Aims of the study: To investigate the effect of clinical predictors on
admission and the set of therapeutic interventions on length of stay,
ICU admission, need for MV and mortality. Methods used to conduct the
study: Retrospective cohort of inpatients with RT-PCR positive for
COVID-19 from March to July 2020. Multivariate models were used to
assess risk for ICU admission, need for MV and hospital mortality.
Logistic regression analysis was conducted to examine factors associated
with the results. Results of the study: 459 patients were enrolled
(median age 60.0 years old). For patients treated with
AZM-Corticosteroid (46.8%) the risk for ICU admission was 0.17 (OR;
95%CI 0.05-0.57), for MV 0.16 (OR; 95%CI 0.04-0.74) and for mortality
0.16 (OR; 95%CI 0.03-0.91). AZM-Corticosteroid also decreased the
length of stay in 1.5 day. AZM-Corticosteroid and anticoagulation when
indicated (17.2%), also reduced the ICU stay in 1.5 and MV in 4 days.
When included HCQ, the benefits were lost and the times increased. Age
>65 years, presence of up one comorbidity, pulmonary
involvement more than or equal to 50%, saturation <93%,
lymphocytes <900 mm3, D-dimers >1,250 ng/mL and
CRP >8.0 mg/dL at admission were clinical predictors for
death. HFNC was able to prevent intubation by 38.1%. Conclusion drawn
from the study and clinical implications: AZM-Corticosteroids and
anticoagulation represented a favorable combination for inpatients with
COVID-19, reducing length of hospitalization, risk of MV and mortality.
HCQ did not yield benefits to combination therapy and we do not support
its use for inpatients. HFNC was able to prevent intubation in one third
of patients. Already on admission some clinical predictors may help to
estimate a higher risk of poor evolution.