Vincenzo Russo1, Gaetano Piccinocchi2, Vincenzo Mandaliti2, Saverio Annunziata3, Giovanni Cimmino1, Emilio Attena4, Nicola Moio5, Pierpaolo Di Micco6, Sergio Severino4, Roberta Trotta7, Michele Del Guercio8. 1. Cardiology Unit, Department of Translational Medical Sciences, University of Campania Luigi Vanvitelli-Monaldi Hospital, 80131 Naples, Italy. 2. Comegen Primary Care Physicians Cooperative SIMG, Italian Society of Family Medicine, 80125 Naples, Italy. 3. KOS Primary Care Physicians Cooperative, 80128 Naples, Italy. 4. Cardiology Unit, Cotugno Hospital, 80131 Naples, Italy. 5. Cardiology Department, Santa Maria delle Grazie Hospital, 80078 Pozzuoli, Italy. 6. Medicine Unit, Fatebenefratelli Hospital, 80131 Naples, Italy. 7. Medical Affairs Department-Daiichi Sankyo, 00142 Roma, Italy. 8. Angiology Unit, District 24, Health Authority Naples 1, 80131 Naples, Italy.
Abstract
INTRODUCTION: The Coronavirus disease 2019 (COVID-19) outbreak is a whole Earth health emergency related to a highly pathogenic human coronavirus responsible for severe acute respiratory syndrome (SARS-CoV-2). Despite the fact that the majority of infected patients were managed in outpatient settings, little is known about the clinical characteristics of COVID-19 patients not requiring hospitalization. The aim of our study was to describe the clinical comorbidity and the pharmacological therapies of COVID-19 patients managed in outpatient settings. MATERIALS AND METHODS: We performed an observational, retrospective analysis of laboratory-confirmed COVID-19 patients managed in outpatient settings in Naples, Italy between 9 March and 1 May 2020. Data were sourced from the prospectively maintained Health Search (HS)/Thales database, shared by 128 primary care physicians (PCPs) in Naples, Italy. The clinical features and pharmacological therapies of COVID-19 patients not requiring hospitalization and managed in outpatient settings have been described. RESULTS: A total of 351 laboratory-confirmed COVID-19 patients (mean age 54 ± 17 years; 193 males) with outpatient management were evaluated. Hypertension was the most prevalent comorbidity (35%). The distribution of cardiovascular comorbidities showed no gender-related differences. A total of 201 patients (57.3%) were treated with at least one experimental drug for COVID-19. Azithromycin, alone (42.78%) or in combination (27.44%), was the most widely used experimental anti-COVID drug in outpatient settings. Low Molecular Weight Heparin and Cortisone were prescribed in 24.87% and 19.4% of the study population, respectively. At multivariate regression model, diabetes (risk ratio (RR): 3.74; 95% CI 1.05 to 13.34; p = 0.04) and hypertension (RR: 1.69; 95% CI 1.05 to 2.7; p = 0.03) were significantly associated with the experimental anti-COVID drug administration. Moreover, only diabetes (RR: 2.43; 95% CI 1.01 to 5.8; p = 0.03) was significantly associated with heparin administration. CONCLUSIONS: Our data show a high prevalence of hypertension, more likely treated with renin-angiotensin-aldosterone system (RASS) inhibitors, among COVID-19 patients not requiring hospitalization. Experimental COVID-19 therapies have been prescribed to COVID-19 patients considered at risk for increased venous thromboembolism based on concomitant comorbidities, in particular diabetes and hypertension.
INTRODUCTION: The Coronavirus disease 2019 (COVID-19) outbreak is a whole Earth health emergency related to a highly pathogenic human coronavirus responsible for severe acute respiratory syndrome (SARS-CoV-2). Despite the fact that the majority of infectedpatients were managed in outpatient settings, little is known about the clinical characteristics of COVID-19patients not requiring hospitalization. The aim of our study was to describe the clinical comorbidity and the pharmacological therapies of COVID-19patients managed in outpatient settings. MATERIALS AND METHODS: We performed an observational, retrospective analysis of laboratory-confirmed COVID-19patients managed in outpatient settings in Naples, Italy between 9 March and 1 May 2020. Data were sourced from the prospectively maintained Health Search (HS)/Thales database, shared by 128 primary care physicians (PCPs) in Naples, Italy. The clinical features and pharmacological therapies of COVID-19patients not requiring hospitalization and managed in outpatient settings have been described. RESULTS: A total of 351 laboratory-confirmed COVID-19patients (mean age 54 ± 17 years; 193 males) with outpatient management were evaluated. Hypertension was the most prevalent comorbidity (35%). The distribution of cardiovascular comorbidities showed no gender-related differences. A total of 201 patients (57.3%) were treated with at least one experimental drug for COVID-19. Azithromycin, alone (42.78%) or in combination (27.44%), was the most widely used experimental anti-COVID drug in outpatient settings. Low Molecular Weight Heparin and Cortisone were prescribed in 24.87% and 19.4% of the study population, respectively. At multivariate regression model, diabetes (risk ratio (RR): 3.74; 95% CI 1.05 to 13.34; p = 0.04) and hypertension (RR: 1.69; 95% CI 1.05 to 2.7; p = 0.03) were significantly associated with the experimental anti-COVID drug administration. Moreover, only diabetes (RR: 2.43; 95% CI 1.01 to 5.8; p = 0.03) was significantly associated with heparin administration. CONCLUSIONS: Our data show a high prevalence of hypertension, more likely treated with renin-angiotensin-aldosterone system (RASS) inhibitors, among COVID-19patients not requiring hospitalization. Experimental COVID-19 therapies have been prescribed to COVID-19patients considered at risk for increased venous thromboembolism based on concomitant comorbidities, in particular diabetes and hypertension.
Authors: Ivan Gentile; Martina Iorio; Emanuela Zappulo; Riccardo Scotto; Alberto Enrico Maraolo; Antonio Riccardo Buonomo; Biagio Pinchera; Giuseppina Muto; Carmela Iervolino; Riccardo Villari; Nicola Schiano Moriello; Maria Michela Scirocco; Maria Triassi; Mariano Paternoster; Vincenzo Russo; Giulio Viceconte Journal: Int J Environ Res Public Health Date: 2022-08-18 Impact factor: 4.614