tetano
Editor, Senior Moderator
Vaccines (Basel)
. 2021 Jun 11;9(6):640.
doi: 10.3390/vaccines9060640.
Clinical Course and Risk Factors for In-Hospital Mortality of 205 Patients with SARS-CoV-2 Pneumonia in Como, Lombardy Region, Italy
Mauro Turrini[SUP] 1 [/SUP], Angelo Gardellini[SUP] 1 [/SUP], Livia Beretta[SUP] 2 [/SUP], Lucia Buzzi[SUP] 3 [/SUP], Stefano Ferrario[SUP] 4 [/SUP], Sabrina Vasile[SUP] 5 [/SUP], Raffaella Clerici[SUP] 6 [/SUP], Andrea Colzani[SUP] 4 [/SUP], Luigi Liparulo[SUP] 7 [/SUP], Giovanni Scognamiglio[SUP] 8 [/SUP], Gianni Imperiali[SUP] 9 [/SUP], Giovanni Corrado[SUP] 10 [/SUP], Antonello Strada[SUP] 11 [/SUP], Marco Galletti[SUP] 12 [/SUP], Nunzio Castiglione[SUP] 13 [/SUP], Claudio Zanon[SUP] 13 [/SUP]
Affiliations
Abstract
The aim of this study is to explore risk factors for in-hospital mortality and describe the effectiveness of different treatment strategies of 205 laboratory-confirmed cases infected with SARS-CoV-2 during the Lombardy outbreak. All patients received the best supportive care and specific interventions that included the main drugs being tested for repurposing to treat COVID-19, such as hydroxychloroquine, anticoagulation and antiviral drugs, steroids, and interleukin-6 pathway inhibitors. Clinical, laboratory, and treatment characteristics were analyzed with univariate and multivariate logistic regression methods to explore their impact on in-hospital mortality. Univariate analyses showed prognostic significance for age greater than 70 years, the presence of two or more relevant comorbidities, a P/F ratio less than 200 at presentation, elevated LDH (lactate dehydrogenase) and CRP (C-reactive protein) values, intermediate- or therapeutic-dose anticoagulation, hydroxychloroquine, early antiviral therapy with lopinavir/ritonavir, short courses of steroids, and tocilizumab therapy. Multivariable regression confirmed increasing odds of in-hospital death associated with age older than 70 years (OR 3.26) and a reduction in mortality for patients treated with anticoagulant (-0.37), antiviral lopinavir/ritonavir (-1.22), or steroid (-0.59) therapy. In contrast, hydroxychloroquine and tocilizumab have not been confirmed to have a significant effect in the treatment of SARS-CoV-2 pneumonia. Results from this real-life single-center experience are in agreement and confirm actual literature data on SARS-CoV-2 pneumonia in terms of both clinical risk factors for in-hospital mortality and the effectiveness of the different therapies proposed for the management of COVID19 disease.
Keywords: SARS-CoV 2; coronavirus disease 2019; mortality; pneumonia; risk factors; therapy; treatment.
. 2021 Jun 11;9(6):640.
doi: 10.3390/vaccines9060640.
Clinical Course and Risk Factors for In-Hospital Mortality of 205 Patients with SARS-CoV-2 Pneumonia in Como, Lombardy Region, Italy
Mauro Turrini[SUP] 1 [/SUP], Angelo Gardellini[SUP] 1 [/SUP], Livia Beretta[SUP] 2 [/SUP], Lucia Buzzi[SUP] 3 [/SUP], Stefano Ferrario[SUP] 4 [/SUP], Sabrina Vasile[SUP] 5 [/SUP], Raffaella Clerici[SUP] 6 [/SUP], Andrea Colzani[SUP] 4 [/SUP], Luigi Liparulo[SUP] 7 [/SUP], Giovanni Scognamiglio[SUP] 8 [/SUP], Gianni Imperiali[SUP] 9 [/SUP], Giovanni Corrado[SUP] 10 [/SUP], Antonello Strada[SUP] 11 [/SUP], Marco Galletti[SUP] 12 [/SUP], Nunzio Castiglione[SUP] 13 [/SUP], Claudio Zanon[SUP] 13 [/SUP]
Affiliations
- PMID: 34208017
- DOI: 10.3390/vaccines9060640
Abstract
The aim of this study is to explore risk factors for in-hospital mortality and describe the effectiveness of different treatment strategies of 205 laboratory-confirmed cases infected with SARS-CoV-2 during the Lombardy outbreak. All patients received the best supportive care and specific interventions that included the main drugs being tested for repurposing to treat COVID-19, such as hydroxychloroquine, anticoagulation and antiviral drugs, steroids, and interleukin-6 pathway inhibitors. Clinical, laboratory, and treatment characteristics were analyzed with univariate and multivariate logistic regression methods to explore their impact on in-hospital mortality. Univariate analyses showed prognostic significance for age greater than 70 years, the presence of two or more relevant comorbidities, a P/F ratio less than 200 at presentation, elevated LDH (lactate dehydrogenase) and CRP (C-reactive protein) values, intermediate- or therapeutic-dose anticoagulation, hydroxychloroquine, early antiviral therapy with lopinavir/ritonavir, short courses of steroids, and tocilizumab therapy. Multivariable regression confirmed increasing odds of in-hospital death associated with age older than 70 years (OR 3.26) and a reduction in mortality for patients treated with anticoagulant (-0.37), antiviral lopinavir/ritonavir (-1.22), or steroid (-0.59) therapy. In contrast, hydroxychloroquine and tocilizumab have not been confirmed to have a significant effect in the treatment of SARS-CoV-2 pneumonia. Results from this real-life single-center experience are in agreement and confirm actual literature data on SARS-CoV-2 pneumonia in terms of both clinical risk factors for in-hospital mortality and the effectiveness of the different therapies proposed for the management of COVID19 disease.
Keywords: SARS-CoV 2; coronavirus disease 2019; mortality; pneumonia; risk factors; therapy; treatment.