ABSTRACT
Introduction and Aim of the study: Hydroxychloroquine has beenauthorized in the therapy of patients with COVID-19. Many publications have not clarified the real efficacy of the drug. Really, thedrug was widely used during the pandemic. A single-center observational cohort study was conducted to evaluate the effectiveness of hydroxychloroquine therapy in a group of subjects admittedin the sub-intensive therapy of the COVID Unit Hospital F. Miulli(Acquaviva delle Fonti, Bari, Italy) from 17 march to 17 may 2020.Materials and Methods: The data contained in the medicalrecords were studied. The sample was divided into two groups withrespect to therapy with or without hydroxychloroquine'. Clinicaland laboratory data were analyzed.Results: A total of 174 patients hospitalized (60.4% males),mean age 68 yrs, with diagnosis of SARS-CoV2, were analyzed.118 patients were treated with hydroxychloroquine. The treatment group consisted of 66.1% males, mean age 63 years. Thetwo groups were homogeneous in comorbidity and in the severityof clinical presentation of SARS-CoV2 infection. The death ratewas significantly higher in the group of untreated than in thosereceiving hydroxychloroquine, 40% vs 2.6% respectively. Therewere no significant differences on QTc prolongation between thetwo groups (467+47 ms control group, 446 + 35 ms, treatmentgroup).Discussion and Conclusions: The data of our study, although referring to a reduced sample, show the effectiveness of hydroxychloroquine in reducing mortality in subjects suffering fromSARS-CoV2 infection.
ABSTRACT
Background and Aim of the study: In the course of the epidemic,COVID 19 disease first appeared severely and then with a gradualreduction in symptoms. Aim of the study was to compare the clinical characteristics of patients hospitalized in two different periodsfrom March to May.Materials and Methods: 174 patients, 161 subjects admitted inthe period March 17 / April 17 and 13 subjects admitted in theperiod April 17 / May 17, at the Covid Unit of F. Miulli Hospital inAcquaviva delle Fonti (Ba), were studied.Results: From the comparison of the two periods, there is a clearreduction in hospitalizations (161 vs 13). The number of asymptomatic or mildly complicated patients is significantly greater inthe second group. The rate of patients hospitalized with severepneumonia (19.9%) or ARDS (6.8%) in the first period is higherthan the patients of the second period (7.7% and 0%). In March/ April, 3.1% of patients needed ICU admission while no patientwas admitted to ICU in the past thirty days. The length of stay wasalso significantly higher in the first period (21 ± 8 days vs 8 ± 2days) as well as mortality (14% vs 11%). IL 6, d-dimers and fibrinogen values were lower (but not statistically significant) in theApril / May period.Discussion and Conclusions: Our sample, although of limitedsize, shows a significant difference in the clinical evolution of theCOVID 19 infection in the two study periods. The reduction inlength of stay, severe respiratory failure and mortality indicate alikely attenuation in coronavirus virulence in the last month of thepandemic spread.
ABSTRACT
Background and Aim of the study: A novel coronavirus (SARSCoV2) in 2019 has been recognized as the responsible of an interstitial pneumonia characterized by a severe acute respiratorysyndrome initially reported in China with a subsequent pandemicoutbreak. Aim of this observational retrospective cohort study wasto describe the CT findings of this new disease in a cohort of patients treated in our COVID Unit.Materials and Methods: TC scan of 49 patients with naso-pharyngeal swab confirmed SARS CoV2 pneumonia admitted toCOVID Unit of F. Miulli General Hospital from 19th March 2020 to03rd May 2020 were retrospectively analyzed.Results: The cohort included 49 patients (42 males, 86%;7 female, 14%);mean age 63,2 years (SD 14,8). Radiological findings distribution was bilateral in the whole cohort;peripheralinvolvement was constant (n=46 [93%]), in some cases exclusively subpleural (n=10;20%), with pleuric sparing in few cases(n=7, 14%). 2 patients had central distribution of alterations (4%).The great part of the cohort showed mixed (central/periferic) distribution (n=29 [60%]). Radiological phenotypes were: predominant ground-glass (GG) (n=20 [41%]), consolidative (C) (n=3,6%) and mixed pattern (n=23, 47%).Conclusions: SARS-CoV2 is characterized by a wide range of CTfeatures with a frequently mixed presence of ground glass and consolidative with a periferic and central - usually bilateral - distribution. Combining assessment of imaging with clinical and laboratory findings could facilitate early diagnosis of COVID-19.
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Background and Aim of the study: Partial or complete ageusiaand anosmia have been observed as initial and sometimes uniquesymptoms of COVID-19 infection, especially in paucisymptomaticpatients. A single-center observational cohort study was conductedto evaluate taste and smell in a group of subjects admitted in thesub-intensive therapy of the COVID UNIT Hospital F. Miulli (Acquaviva delle Fonti, Bari, Italy) from 8 april to 11 may 2020.Materials e Methods: A questionnaire was administered to agroup of patients, with normal cognitive system. The laboratoryand clinical data contained in the medical records were studied.Results: 53 patients, 35 male and 18 female aged between 23and 82 replied to the questionnaire. 19 patients reported no loss,3 reported only loss of smell and 31 loss of taste;of these, 23also reported an associated loss of smell (9 partial loss and 14total loss). Patients with olfactory deficits complained of nasalcongestion and the need to breathe through the mouth in 23% ofcases and rhinorrhea in 15%. The loss of taste was rarely associated with a decrease in appetite (3%) and in 65% this deficit wastotal. The division of patients into 4 phenotype groups (based onthe severity of the clinical presentation) did not reveal significantdifferences between the groups.Conclusions: The data of our study, although referring to a reducedsample, show that olfactory and gustatory deficits are associatedwith SARS-CoV2 infection in a high percentage of patients. The phenotype did not show a role in the development of these symptoms.
ABSTRACT
Background and Aim of the study: From March 2020 to May2020 we treated 133 SARS-CoV-2 patients in our COVID Unit at'F. Miulli' Hospital, 15 of these were also affected by severe acuterespiratory syndrome that needed CPAP support. The aim of thestudy was to evaluate the clinical features of patients with severerespiratory failure treated with CPAP compared to those with milderone that didn't require it.Materials and Methods: A retrospective observational study on133 patients was performed. Patients have been divided into twogroups: those who needed CPAP (15) and those who didn't (118)to compare comorbidities and the supportive medical therapy.Results: 80% of the patients treated with CPAP were males (age71 ± 12). Only 13% were smokers;the most frequent comorbidities were heart failure (20%) and renal failure (40%);pre-existentrespiratory diseases, high blood pressure and diabetes mellitusdidn't show a significant impact on the respiratory outcome. Comparing the 2 groups we found a significant difference about theprobability to be transferred in Intensive Care Unit, higher in CPAPtreated patients (p 0,034). We also found differences between thetwo groups about the medical therapy support, in particular theuse of diuretics, resulted significantly higher (p 0,002) in CPAPtreated patients.Conclusions: A severe respiratory failure related to COVID 19 ap pears to be more frequently associated with kidney and heart disease rather than pre-existing worst respiratory situation and so requires in association with C-PAP support also a more substantialmedical therapy.