Severe COVID-19 pneumonia in Piacenza, Italy – a cohort study of the first pandemic wave
Guglielmetti et al.,
Severe COVID-19 pneumonia in Piacenza, Italy – a cohort study of the first pandemic wave,
Journal of Infection and Public Health, doi:10.1016/j.jiph.2020.11.012
Retrospective 218 hospitalized patients in Italy showing non-statistically significant 35% lower mortality with HCQ, hazard ratio aHR 0.65 [0.33–1.30].
risk of death, 35.0% lower, RR 0.65, p = 0.22, treatment 181, control 37, adjusted per study, multivariable Cox.
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Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
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Guglielmetti et al., 9 Dec 2020, retrospective, Italy, peer-reviewed, 16 authors, average treatment delay 8.0 days.
Abstract: Journal of Infection and Public Health 14 (2021) 263–270
Contents lists available at ScienceDirect
Journal of Infection and Public Health
journal homepage: http://www.elsevier.com/locate/jiph
Severe COVID-19 pneumonia in Piacenza, Italy — A cohort study of the
first pandemic wave
Lorenzo Guglielmetti a,b,c,∗ , Irina Kontsevaya d,e,f , Maria C. Leoni c , Patrizia Ferrante c,g ,
Elisa Fronti c , Laura Gerna c , Caterina Valdatta c , Alessandra Donisi h , Alberto Faggi c ,
Franco Paolillo c , Giovanna Ratti c , Alessandro Ruggieri c , Marta Scotti c , Daria Sacchini c ,
Gloria Taliani c,i,j,1 , Mauro Codeluppi c,1 , For the COVID-Piacenza Group2
a
Sorbonne Université, INSERM, U1135, Centre d’Immunologie et des Maladies Infectieuses, Cimi-Paris, équipe 13, Paris, France
APHP, Groupe Hospitalier Universitaire Sorbonne Université, Hôpital Pitié-Salpêtrière, Centre National de Référence des Mycobactéries et de la Résistance
des Mycobactéries aux Antituberculeux, Paris, France
c
Infectious Diseases Unit, Piacenza Hospital, Piacenza, Italy
d
Research Center Borstel, Borstel, Germany
e
German Center for Infection Research, Hamburg-Lübeck-Borstel-Riems, Borstel, Germany
f
International Health/Infectious Diseases, University of Lübeck, Lübeck, Germany
g
Institute for Cross-Disciplinary Physics and Complex Systems IFISC (UIB-CSIC), Campus Universitat Illes Balears, E-07122 Palma de Mallorca, Spain
h
Migration Health Unit, Primary Health Care Department, “Guglielmo da Saliceto” Hospital, Piacenza, Italy
i
Infectious and Tropical Disease Unit, Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
j
Anti-COVID Task Force of the Italian Civil Protection
b
a r t i c l e
i n f o
Article history:
Received 11 August 2020
Received in revised form
13 November 2020
Accepted 18 November 2020
Keywords:
SARS-CoV-2
Coronavirus
Viral pneumonia
Acute respiratory distress syndrome
Mortality
a b s t r a c t
Background: Piacenza is the closest city to the first coronavirus disease 2019 (COVID-19) cluster in Italy
and has the highest national COVID-19 death rates per population. The objective of this study is to present
characteristics and outcomes of patients admitted to medical departments of the Hospital of Piacenza
during the first wave of the epidemic.
Methods: A total of 218 patients with confirmed or suspect COVID-19 and severe pneumonia were
included from February 21st to May 15th, 2020. Routinely-collected clinical and laboratory data were retrospectively retrieved from electronic medical files. A Cox proportional-hazards model was fit to assess
the association of treatment and other variables with death.
Results: Median age of patients was 68 years; 150 patients (69%) had comorbidities, mainly hypertension
(107, 49%). Overall, 185 (85%) patients had acute respiratory distress syndrome (ARDS) on admission,
including 103 (47%) with moderate or severe ARDS. Chest computed tomography scan showed bilateral
disease in 201 (98%) and extensive lung involvement in 79 (50%) patients. Most patients received antiviral
treatment (187, 86%) and corticosteroids (134, 61%). All patients received respiratory support and 64 (29%)
were admitted to intensive care unit. As of June 30th, 100 patients (46%) died, 109 patients (50%) were
discharged, and 9 patients (4%) were still hospitalized. In multivariable Cox analysis, age above 65 years,
having more than one comorbidity, severe ARDS, low platelet counts, and high LDH levels at..
Late treatment
is less effective
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