Clinical Course and Risk Factors for In-Hospital Mortality of 205 Patients with SARS-CoV-2 Pneumonia in Como, Lombardy Region, Italy

Vaccines

卷:9

Antonello Strada¹  Marco Galletti²  Giovanni Corrado³  Gianni Imperiali⁴  Angelo Gardellini⁵  Mauro Turrini⁵  Luigi Liparulo⁶  Raffaella Clerici⁷  Giovanni Scognamiglio⁸  Andrea Colzani⁹  Stefano Ferrario⁹  Sabrina Vasile¹⁰  Claudio Zanon¹¹  Nunzio Castiglione¹¹  Lucia Buzzi¹²  Livia Beretta¹³ 

[1] Department of Emergency Medicine, Valduce Hospital, 22100 Como, Italy;

[2] Department of Intensive Care Medicine, Valduce Hospital, 22100 Como, Italy;

[3] Department of Medicine, Division of Cardiology, Valduce Hospital, 22100 Como, Italy;

[4] Department of Medicine, Division of Gastroenterology, Valduce Hospital, 22100 Como, Italy;

[5] Department of Medicine, Division of Hematology, Valduce Hospital, 22100 Como, Italy;

[6] Department of Medicine, Division of Internal Medicine, Valduce Hospital, 22100 Como, Italy;

[7] Department of Medicine, Division of Neurology, Valduce Hospital, 22100 Como, Italy;

[8] Department of Medicine, Division of Oncology, Valduce Hospital, 22100 Como, Italy;

[9] Department of Medicine, Division of Pneumology, Valduce Hospital, 22100 Como, Italy;

[10] Department of Mother and Child, Division of Paediatric and Neonatology, Infectious Diseases Consultant, Valduce Hospital, 22100 Como, Italy;

[11] Hospital Health Management, Valduce Hospital, 22100 Como, Italy;

[12] Quality Management System, Valduce Hospital, 22100 Como, Italy;

[13] Risk Management, Valduce Hospital, 22100 Como, Italy;

关键词: SARS-CoV 2;    coronavirus disease 2019;    pneumonia;    therapy;    treatment;    mortality;   

DOI  :  10.3390/vaccines9060640

来源: DOAJ

【 摘 要 】

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.

【 授权许可】

Unknown