Background. Evidence has shown a close association between COVID-19 infection and renal complications in both individuals with previously normal renal function and those with chronic kidney disease (CKD). Methods. The aim of this study is to evaluate the in-hospital mortality of SARS-CoV-2 patients according to their clinical history of CKD or estimated glomerular filtration rate (eGFR). This is a prospective multicenter observational cohort study which involved adult patients (≥18 years old) who tested positive with SARS-CoV-2 infection and completed their hospitalization in the period between November 2020 and June 2021. Results. 1246 patients were included in the study, with a mean age of 64 years (SD 14.6) and a median duration of hospitalization of 15 days (IQR 9–22 days). Cox’s multivariable regression model revealed that mortality risk was strongly associated with the stage of renal impairment and the Kaplan–Meier survival analysis showed a progressive and statistically significant difference (p < 0.0001) in mortality according to the stage of CKD. Conclusion. This study further validates the association between CKD stage at admission and mortality in patients hospitalized for COVID-19. The risk stratification based on eGFR allows clinicians to identify the subjects with the highest risk of intra-hospital mortality despite the duration of hospitalization.

Background and Objectives: West Nile virus (WNV) infection has a broad clinical spectrum ranging from asymptomatic or mild disease to severe neuroinvasive forms. Data on hospitalized patients with atypical or non-neurological presentations remain limited. Materials and Methods: We conducted a retrospective multicenter observational study including 30 patients with laboratory-confirmed WNV infection admitted to internal medicine wards during a seasonal outbreak in Southern Italy. Clinical characteristics, hematological parameters, and in-hospital outcomes were analyzed. Results: Median age was 77 years, and 53% of patients were male. Neurological involvement was observed in 50% of patients, whereas 37% presented with septic-like manifestations. Overall in-hospital mortality was 43%, and early mortality within 10 days occurred in 17%. Neurological involvement was significantly more frequent among non-survivors and was associated with increased in-hospital mortality. Higher monocyte percentages were associated with overall mortality, whereas eosinopenia, leukopenia, and thrombocytopenia were associated with early mortality in exploratory analyses. Conclusions: Hospitalized patients with WNV infection may present with heterogeneous clinical phenotypes extending beyond classical neuroinvasive disease. Neurological involvement appears to be the main clinical marker of adverse outcome, while selected hematological parameters may provide preliminary prognostic information. Given the limited sample size and retrospective design, these findings should be considered hypothesis-generating.

Background and Aims: The COVID-19 pandemic, caused by the novel coronavirus SARS-CoV-2, has fundamentally reshaped the landscape of global public health, with some people suffering more adverse clinical outcomes than others. The aim of this study is to deepen our understanding of the specific impact of acute kidney injury (AKI) on the in-hospital mortality in octogenarian patients with COVID-19. Methods: This is a prospective observational cohort study, which involved 23 COVID-19 hospital units in the Campania Region, Italy. Exposure variables were collected during hospital admission and at discharge. Only patients aged ≥80 years were deemed eligible for the study. Results: 197 patients were included in the study (median age 83.0 [82.0–87.0] years; 51.5% men), with a median duration of hospitalization of 15.0 [8.0–25.0] days. From the multivariable Cox regression analysis, after the application of Šidák correction, only the respiratory rate (HR 1.09, 95% CI: 1.04 to 1.14; p < 0.001) and AKI development (HR: 3.40, 95% CI: 1.80 to 6.40; p < 0.001) were independently associated with the primary outcome. Moreover, the Kaplan–Meier analysis showed a significantly different risk of in-hospital mortality between patients with and without AKI (log-rank: <0.0001). Conclusions: In our investigation, we identified a significant association between AKI and mortality rates among octogenarian patients admitted for COVID-19. These findings raise notable concerns and emphasize the imperative for vigilant monitoring of this demographic cohort.