https://orcid.org/0000-0001-6289-9144
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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.
Acknowledgements
The authors want to thank all members of GECOVID study group.
Authors’ contributions
Conceptualization: S.D., G.B., F.P., C.D.; Data collection: S.D., G.B., F.P, S.M., B.B.,; Statistical analysis: M.P., C.M., A.S.; Writing-original draft: S.D., G.B., F.P., C.D., L.M., C.S., M.P., C.M.; Writing—review and editing: L.M., M.M., F.M., E.D, E.B., A.V., D.R.G., L.B., M.M., A.D.B., B.B., A.S., M.G., M.B. All authors have read and agreed to the published version of the manuscript.
Disclosure statement
Outside the submitted work: C.D. has received speaker honoraria from Angelini, Novartis, Gilead, ViiV and Shinogi. D. R. G. reports re- search grants and/or personal fees for advisor/consultant and/or speaker/chairman from Gilead, Shionogi, Pfizer, and Tillotts Pharma. A.D.B. reports a hospital grant from Gilead and consultancy for ViiV, Janssen, MSD, Gilead and Abbvie. M. B. serves on the scientific advisory boards for Angelini, AstraZeneca, Bayer, Cubist, Pfizer, Menarini, MSD, Nabriva, Paratek, Roche, Shionogi, Tetraphase, The Medicine Company and Astellas Pharma Inc, and has received funding for travel or speaker honoraria from Algorithm, Angelini, Astellas Pharma Inc., AstraZeneca, Cubist, Pfizer, MSD, Gilead Sciences, Menarini, Novartis, Ranbaxy and Teva. The other authors have no conflicts of interest to disclose.