Mortality predictors in hospitalised COVID-19 patients and the role of anti-SARS-CoV-2 IgG antibodies and remdesivir.

Q2 Medicine Infezioni in Medicina Pub Date : 2023-01-01 DOI:10.53854/liim-3102-10
Sergio Venturini, Daniele Orso, Francesco Cugini, Danilo Villalta, Maurizio Tonizzo, Alessandro Grembiale, Ada Zanier, Serena Cecco, Astrid Callegari, Silvia Duranti, Giovanni Del Fabro, Massimo Crapis
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Abstract

Background: In a pre-vaccination era serologic tests may be used to evaluate the seroprevalence and efficacy of containment strategies applied to the community. Subsequently, SARS-CoV-2 vaccination has successfully reduced hospitalization and admission to intensive care. The role of antiviral treatment for COVID-19 remains debated.

Objective: We investigated the effect of SARS-CoV-2 IgG Spike (S) antibody responses in hospitalized patients on 30-day mortality. Finally, we assessed whether other predictive factors affected mortality after 30 days.

Methods: Observational study on COVID-19 patients admitted from October 1, 2021, to January 30, 2022.

Results: 520 patients were studied; 108 died at the 30-day follow-up (21%). A borderline significance for mortality was observed in favour of the high antibody titer group (24% vs 17%, p=0.05). From the univariate Cox regression analysis, a high IgG-S titer was significantly correlated to lower 30-day mortality (p=0.04, HR: 0.7; 95%CI: 0.44-0.98). The administration of remdesivir (p=0.01) and the age <65 years (p=2.3e-05) were found to be protective for the considered outcome (respectively, HR: 0.5, 95%CI: 0.34-0.86, and HR: 0.1, 95%CI: 0.04-0.30).

Conclusions: S-antibodies and remdesivir could play a protecting role in increasing the survival of hospitalized COVID-19 patients who are not suffering from a critical disease. Advanced age is a risk factor for poor outcomes among infected people.

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COVID-19住院患者的死亡率预测因素及抗sars - cov -2 IgG抗体和瑞德西韦的作用
背景:在疫苗接种前,血清学检测可用于评估社区控制策略的血清流行率和效果。随后,SARS-CoV-2疫苗接种成功地减少了住院率和重症监护率。抗病毒治疗在COVID-19中的作用仍存在争议。目的:探讨SARS-CoV-2 IgG Spike (S)抗体应答对住院患者30天死亡率的影响。最后,我们评估了其他预测因素是否会影响30天后的死亡率。方法:对2021年10月1日至2022年1月30日住院的COVID-19患者进行观察研究。结果:共纳入520例患者;随访30天死亡108例(21%)。观察到高抗体滴度组的死亡率具有临界意义(24% vs 17%, p=0.05)。单因素Cox回归分析显示,高IgG-S滴度与较低的30天死亡率显著相关(p=0.04, HR: 0.7;95%置信区间:0.44—-0.98)。结论:s抗体和瑞德西韦对提高非危重症住院COVID-19患者的生存具有保护作用。高龄是受感染者预后不良的一个风险因素。
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来源期刊
Infezioni in Medicina
Infezioni in Medicina Medicine-Infectious Diseases
CiteScore
8.40
自引率
0.00%
发文量
62
期刊介绍: The Journal publishes original papers, in Italian or in English, on topics concerning aetiopathogenesis, prevention, epidemiology, diagnosis, clinical features and therapy of infections, whose acceptance is subject to the referee’s assessment. The Journal is of interest not only to infectious disease specialists, microbiologists and pharmacologists, but also to internal medicine specialists, paediatricians, pneumologists, and to surgeons as well. The Editorial Board includes experts in each of the above mentioned fields.
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