COVID-19 throughout pandemic waves and virus variants: a real-life experience in an Italian hospital.

IF 1.9 4区医学 Q3 INFECTIOUS DISEASES Journal of Chemotherapy Pub Date : 2024-08-19 DOI:10.1080/1120009X.2024.2384321

Silvia Dettori, Giorgia Brucci, Federica Portunato, Marta Ponzano, Laura Magnasco, Michele Mirabella, Federica Magnè, Emanuele Delfino, Elisa Balletto, Chiara Sepulcri, Antonio Vena, Daniele Roberto Giacobbe, Cristina Marelli, Lorenzo Ball, Malgorzata Mikulska, Antonio Di Biagio, Bianca Bruzzone, Alessio Signori, Sara Mora, Mauro Giacomini, Chiara Dentone, Matteo Bassetti

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Abstract

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.

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COVID-19 在整个大流行病浪潮和病毒变种中的应用：意大利一家医院的实际经验。

新疗法和疫苗改变了 COVID-19 的治疗方法。这项回顾性研究旨在描述中度/重度 COVID-19 患者的特征、院内死亡率及其预测因素，同时考虑到 2020 年 2 月至 2022 年 1 月期间 4 次不同的大流行浪潮和病毒变种的流行情况。在纳入的1135名患者中，873人（77%）至少患有一种并发症，177人（16%）免疫力低下。从第 1 波到第 4 波，严重呼吸衰竭和入住 ICU 的患者随时间推移而减少（p p p = 0.010），血清学阳性（aHR = 0.66，p = 0.027）对生存具有保护作用。这些数据支持了为未来的 COVID-19 疫苗接种活动量身定制疫苗的必要性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Chemotherapy 医学-药学

CiteScore

3.70

自引率

0.00%

发文量

144

审稿时长

6-12 weeks

期刊介绍： The Journal of Chemotherapy is an international multidisciplinary journal committed to the rapid publication of high quality, peer-reviewed, original research on all aspects of antimicrobial and antitumor chemotherapy. The Journal publishes original experimental and clinical research articles, state-of-the-art reviews, brief communications and letters on all aspects of chemotherapy, providing coverage of the pathogenesis, diagnosis, treatment, and control of infection, as well as the use of anticancer and immunomodulating drugs. Specific areas of focus include, but are not limited to: · Antibacterial, antiviral, antifungal, antiparasitic, and antiprotozoal agents; · Anticancer classical and targeted chemotherapeutic agents, biological agents, hormonal drugs, immunomodulatory drugs, cell therapy and gene therapy; · Pharmacokinetic and pharmacodynamic properties of antimicrobial and anticancer agents; · The efficacy, safety and toxicology profiles of antimicrobial and anticancer drugs; · Drug interactions in single or combined applications; · Drug resistance to antimicrobial and anticancer drugs; · Research and development of novel antimicrobial and anticancer drugs, including preclinical, translational and clinical research; · Biomarkers of sensitivity and/or resistance for antimicrobial and anticancer drugs; · Pharmacogenetics and pharmacogenomics; · Precision medicine in infectious disease therapy and in cancer therapy; · Pharmacoeconomics of antimicrobial and anticancer therapies and the implications to patients, health services, and the pharmaceutical industry.