tetano
Editor, Senior Moderator
Int J Environ Res Public Health
. 2020 Dec 25;18(1):E102.
doi: 10.3390/ijerph18010102.
Cardiovascular Comorbidities and Pharmacological Treatments of COVID-19 Patients Not Requiring Hospitalization
Vincenzo Russo[SUP] 1 [/SUP], Gaetano Piccinocchi[SUP] 2 [/SUP], Vincenzo Mandaliti[SUP] 2 [/SUP], Saverio Annunziata[SUP] 3 [/SUP], Giovanni Cimmino[SUP] 1 [/SUP], Emilio Attena[SUP] 4 [/SUP], Nicola Moio[SUP] 5 [/SUP], Pierpaolo Di Micco[SUP] 6 [/SUP], Sergio Severino[SUP] 4 [/SUP], Roberta Trotta[SUP] 7 [/SUP], Michele Del Guercio[SUP] 8 [/SUP]
Affiliations
Abstract
Introduction: The Coronavirus disease 2019 (COVID-19) outbreak is a whole Earth health emergency related to a highly pathogenic human coronavirus responsible for severe acute respiratory syndrome (SARS-CoV-2). Despite the fact that the majority of infected patients were managed in outpatient settings, little is known about the clinical characteristics of COVID-19 patients not requiring hospitalization. The aim of our study was to describe the clinical comorbidity and the pharmacological therapies of COVID-19 patients managed in outpatient settings.
Materials and methods: We performed an observational, retrospective analysis of laboratory-confirmed COVID-19 patients managed in outpatient settings in Naples, Italy between 9 March and 1 May 2020. Data were sourced from the prospectively maintained Health Search (HS)/Thales database, shared by 128 primary care physicians (PCPs) in Naples, Italy. The clinical features and pharmacological therapies of COVID-19 patients not requiring hospitalization and managed in outpatient settings have been described.
Results: A total of 351 laboratory-confirmed COVID-19 patients (mean age 54 ? 17 years; 193 males) with outpatient management were evaluated. Hypertension was the most prevalent comorbidity (35%). The distribution of cardiovascular comorbidities showed no gender-related differences. A total of 201 patients (57.3%) were treated with at least one experimental drug for COVID-19. Azithromycin, alone (42.78%) or in combination (27.44%), was the most widely used experimental anti-COVID drug in outpatient settings. Low Molecular Weight Heparin and Cortisone were prescribed in 24.87% and 19.4% of the study population, respectively. At multivariate regression model, diabetes (risk ratio (RR): 3.74; 95% CI 1.05 to 13.34; p = 0.04) and hypertension (RR: 1.69; 95% CI 1.05 to 2.7; p = 0.03) were significantly associated with the experimental anti-COVID drug administration. Moreover, only diabetes (RR: 2.43; 95% CI 1.01 to 5.8; p = 0.03) was significantly associated with heparin administration.
Conclusions: Our data show a high prevalence of hypertension, more likely treated with renin-angiotensin-aldosterone system (RASS) inhibitors, among COVID-19 patients not requiring hospitalization. Experimental COVID-19 therapies have been prescribed to COVID-19 patients considered at risk for increased venous thromboembolism based on concomitant comorbidities, in particular diabetes and hypertension.
Keywords: COVID-19; anticoagulation; cardiovascular diseases; experimental drugs; hypertension; low molecular weight heparin; outpatient’s setting; risk factors; venous thromboembolism.
. 2020 Dec 25;18(1):E102.
doi: 10.3390/ijerph18010102.
Cardiovascular Comorbidities and Pharmacological Treatments of COVID-19 Patients Not Requiring Hospitalization
Vincenzo Russo[SUP] 1 [/SUP], Gaetano Piccinocchi[SUP] 2 [/SUP], Vincenzo Mandaliti[SUP] 2 [/SUP], Saverio Annunziata[SUP] 3 [/SUP], Giovanni Cimmino[SUP] 1 [/SUP], Emilio Attena[SUP] 4 [/SUP], Nicola Moio[SUP] 5 [/SUP], Pierpaolo Di Micco[SUP] 6 [/SUP], Sergio Severino[SUP] 4 [/SUP], Roberta Trotta[SUP] 7 [/SUP], Michele Del Guercio[SUP] 8 [/SUP]
Affiliations
- PMID: 33375676
- DOI: 10.3390/ijerph18010102
Abstract
Introduction: The Coronavirus disease 2019 (COVID-19) outbreak is a whole Earth health emergency related to a highly pathogenic human coronavirus responsible for severe acute respiratory syndrome (SARS-CoV-2). Despite the fact that the majority of infected patients were managed in outpatient settings, little is known about the clinical characteristics of COVID-19 patients not requiring hospitalization. The aim of our study was to describe the clinical comorbidity and the pharmacological therapies of COVID-19 patients managed in outpatient settings.
Materials and methods: We performed an observational, retrospective analysis of laboratory-confirmed COVID-19 patients managed in outpatient settings in Naples, Italy between 9 March and 1 May 2020. Data were sourced from the prospectively maintained Health Search (HS)/Thales database, shared by 128 primary care physicians (PCPs) in Naples, Italy. The clinical features and pharmacological therapies of COVID-19 patients not requiring hospitalization and managed in outpatient settings have been described.
Results: A total of 351 laboratory-confirmed COVID-19 patients (mean age 54 ? 17 years; 193 males) with outpatient management were evaluated. Hypertension was the most prevalent comorbidity (35%). The distribution of cardiovascular comorbidities showed no gender-related differences. A total of 201 patients (57.3%) were treated with at least one experimental drug for COVID-19. Azithromycin, alone (42.78%) or in combination (27.44%), was the most widely used experimental anti-COVID drug in outpatient settings. Low Molecular Weight Heparin and Cortisone were prescribed in 24.87% and 19.4% of the study population, respectively. At multivariate regression model, diabetes (risk ratio (RR): 3.74; 95% CI 1.05 to 13.34; p = 0.04) and hypertension (RR: 1.69; 95% CI 1.05 to 2.7; p = 0.03) were significantly associated with the experimental anti-COVID drug administration. Moreover, only diabetes (RR: 2.43; 95% CI 1.01 to 5.8; p = 0.03) was significantly associated with heparin administration.
Conclusions: Our data show a high prevalence of hypertension, more likely treated with renin-angiotensin-aldosterone system (RASS) inhibitors, among COVID-19 patients not requiring hospitalization. Experimental COVID-19 therapies have been prescribed to COVID-19 patients considered at risk for increased venous thromboembolism based on concomitant comorbidities, in particular diabetes and hypertension.
Keywords: COVID-19; anticoagulation; cardiovascular diseases; experimental drugs; hypertension; low molecular weight heparin; outpatient’s setting; risk factors; venous thromboembolism.