A simple, home-therapy algorithm to prevent hospitalisation for COVID-19 patients: A retrospective observational matched-cohort study

EClinicalMedicine

Annalisa Perna¹  Umberto Cantarelli²  Chiara Moroni³  Elena Consolaro³  Stefania Pedroni³  Maria Vittoria Paganini³  Elena Pastò³  Fredy Suter⁴  Giuseppe Remuzzi⁴  Tobia Peracchi⁵  Piero Ruggenenti⁵  Nadia Rubis⁵  Norberto Perico⁵  Grazia Pravettoni⁶ 

[1] Corresponding author at: Norberto Perico MD, Istituto di Ricerche Farmacologiche IRCCS, Centro di Ricerche Cliniche per Malattie Rare Aldo e Cele Daccò, Via GB Camozzi 3, 24020 Ranica, Bergamo, Italy.;ASL Teramo, Teramo, Italy;ATS Insubria, Varese, Italy;Azienda Socio-Sanitaria Territoriale (ASST) Papa Giovanni XXIII, Bergamo, Italy;Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Bergamo, Italy;Ospedale Circolo di Busto Arsizio, Varese, Italy;

关键词: COVID-19;    SARS-CoV-2;    Simple home-therapy algorithm;    Matched-cohort observational study;    Family physicians;    Early symptoms at home;   

DOI  :  

来源: DOAJ

【 摘 要 】

Background: Effective home treatment algorithms implemented based on a pathophysiologic and pharmacologic rationale to accelerate recovery and prevent hospitalisation of patients with early coronavirus disease 2019 (COVID-19) would have major implications for patients and health system. Methods: This academic, matched-cohort study compared outcomes of 90 consecutive consenting patients with mild COVID-19 treated at home by their family physicians between October 2020 and January 2021 in Northern and Central Italy, according to the proposed recommendation algorithm, with outcomes for 90 age-, sex-, and comorbidities-matched patients who received other therapeutic regimens. Primary outcome was time to resolution of major symptoms. Secondary outcomes included prevention of hospitalisation. Analyses were by intention-to-treat. Findings: All patients achieved complete remission. The median [IQR] time to resolution of major symptoms was 18 [14–23] days in the ‘recommended schedule' cohort and 14 [7–30] days in the matched ‘control’ cohort (p = 0·033). Other symptoms persisted in a lower percentage of patients in the ‘recommended’ than in the ‘control’ cohort (23·3% versus 73·3%, respectively, p<0·0001) and for a shorter period (p = 0·0107). Two patients in the ‘recommended’ cohort were hospitalised compared to 13 (14·4%) controls (p = 0·0103). The prevention algorithm reduced the days and cumulative costs of hospitalisation by >90%. Interpretation: Implementation of an early home treatment algorithm failed to accelerate recovery from major symptoms of COVID-19, but reduced the risk of hospitalisation and related treatment costs. Given the study design, additional research would be required to consolidate the proposed treatment recommendations. Funding: Fondazione Cav.Lav. Carlo Pesenti

【 授权许可】

Unknown