni GUARALDI ;
Kidney Research and Clinical Practice 2021;40(2):231-240
Background:
The development of acute kidney injury (AKI) in patients with coronavirus disease 2019 (COVID-19) is associated with a high risk of death. Published data demonstrate the possibility of severe kidney injury in patients suffering from COVID-19. However, these data are still controversial.
Methods:
A total of 1,280 patients with a proven diagnosis of COVID-19 were included in our study. COVID-19 was confirmed in all patients using reverse transcriptase polymerase chain reaction test of a nasopharyngeal swab, and based on the typical computed tomography findings. Demographic data, underlying comorbidities, and laboratory blood tests were assessed. We assessed the incidence of AKI and its associated mortality defined by survival status at discharge.
Results:
Proteinuria was identified with 648 patients (50.6%) with COVID-19. AKI was identified in 371 patients (29.0%). Ten of these patients (2.7%) required dialysis. The risk factors for AKI included age of > 65 years, augmentation of C-reactive protein, ferritin and an increase in values of activated partial thromboplastin time. Overall, 162 of the 1,280 hospitalized patients (12.7%) and 111 of the 371 patients (29.9%) with AKI did not survive. The hazard ratio (HR) for mortality was 3.96 (95% confidence interval, 2.83–5.54) for patients with AKI vs. no AKI.
Conclusion
AKI was a relatively common finding among patients with COVID-19. The risk factors for AKI in COVID-19 included old age, the inflammatory response, the severity of lung involvement, and disseminated intravascular coagulation. These same factors, in addition to arterial hypertension, were found to increase the risk of mortality.
2.Twenty-four-hour serum creatinine variation is associated with poor outcome in the novel coronavirus disease 2019 (COVID-19) patients
Gaetano ALFANO ; Annachiara FERRARI ; Francesco FONTANA ; Giacomo MORI ; Giulia LIGABUE ; Silvia GIOVANELLA ; Riccardo MAGISTRONI ; Marianna MESCHIARI ; Erica FRANCESCHINI ; Marianna MENOZZI ; Gianluca CUOMO ; Gabriella ORLANDO ; Antonella SANTORO ; Margherita DI GAETANO ; Cinzia PUZZOLANTE ; Federica CARLI ; Andrea BEDINI ; Jovana MILIC ; Cristina MUSSINI ; Gianni CAPPELLI ; Giovanni GUARALDI ;
Kidney Research and Clinical Practice 2021;40(2):231-240
Background:
The development of acute kidney injury (AKI) in patients with coronavirus disease 2019 (COVID-19) is associated with a high risk of death. Published data demonstrate the possibility of severe kidney injury in patients suffering from COVID-19. However, these data are still controversial.
Methods:
A total of 1,280 patients with a proven diagnosis of COVID-19 were included in our study. COVID-19 was confirmed in all patients using reverse transcriptase polymerase chain reaction test of a nasopharyngeal swab, and based on the typical computed tomography findings. Demographic data, underlying comorbidities, and laboratory blood tests were assessed. We assessed the incidence of AKI and its associated mortality defined by survival status at discharge.
Results:
Proteinuria was identified with 648 patients (50.6%) with COVID-19. AKI was identified in 371 patients (29.0%). Ten of these patients (2.7%) required dialysis. The risk factors for AKI included age of > 65 years, augmentation of C-reactive protein, ferritin and an increase in values of activated partial thromboplastin time. Overall, 162 of the 1,280 hospitalized patients (12.7%) and 111 of the 371 patients (29.9%) with AKI did not survive. The hazard ratio (HR) for mortality was 3.96 (95% confidence interval, 2.83–5.54) for patients with AKI vs. no AKI.
Conclusion
AKI was a relatively common finding among patients with COVID-19. The risk factors for AKI in COVID-19 included old age, the inflammatory response, the severity of lung involvement, and disseminated intravascular coagulation. These same factors, in addition to arterial hypertension, were found to increase the risk of mortality.
