Clinical Course and Risk Factors for In-Hospital Mortality of 205 Patients with SARS-CoV-2 Pneumonia in Como, Lombardy Region, Italy
This article has been Reviewed by the following groups
Listed in
- Evaluated articles (ScreenIT)
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.
Article activity feed
-
-
SciScore for 10.1101/2021.02.25.20134866: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Institutional Review Board Statement not detected. Randomization not detected. Blinding not detected. Power Analysis not detected. Sex as a biological variable not detected. Table 2: Resources
No key resources detected.
Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).
Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:Our study has several limitations due to the retrospective nature of the study. Overall, we found that age at the onset of SARS-CoV-2 disease is a powerful predictor of in-hospital mortality. In addition, intermediate or …
SciScore for 10.1101/2021.02.25.20134866: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Institutional Review Board Statement not detected. Randomization not detected. Blinding not detected. Power Analysis not detected. Sex as a biological variable not detected. Table 2: Resources
No key resources detected.
Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).
Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:Our study has several limitations due to the retrospective nature of the study. Overall, we found that age at the onset of SARS-CoV-2 disease is a powerful predictor of in-hospital mortality. In addition, intermediate or therapeutic-dose anticoagulation, early short-term antiviral therapy and short course of corticosteroids at the end of the viral replication phase proved to be effective treatments in COVID-19 disease. Interestingly, hydroxychloroquine therapy has not been confirmed as significant in the treatment of SARS-CoV-2 infection, in accordance with latest literature data. Finally, impairment in inflammation markers can find application as predictors of poor outcomes for hospitalized patients when incorporated into an easy-to-use prognostic score, helping clinicians to identify patients with poor prognosis at an early stage. Confirmation from a validation cohort is expected. Results from this real-life single-center experience are in agreement and confirm actual literature data on SARS-CoV-2 pneumonia, both in terms of risk factors for in-hospital mortality and as regards the effectiveness of the different therapies proposed for the management of COVID-19 disease. Results from randomized clinical trials are expected.
Results from TrialIdentifier: We found the following clinical trial numbers in your paper:
Identifier Status Title NCT04315948 Active, not recruiting Trial of Treatments for COVID-19 in Hospitalized Adults NCT04317092 Active, not recruiting Tocilizumab in COVID-19 Pneumonia (TOCIVID-19) NCT04346355 Terminated Efficacy of Early Administration of Tocilizumab in COVID-19 … Results from Barzooka: We did not find any issues relating to the usage of bar graphs.
Results from JetFighter: We did not find any issues relating to colormaps.
Results from rtransparent:- Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
- Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
- No protocol registration statement was detected.
-
