{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T05:20:51Z","timestamp":1791523251992,"version":"4.3.4"},"reference-count":31,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2021,3,25]],"date-time":"2021-03-25T00:00:00Z","timestamp":1616630400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:p>Italy was one of the worst affected European countries during the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic. More than 50% of Italian cases occurred in the northern region of Lombardy, where the saturation of health services between March and April 2020 forced hospitals to allocate patients according to available resources. Eighteen severe coronavirus disease 2019 (COVID-19) patients were admitted to our hospital needing intensive support. Given the disease fatality, we investigated the patients' characteristics to identify mortality predictors. We counted seven deaths from multiple organ failure, two from septic shock, and two from collapsed lungs. The maximum case fatality was observed in patients who contracted SARS-CoV-2 in hospitals. The fatal outcome was associated with the following baseline characteristics: polymorbidity (OR 2.519, <jats:italic>p<\/jats:italic> = 0.048), low body mass index (OR 2.288, <jats:italic>p<\/jats:italic> = 0.031), low hemoglobin (OR 3.012, <jats:italic>p<\/jats:italic> = 0.046), and antithrombin III (OR 1.172, <jats:italic>p<\/jats:italic> = 0.048), along with a worsening of PaO<jats:sub>2<\/jats:sub>\/FiO<jats:sub>2<\/jats:sub> ratio in the first 72 h after admission (OR 1.067, <jats:italic>p<\/jats:italic> = 0.031). The occurrence of co-infections during hospitalization was associated with a longer need for intensive care (B = 4.511, <jats:italic>p<\/jats:italic> = 0.001). More information is needed to inform intensive care for patients with severe COVID-19, but our findings would certainly contribute to shed some light on this unpredictable and multifaceted disease.<\/jats:p>","DOI":"10.3389\/fmed.2021.582896","type":"journal-article","created":{"date-parts":[[2021,3,25]],"date-time":"2021-03-25T07:42:52Z","timestamp":1616658172000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":11,"title":["Clinical Characteristics of Severe COVID-19 Patients Admitted to an Intensive Care Unit in Lombardy During the Italian Pandemic"],"prefix":"10.3389","volume":"8","author":[{"given":"Matteo","family":"Briguglio","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tiziano","family":"Crespi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabio","family":"Pino","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Mazzocchi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mauro","family":"Porta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"De Vecchi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Banfi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paolo","family":"Perazzo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2021,3,25]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"671","DOI":"10.3389\/fphys.2020.00671","article-title":"Disentangling the hypothesis of host dysosmia and SARS-CoV-2: the bait symptom that hides neglected neurophysiological routes","volume":"11","author":"Briguglio","year":"2020","journal-title":"Front Physiol"},{"key":"B2","doi-asserted-by":"publisher","first-page":"287","DOI":"10.1164\/rccm.202004-1226LE","article-title":"Respiratory mechanics of COVID-19 vs. non-COVID-19 associated acute respiratory distress syndrome","volume":"202","author":"Haudebourg","year":"2020","journal-title":"Am J Respir Crit Care Med"},{"key":"B3","doi-asserted-by":"publisher","first-page":"e13404","DOI":"10.1111\/tid.13404","article-title":"SARS-CoV2 and immunosuppression: a double-edged sword","volume":"8","author":"Lai","year":"2020","journal-title":"Transpl Infect Dis."},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1097\/MEG.0000000000001817","article-title":"COVID-19 and liver injury: a meta-analysis","author":"Wijarnpreecha","year":"2020","journal-title":"Eur J Gastroenterol Hepatol."},{"key":"B5","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1007\/s00264-020-04590-1","article-title":"Changes of clinical activities in an orthopaedic institute in North Italy during the spread of COVID-19 pandemic: a seven-week observational analysis","volume":"24","author":"Zagra","year":"2020","journal-title":"Int Orthop."},{"key":"B6","doi-asserted-by":"publisher","first-page":"134818","DOI":"10.3390\/ijerph17134818","article-title":"Managing a tertiary orthopedic hospital during the COVID-19 epidemic, main challenges and solutions adopted","volume":"17","author":"Magro","year":"2020","journal-title":"Int J Environ Res Public Health."},{"key":"B7","doi-asserted-by":"publisher","first-page":"e799","DOI":"10.1097\/CCM.0000000000004457","article-title":"ICU and ventilator mortality among critically ill adults with coronavirus disease 2019","volume":"48","author":"Auld","year":"2020","journal-title":"Crit Care Med."},{"key":"B8","doi-asserted-by":"publisher","first-page":"2012","DOI":"10.1056\/NEJMoa2004500","article-title":"Covid-19 in critically ill patients in the seattle region - 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