Objective To provide Covid-19 fatality rate, correlations with comorbidities and sensitivity of nasopharingeal swab. Design Prospective cohort study performed between February 21th and March 19rd, 2020 Setting Hospital-based study Participants Of 2,217 admitted, 766 consecutive individuals either reporting or presenting with fever, cough or dyspnea, and suspected to carry Covid-19 infection were examined. Intervention All individuals underwent body temperature and pulse oximetry recording,

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... ological screening, chest X-ray and/or computed tomography (CT) and SARS-COV-2 assay on nasopharyngeal swab. Onset symptoms, course, comorbidities, number of drugs, use of angiotensin converting enzyme inhibitors and angiotensin-II-receptor antagonists, and follow-up swab, clinical, hematological, and radiological exams, treatments, non-invasive respiratory support, ICU admission, and deaths were recorded. Main outcome measures Primary outcomes were non-invasive respiratory support, intensive care unit (ICU) admission, and death. Results Median age of 411 Covid-19 patients was 70.5 years (range 1-99; 66.6% males). CT was positive in 74% and negative in 3.2%. Six patients died within 72 hours; another 66 during hospitalization. Fatality rate was 17.5% (74% males). No death occurred below 60 years. Mortality was 6.6% in 60-69 decade, 21.1% in 70-79, 38.8% in 80-89, and 83.3% above 90 years. Non-invasive respiratory support rate was 27.2%; ICU admission 6.8%. Older age, cough and dyspnea at onset, hypertension, cardiovascular diseases, diabetes, renal insufficiency, >7 drugs intake and positive X-ray at admission were significantly associated with death. Low lymphocyte count, high C-reactive protein, aspartate aminotransferase and lactate dehydrogenase, and low PO2 partial pressure with high lactate at arterial blood gas analysis at admission were also significantly associated with death. Of 32 swab negative patients, 40.6% turned positive at follow-up. Using CT as reference, nasopharyngeal swab had 80% sensitivity. Comorbidity network analysis revealed homogenous distribution of deceased and 60-80 aged patients across diseases. Conclusions Covid-19 caused high mortality among patients older than 70 years and correlated by pre-existing multiorgan impairment irrespective of the age.