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Article

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

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Department of Medicine, Division of Hematology, Valduce Hospital, 22100 Como, Italy
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Risk Management, Valduce Hospital, 22100 Como, Italy
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Quality Management System, Valduce Hospital, 22100 Como, Italy
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Department of Medicine, Division of Pneumology, Valduce Hospital, 22100 Como, Italy
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Department of Mother and Child, Division of Paediatric and Neonatology, Infectious Diseases Consultant, Valduce Hospital, 22100 Como, Italy
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Department of Medicine, Division of Neurology, Valduce Hospital, 22100 Como, Italy
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Department of Medicine, Division of Internal Medicine, Valduce Hospital, 22100 Como, Italy
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Department of Medicine, Division of Oncology, Valduce Hospital, 22100 Como, Italy
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Department of Medicine, Division of Gastroenterology, Valduce Hospital, 22100 Como, Italy
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Department of Medicine, Division of Cardiology, Valduce Hospital, 22100 Como, Italy
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Department of Emergency Medicine, Valduce Hospital, 22100 Como, Italy
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Department of Intensive Care Medicine, Valduce Hospital, 22100 Como, Italy
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Hospital Health Management, Valduce Hospital, 22100 Como, Italy
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Author to whom correspondence should be addressed.
Academic Editors: Ralph A. Tripp, Steven B. Bradfute and Scott Anthony
Vaccines 2021, 9(6), 640; https://doi.org/10.3390/vaccines9060640
Received: 1 May 2021 / Revised: 7 June 2021 / Accepted: 8 June 2021 / Published: 11 June 2021
(This article belongs to the Collection COVID-19 Vaccines and Vaccination)
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. View Full-Text
Keywords: SARS-CoV 2; coronavirus disease 2019; pneumonia; therapy; treatment; mortality; risk factors SARS-CoV 2; coronavirus disease 2019; pneumonia; therapy; treatment; mortality; risk factors
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MDPI and ACS Style

Turrini, M.; Gardellini, A.; Beretta, L.; Buzzi, L.; Ferrario, S.; Vasile, S.; Clerici, R.; Colzani, A.; Liparulo, L.; Scognamiglio, G.; Imperiali, G.; Corrado, G.; Strada, A.; Galletti, M.; Castiglione, N.; Zanon, C. Clinical Course and Risk Factors for In-Hospital Mortality of 205 Patients with SARS-CoV-2 Pneumonia in Como, Lombardy Region, Italy. Vaccines 2021, 9, 640. https://doi.org/10.3390/vaccines9060640

AMA Style

Turrini M, Gardellini A, Beretta L, Buzzi L, Ferrario S, Vasile S, Clerici R, Colzani A, Liparulo L, Scognamiglio G, Imperiali G, Corrado G, Strada A, Galletti M, Castiglione N, Zanon C. Clinical Course and Risk Factors for In-Hospital Mortality of 205 Patients with SARS-CoV-2 Pneumonia in Como, Lombardy Region, Italy. Vaccines. 2021; 9(6):640. https://doi.org/10.3390/vaccines9060640

Chicago/Turabian Style

Turrini, Mauro, Angelo Gardellini, Livia Beretta, Lucia Buzzi, Stefano Ferrario, Sabrina Vasile, Raffaella Clerici, Andrea Colzani, Luigi Liparulo, Giovanni Scognamiglio, Gianni Imperiali, Giovanni Corrado, Antonello Strada, Marco Galletti, Nunzio Castiglione, and Claudio Zanon. 2021. "Clinical Course and Risk Factors for In-Hospital Mortality of 205 Patients with SARS-CoV-2 Pneumonia in Como, Lombardy Region, Italy" Vaccines 9, no. 6: 640. https://doi.org/10.3390/vaccines9060640

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