. In this systematic review and meta-analysis male gender, age over 65 years, current smoking habit and the presence of underlying diseases were associated with severe coronavirus disease (COVID-19) and poor outcomes.
As of May 03, 2020, there were 210,717 confirmed cases of COVID-19 in Italy and 28,884 deaths, mostly aged 70 or more, thus severely testing the national healthcare system.
To date, published studies describing short-term outcomes in elderly with severe COVID-19 disease admitted in the Italian Infectious Diseases units, are still limited (3). Therefore, we would like to describe short-term outcomes in all consecutive patients, aged 65 or more, with severe COVID-19 infection, hospitalized in our Infectious Diseases Unit. To our knowledge, this is the first report regarding elderly with COVID-19 from Southern Italy.
Our inpatient unit is composed of 37 beds served continuously by eleven infectious diseases specialists, and is designed by the regional COVID-19 pandemic plan as one of the reference institutions for the hospital care of COVID-19 in Apulia region.
Among the 67 patients with confirmed COVID-19 hospitalized from February 25, 2020, to April 29, 2020, 31 (46.2%), aged ≥ 65 years, were evaluated. Clinical, laboratory and radiological findings of these patients at baseline are illustrated in Table 1 Short-term outcomes were classified as follows: discharged, not discharged and death. Clinical findings according to the short-term outcomes are reported in Table 2 . Pneumonia was radiologically confirmed in 30 individuals (96.7%), 27 of whom were defined severe according to the American Thoracic Society guidelines for community-acquired pneumonia (4).
Oxygen supplement was administered in 28 cases (90.3%) including 8 patients (25.8%) who required invasive ventilation and were transferred to the intensive care unit. No patient underwent non-invasive ventilator support. A total of 28 severe clinical events were observed in 16 patients (51.6%), six of whom showed at least two severe events. Six deaths occurred due to acute respiratory distress syndrome, complicated by septic shock in three cases and acute hearth injury in one patient.
Overall, median length of hospitalization was 23 days including 18 patients who are still hospitalized thus suggesting that prolonged hospital stay might have been depended on several factors, including onset of complications, frailty, slower healing, social and behavioural issues (5).
Our results are in agreement with other studies reporting higher rates of severe outcomes in patients with COVID-19 aged 65 or more (6, 7) .
Moreover, the remarkable burden of comorbidities of this peculiar population probably plays a role in increasing the rate of severe outcomes, prolonging the duration of hospital stay and, consequently, raising healthcare costs.
Altogether, these considerations call for further studies aiming to improve clinical management of serious disease complications in the elderly with COVID-19.
We all contributed to editing the tables, and writing and editing the manuscript.
None. 