A retrospective analysis on pharmacological approaches to COVID-19 patients in an Italian hub hospital during the early phase of the pandemic

COVID-19 is a complex, multi-organ systemic disease caused by the SARS-CoV-2 coronavirus whose pathophysiological basis and pharmacological approaches are still to be defined. Our study aims to retrospectively evaluate the role played by clinical and demographic variables as well as the specific therapies administered in COVID-19 patients admitted to a referral Hospital in Northern Italy (Santa Croce e Carle Hospital, Cuneo) during the COVID-19 first epidemic wave. We analyzed data from 277 patients with virological diagnosis of COVID-19 who were admitted to the hospital from February 20 th to April 30 th 2020. The inpatients' pharmacological treatments and clinical outcomes were assessed up to May 31 st 2020. Correlations between pharmacological treatments as well as clinical and demographic variables and clinical outcomes have been performed. Several drugs were used in different dosages and combinations. In the first weeks of the epidemic, the most widely used drugs were hydroxychloroquine and the antivirals lopinavir/ritonavir and darunavir/cobicistat, then replaced by corticosteroids and heparin derivatives. Supplementation with vitamin C, D, or polyvitamins exerted a slight, but not significant, increase in survival rate, mainly in patients over 65 years old. Results showed that age and comorbidities significantly affected the survival as shown by the Charlson Comorbidity Index which was significantly higher in patients who died than in those who survived, thus confirming that victims of the disease were mostly debilitated and elderly people. The most influencing COVID-19 survival factors here recorded were age and comorbidities. No statistically significant differences were detected among the different pharmacological treatments used in our clinical setting during the first epidemic wave. Impact statement No significant differences have been recorded in terms of efficacy among the several pharmacological approaches used during the first epidemic way in an Italian hub hospital.