COVID-19 throughout pandemic waves and virus variants: a real-life experience in an Italian hospital.
Silvia DettoriGiorgia BrucciFederica PortunatoMarta PonzanoLaura MagnascoMichele MirabellaFederica MagnèEmanuele DelfinoElisa BallettoChiara SepulcriAntonio VenaDaniele Roberto GiacobbeCristina MarelliLorenzo BallMalgorzata MikulskaAntonio Di BiagioBianca BruzzoneAlessio SignoriSara MoraMauro GiacominiChiara DentoneMatteo BassettiPublished in: Journal of chemotherapy (Florence, Italy) (2024)
New therapies and vaccines changed the management of COVID-19. The aim of this retrospective study was to describe characteristics, in-hospital mortality and its predictors in patients with moderate/severe COVID-19, considering the 4 different pandemic waves and viral variants' prevalence from February 2020 to January 2022. Among 1135 patients included, 873 (77%) had at least one comorbidity, 177 (16%) were immunocompromised. From waves 1 to 4, patients with severe respiratory failure and ICU admission decreased over time ( p < 0.001), like the length of in-hospital stay ( p < 0.001). Despite a reduction of in-hospital mortality from 19% to 11%, increased risk of death was related to older age and immunocompromising conditions, especially during the 4th wave (HR = 5.07 and HR = 10.86, p < 0.001 respectively) while remdesivir treatment in the 3rd wave (HR = 0.41, p = 0.010) and positive serology (aHR = 0.66, p = 0.027) were protective for survival. These data support the need for tailoring vaccine campaign for future COVID-19 waves.
Keyphrases
- sars cov
- coronavirus disease
- respiratory failure
- respiratory syndrome coronavirus
- healthcare
- emergency department
- mechanical ventilation
- extracorporeal membrane oxygenation
- early onset
- big data
- machine learning
- risk factors
- current status
- middle aged
- drug induced
- gene expression
- acute respiratory distress syndrome
- community dwelling
- smoking cessation