ABSTRACT
Background and Aims: The outbreak by SARS-CoV-2 has soon stolen the spotlight worldwide: specific strategies able to adequately limit the inflammatory response to the virus are still needed even if many drugs were thought to be somehow effective. Statins, in particular, were chosen for their anti-inflammatory properties. The aim of our work was to evaluate the role of statin therapy in a cohort of patients hospitalized for COVID-19, trying to understand whether such drugs were able to improve the patients’ outcomes. Methods: We retrospectively evaluated 501 adult inpatients admitted to the two COVID-hospitals of Ferrara’s territory, dividing them into two groups: ST=patients (on statin therapy on admission) and NST=patients (not on statin therapy). We searched for differences between groups in terms of anamnestic, clinical and laboratory data and then of disease outcomes. Results: We found significant differences between groups in terms of age, comorbidities, procalcitonin and CPK serum levels: ST patients were older, more comorbid, with lower procalcitonin and higher CPK serum levels. Male gender was the only independent predictor of needing intensification of care, while age and the Charlson Comorbidity Index (CCI) were good predictors of in-hospital and 30-day mortality. Differences were also found in the survival functions between the groups. Conclusions: After a period of observation of 100 days, ST patients, despite their older age and their greater load of comorbidities, have similar survival functions to NST patients. Adjusted for age and CCI, the survival functions of the ST group are considerably more favorable than those of the second group.
ABSTRACT
OBJECTIVE: Diffuse thrombosis represents one of the most predominant causes of death by COVID-19 and SARS-CoV-2 infection seems to increase the risk of developing venous thromboembolic diseases (VTE). Aim of this study is to analyze the relationship between validated predictive scores for VTE such as IMPROVE and IMPROVEDD and: (1) Intensification of Care (IoC, admission to Pulmonology Department or Intensive Care Unit) (2) in-hospital mortality rate 3) 30-days mortality rate. PATIENTS AND METHODS: We retrospectively evaluated 51 adult patients with laboratory diagnosis of SARS-CoV-2 infection and calculated IMPROVE and IMPROVEDD scores. All patients underwent venous color-Doppler ultrasound of the lower limbs to assess the presence of superficial vein thrombosis (SVT) and/or deep vein thrombosis (DVT). Patients with normal values of D-dimer did not receive heparin therapy (LMWH); patients with ≥ 4 ULN values of D-dimer or with a diagnosis of DVT were treated with therapeutic LMWH dosage, while the remaining patients were treated with prophylactic LMWH dosages. RESULTS: We found strong relations between IMPROVE score and the need for IoC and with the in-hospital mortality rate and between the IMPROVEDD score and the need for IoC. We defined that an IMPROVE score greater than 4 points was significantly associated to in-hospital mortality rate (p = 0.05), while an IMPROVEDD score greater than 3 points was associated with the need for IoC (p = 0.04). Multivariate logistic analysis showed how IMPROVE score was significantly associated to in-hospital and 30-days mortality rates. CONCLUSIONS: IMPROVE score can be considered an independent predictor of in-hospital and 30-days mortality.