Early Outpatient Treatment of COVID-19: A Retrospective Analysis of 392 Cases in Italy
Marco Cosentino, Veronica Vernocchi, Stefano Martini, Franca Marino, Barbara Allasino, Maria Antonietta Bàlzola, Fabio Burigana, Alberto Dallari, Carlo Servo Florio Pagano, Antonio Palma, Mauro Rango
Journal of Clinical Medicine, doi:10.3390/jcm11206138
COVID-19 was declared a pandemic in March 2020. The knowledge of COVID-19 pathophysiology soon provided a strong rationale for the early use of both anti-inflammatory and antithrombotic drugs; however, its evidence was slowly and partially incorporated into institutional guidelines. The unmet needs of COVID-19 outpatients were taken care of by networks of physicians and researchers. We analyse the characteristics, management and outcomes in COVID-19 outpatients who were taken care of by physicians within the IppocrateOrg Association. In this observational retrospective study, volunteering doctors provided data on 392 COVID-19 patients. The mean age of patients was 48.5 years (range: 0.5-97), and patients were taken care of in COVID-19 stage 0 (15.6%), stage 1 (50.0%), stage 2a (28.8%) and stage 2b (5.6%). Many patients were overweight (26%) or obese (11.5%), with chronic comorbidities (34.9%), mainly cardiovascular (23%) and metabolic (13.3%). The most frequently prescribed drugs included: vitamins and supplements (98.7%), aspirin (66.1%), antibiotics (62%), glucocorticoids (41.8%), hydroxychloroquine (29.6%), enoxaparin (28.6%), colchicine (8.9%), oxygen therapy (6.9%), and ivermectin (2.8%). Hospitalization occurred in 5.8% of cases, mainly in stage 2b (27.3%). A total of 390 patients (99.6%) recovered; one patient was lost at follow up, and one patient died after hospitalization. This is the first real-world study describing the behaviours of physicians caring for COVID-19 outpatients, and the outcomes of COVID-19 early treatment. The lethality in this cohort was 0.2%, while overall, and over the same period, the COVID-19 lethality in Italy was over 3%. The drug use described in this study appears effective and safe. The present evidence should be carefully considered by physicians and political decision makers.
Supplementary Materials: The following supporting information can be downloaded at: https: //www.mdpi.com/article/10.3390/jcm11206138/s1, Table S1 : Vitamins and supplements recommended in COVID-19 phase 0 (asymptomatic with positive swab) . Table S2 . Drugs recommended in COVID-19 phase 1 (symptomatic without signs of lung disease) [62] [63] [64] [65] [66] [67] [68] [69] [70] [71] [72] [73] [74] [75] . Table S3 . Drugs recommended in COVID-19 phase 2a (symptomatic with lung disease) [76] [77] [78] [79] . Supplementary Table S4 . Drugs recommended in COVID-19 phase 2b (symptomatic with lung disease and desaturation) [76, 77, 80] . Supplementary Material: Questionnaire for Physicians, Supplementary Data: Raw Data. Author Contributions: Concept and design: M.C., V.V. and M.R. Data acquisition: B.A., M.A.B., F.B., A.D., C.S.F.P. and A.P. Data analysis and interpretation: V.V., M.C., S.M. and F.M. Manuscript drafting: M.C. Critical manuscript revision for important intellectual content: all authors. Statistical analysis: M.C. and S.M. Administrative, technical or material support: V.V. Collected data was provided by participating physicians to the IppocrateOrg Association and was routinely collected during their professional activity. Each physician is responsible for the integrity of data s/he provided. M.C., V.V., S.M. and F.M. had full access to anonymized data in the study and take responsibility for the integrity of data records and accuracy of data analysis. All..
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"abstract": "<jats:p>COVID-19 was declared a pandemic in March 2020. The knowledge of COVID-19 pathophysiology soon provided a strong rationale for the early use of both anti-inflammatory and antithrombotic drugs; however, its evidence was slowly and partially incorporated into institutional guidelines. The unmet needs of COVID-19 outpatients were taken care of by networks of physicians and researchers. We analyse the characteristics, management and outcomes in COVID-19 outpatients who were taken care of by physicians within the IppocrateOrg Association. In this observational retrospective study, volunteering doctors provided data on 392 COVID-19 patients. The mean age of patients was 48.5 years (range: 0.5–97), and patients were taken care of in COVID-19 stage 0 (15.6%), stage 1 (50.0%), stage 2a (28.8%) and stage 2b (5.6%). Many patients were overweight (26%) or obese (11.5%), with chronic comorbidities (34.9%), mainly cardiovascular (23%) and metabolic (13.3%). The most frequently prescribed drugs included: vitamins and supplements (98.7%), aspirin (66.1%), antibiotics (62%), glucocorticoids (41.8%), hydroxychloroquine (29.6%), enoxaparin (28.6%), colchicine (8.9%), oxygen therapy (6.9%), and ivermectin (2.8%). Hospitalization occurred in 5.8% of cases, mainly in stage 2b (27.3%). A total of 390 patients (99.6%) recovered; one patient was lost at follow up, and one patient died after hospitalization. This is the first real-world study describing the behaviours of physicians caring for COVID-19 outpatients, and the outcomes of COVID-19 early treatment. The lethality in this cohort was 0.2%, while overall, and over the same period, the COVID-19 lethality in Italy was over 3%. The drug use described in this study appears effective and safe. The present evidence should be carefully considered by physicians and political decision makers.</jats:p>",
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