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.
【저자키워드】 Treatment, Coronavirus disease 2019, therapy, Risk factors, Mortality, Pneumonia, SARS-CoV 2, 【초록키워드】 COVID-19, antiviral therapy, COVID19, anticoagulation, Hydroxychloroquine, Antiviral, Tocilizumab, antiviral drugs, Comorbidities, interleukin-6, LDH, C-reactive protein, CRP, Intervention, drug, risk factor, lactate dehydrogenase, inhibitors, Steroids, Laboratory, Characteristics, outbreak, clinical, management, Patient, Effectiveness, pathway, age, SARS-CoV-2 pneumonia, prognostic, disease, in-hospital mortality, Anticoagulant, supportive care, Analysis, treatment strategy, lombardy, In-hospital death, Older, significant effect, Multivariable regression, multivariate logistic regression, single-center, P/F ratio, treat, tocilizumab therapy, laboratory-confirmed, reduction in mortality, Course, Result, greater, tested, analyzed, elevated, less, clinical risk factor, infected with SARS-CoV-2, patients treated, 【제목키워드】 SARS-CoV-2, Italy, Region, clinical, lombardy, Factor,