Risk Factors for Mortality in COVID-19 Hospitalized Patients in Piedmont, Italy: Results from the Multicenter, Regional, CORACLE Registry

doi:10.3390/jcm10091951

. 2021 May 1;10(9):1951.

doi: 10.3390/jcm10091951.

Risk Factors for Mortality in COVID-19 Hospitalized Patients in Piedmont, Italy: Results from the Multicenter, Regional, CORACLE Registry

Francesco Giuseppe De Rosa^{1

2}, Annagloria Palazzo¹, Tiziana Rosso³, Nour Shbaklo¹, Marco Mussa⁴, Lucio Boglione⁵, Enrica Borgogno⁶, Antonella Rossati⁷, Simone Mornese Pinna¹, Silvia Scabini¹, Guido Chichino⁴, Silvio Borrè⁸, Valerio Del Bono⁶, Pietro Luigi Garavelli⁷, Diego Barillà⁹, Francesco Cattel⁹, Giovanni Di Perri¹, Giovannino Ciccone³, Tommaso Lupia², Silvia Corcione^{1

10}

Affiliations

¹ Department of Medical Sciences, University of Turin, 10126 Turin, Italy.
² Infectious Diseases Unit, Cardinal Massaia Hospital, 14100 Asti, Italy.
³ Unit of Clinical Epidemiology, CPO, AOU "Città della Salute e della Scienza", 10126 Turin, Italy.
⁴ Infectious Diseases Unit, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, 15121 Alessandria, Italy.
⁵ Department of Translational Medicine, University of Eastern Piedmont, 13100 Novara, Italy.
⁶ Infectious Diseases Unit, Azienda Ospedaliera S. Croce e Carle, 12100 Cuneo, Italy.
⁷ Infectious Diseases Department, University Hospital "Maggiore della Carità", 28100 Novara, Italy.
⁸ Unit of Infectious Diseases, Saint Andrea Hospital, 13100 Vercelli, Italy.
⁹ Hospital Pharmacy, Città della Salute e della Scienza, 10126 Turin, Italy.
¹⁰ Department of Infectious Diseases, Tufts University School of Medicine, Boston, MA 02109, USA.

PMID: 34062864
PMCID: PMC8124506
DOI: 10.3390/jcm10091951

Risk Factors for Mortality in COVID-19 Hospitalized Patients in Piedmont, Italy: Results from the Multicenter, Regional, CORACLE Registry

Francesco Giuseppe De Rosa et al. J Clin Med. 2021.

. 2021 May 1;10(9):1951.

doi: 10.3390/jcm10091951.

Authors

Affiliations

¹ Department of Medical Sciences, University of Turin, 10126 Turin, Italy.
² Infectious Diseases Unit, Cardinal Massaia Hospital, 14100 Asti, Italy.
³ Unit of Clinical Epidemiology, CPO, AOU "Città della Salute e della Scienza", 10126 Turin, Italy.
⁴ Infectious Diseases Unit, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, 15121 Alessandria, Italy.
⁵ Department of Translational Medicine, University of Eastern Piedmont, 13100 Novara, Italy.
⁶ Infectious Diseases Unit, Azienda Ospedaliera S. Croce e Carle, 12100 Cuneo, Italy.
⁷ Infectious Diseases Department, University Hospital "Maggiore della Carità", 28100 Novara, Italy.
⁸ Unit of Infectious Diseases, Saint Andrea Hospital, 13100 Vercelli, Italy.
⁹ Hospital Pharmacy, Città della Salute e della Scienza, 10126 Turin, Italy.
¹⁰ Department of Infectious Diseases, Tufts University School of Medicine, Boston, MA 02109, USA.

PMID: 34062864
PMCID: PMC8124506
DOI: 10.3390/jcm10091951

Abstract

Background: CORACLE is a retrospective and prospective, regional multicenter registry, developed to evaluate risk factors for mortality in a cohort of patients admitted with SARS-CoV-2 infection within non-intensive wards.