3.Characteristics and patterns of care of endometrial cancer before and during COVID-19 pandemic
Giorgio BOGANI ; Giovanni SCAMBIA ; Chiara CIMMINO ; Francesco FANFANI ; Barbara COSTANTINI ; Matteo LOVERRO ; Gabriella FERRANDINA ; Fabio LANDONI ; Luca BAZZURINI ; Tommaso GRASSI ; Domenico VITOBELLO ; Gabriele SIESTO ; Anna Myriam PERRONE ; Vanna ZANAGNOLO ; Pierandrea DE IACO ; Francesco MULTINU ; Fabio GHEZZI ; Jvan CASARIN ; Roberto BERRETTA ; Vito A CAPOZZI ; Errico ZUPI ; Gabriele CENTINI ; Antonio PELLEGRINO ; Silvia CORSO ; Guido STEVENAZZI ; Serena MONTOLI ; Anna Chiara BOSCHI ; Giuseppe COMERCI ; Pantaleo GRECO ; Ruby MARTINELLO ; Francesco SOPRACORDEVOLE ; Giorgio GIORDA ; Tommaso SIMONCINI ; Marta CARETTO ; Enrico SARTORI ; Federico FERRARI ; Antonio CIANCI ; Giuseppe SARPIETRO ; Maria Grazia MATARAZZO ; Fulvio ZULLO ; Giuseppe BIFULCO ; Michele MORELLI ; Annamaria FERRERO ; Nicoletta BIGLIA ; Fabio BARRA ; Simone FERRERO ; Umberto Leone Roberti MAGGIORE ; Stefano CIANCI ; Vito CHIANTERA ; Alfredo ERCOLI ; Giulio SOZZI ; Angela MARTOCCIA ; Sergio SCHETTINI ; Teresa ORLANDO ; Francesco G CANNONE ; Giuseppe ETTORE ; Andrea PUPPO ; Martina BORGHESE ; Canio MARTINELLI ; Ludovico MUZII ; Violante Di DONATO ; Lorenza DRIUL ; Stefano RESTAINO ; Alice BERGAMINI ; Giorgio CANDOTTI ; Luca BOCCIOLONE ; Francesco PLOTTI ; Roberto ANGIOLI ; Giulia MANTOVANI ; Marcello CECCARONI ; Chiara CASSANI ; Mattia DOMINONI ; Laura GIAMBANCO ; Silvia AMODEO ; Livio LEO ; Raphael THOMASSET ; Diego RAIMONDO ; Renato SERACCHIOLI ; Mario MALZONI ; Franco GORLERO ; Martina Di LUCA ; Enrico BUSATO ; Sami KILZIE ; Andrea DELL'ACQUA ; Giovanna SCARFONE ; Paolo VERCELLINI ; Marco PETRILLO ; Salvatore DESSOLE ; Giampiero CAPOBIANCO ; Andrea CIAVATTINI ; Giovanni Delli CARPINI
Journal of Gynecologic Oncology 2022;33(1):e10-
Objective:
Coronavirus disease 2019 (COVID-19) outbreak has correlated with the disruption of screening activities and diagnostic assessments. Endometrial cancer (EC) is one of the most common gynecological malignancies and it is often detected at an early stage, because it frequently produces symptoms. Here, we aim to investigate the impact of COVID-19 outbreak on patterns of presentation and treatment of EC patients.
Methods:
This is a retrospective study involving 54 centers in Italy. We evaluated patterns of presentation and treatment of EC patients before (period 1: March 1, 2019 to February 29, 2020) and during (period 2: April 1, 2020 to March 31, 2021) the COVID-19 outbreak.
Results:
Medical records of 5,164 EC patients have been retrieved: 2,718 and 2,446 women treated in period 1 and period 2, respectively. Surgery was the mainstay of treatment in both periods (p=0.356). Nodal assessment was omitted in 689 (27.3%) and 484 (21.2%) patients treated in period 1 and 2, respectively (p<0.001). While, the prevalence of patients undergoing sentinel node mapping (with or without backup lymphadenectomy) has increased during the COVID-19 pandemic (46.7% in period 1 vs. 52.8% in period 2; p<0.001). Overall, 1,280 (50.4%) and 1,021 (44.7%) patients had no adjuvant therapy in period 1 and 2, respectively (p<0.001). Adjuvant therapy use has increased during COVID-19 pandemic (p<0.001).
Conclusion
Our data suggest that the COVID-19 pandemic had a significant impact on the characteristics and patterns of care of EC patients. These findings highlight the need to implement healthcare services during the pandemic.