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The Deadly Quartet (Covid-19, Old Age, Lung Disease, and Heart Failure) Explains Why Coronavirus-Related Mortality in Northern Italy Was So High

[ Vol. 17 , Issue. 1 ]

Author(s):

Giuseppe Calcaterra, Pier Paolo Bassareo*, Francesco Barilla, Domenico Sergi, Marcello Chiocchi, Francesco Romeo and Jawahar L. Mehta   Pages 74 - 77 ( 4 )

Abstract:


Since its outbreak in China at the end of 2019, the new coronavirus disease (COVID-19) was characterized by both easy spreading and high mortality. The latter proved to be way more elevated in the North of Italy -with a peak of 18.4% in region Lombardia and even 31% in the city of Bergamo and surrounding county- than in the rest of the world. In an attempt to conceptualize the reasons for such a dramatic situation, four key elements have been identified: COVID-19 itself, old age, lung disease, and heart failure. Their harmful combination has been named “The deadly quartet”. The underlying risk factors, among which a lot of them are distinctive features of the population in northern Italy, have been summarized as “unmodifiable”, “partially modifiable”, and “modifiable”, for the sake of clarity. Up-to-date scientific evidence in this field has been described in the form of a narrative and easy-to-read review.

Keywords:

COVID-19, coronavirus, Italy, mortality, lung, heart.

Affiliation:

Post graduate medical School, University of Palermo, Palermo, University College of Dublin, Mater Misericordiae University Hospital, Dublin, Cardiac Department, Università La Sapienza, Rome, Department of Cardiology, University of Rome “Tor Vergata”, Rome, Department of Cardiology, University of Rome “Tor Vergata”, Rome, Department of Cardiology, University of Rome “Tor Vergata”, Rome, Division of Cardiology, University of Arkansas for Medical Sciences and the VA Medical Center, Little Rock, AR



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