Methods: The primary objective was to estimate the role of several prognostic factors on hospital mortality in terms of adjusted Odds Ratios (aOR) with multivariable logistic regression models.

Results: A total of 1538 patients were enrolled; 42% were female, and 58% were >70 years old. Deceased patients were 422 (27%), with a median age of 83 years (IQR (Inter Quartile Range) 76-87). Older age at admission (aOR 1.07 per year, 95%CI 1.06-1.09), diabetes (1.41, 1.02-1.94), cardiovascular disease (1.79, 1.31-2.44), immunosuppression (1.65, 1.04-2.62), estimated glomerular filtration rate (eGFR) <30 mL/min/1.73 m² (3.53, 2.26-5.51), higher C-reactive protein values and a decreased PaO₂/FiO₂ ratio at admission were associated with a higher risk of hospital mortality. Amongst patients still alive on day 7, only hydroxychloroquine (HCQ) treatment was associated with reduced mortality (0.57, 0.36-0.90).

Conclusions: Several risk factors were associated with mortality in SARS-CoV-2 positive patients. Although HCQ seems to be the only factor significantly associated with reduced mortality, this result is in contrast with evidence from randomized studies. These results should be interpreted in light of the study limitations.

Keywords: COVID-19; SARS-CoV-2; hydroxichloroquine; mortality; pneumonia.

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Conflict of interest statement

The authors have not conflict of interest regarding the CORACLE registry.

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[3] Li Q., Guan X., Wu P., Wang X., Zhou L., Tong Y., Ren R., Leung K.S.M., Lau E.H.Y., Wong J.Y., et al. Early Transmission Dynamics in Wuhan, China, of Novel Coronavirus—Infected Pneumonia. N. Engl. J. Med. 2020;382:1199–1207. doi: 10.1056/NEJMoa2001316. - DOI - PMC - PubMed

[4] Li Q., Guan X., Wu P., Wang X., Zhou L., Tong Y., Ren R., Leung K.S.M., Lau E.H.Y., Wong J.Y., et al. Early Transmission Dynamics in Wuhan, China, of Novel Coronavirus—Infected Pneumonia. N. Engl. J. Med. 2020;382:1199–1207. doi: 10.1056/NEJMoa2001316. - DOI - PMC - PubMed

[5] Petrosillo N., Viceconte G., Ergonul O., Ippolito G., Petersen E. COVID-19, SARS and MERS: Are they Closely Related? Clin. Microbiol. Infect. 2020;26:729–734. doi: 10.1016/j.cmi.2020.03.026. - DOI - PMC - PubMed

[6] Petrosillo N., Viceconte G., Ergonul O., Ippolito G., Petersen E. COVID-19, SARS and MERS: Are they Closely Related? Clin. Microbiol. Infect. 2020;26:729–734. doi: 10.1016/j.cmi.2020.03.026. - DOI - PMC - PubMed

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[8] Lupia T., Corcione S., De Rosa F.G. COVID-19: In the Uncertainty, do Not Try this at Home. Intern. Emerg. Med. 2020;15:1599–1600. doi: 10.1007/s11739-020-02471-4. - DOI - PMC - PubMed

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[10] Yan Y., Shin W.I., Pang Y.X., Meng Y., Lai J., You C., Zhao H., Lester E., Wu T., Pang C.H. The First 75 Days of Novel Coronavirus (SARS-CoV-2) Outbreak: Recent Advances, Prevention, and Treatment. Int. J. Environ. Res. Public Health. 2020;17:2323. doi: 10.3390/ijerph17072323. - DOI - PMC - PubMed

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Risk Factors for Mortality in COVID-19 Hospitalized Patients in Piedmont, Italy: Results from the Multicenter, Regional, CORACLE Registry

Affiliations

Risk Factors for Mortality in COVID-19 Hospitalized Patients in Piedmont, Italy: Results from the Multicenter, Regional, CORACLE Registry

Authors

Affiliations

Abstract

Conflict of interest statement

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