Lessons learned and implications of early therapies for coronavirus disease in a territorial service centre in the Calabria region: a retrospective study

Medientyp: E-Artikel
Titel: Lessons learned and implications of early therapies for coronavirus disease in a territorial service centre in the Calabria region: a retrospective study
Beteiligte: Scaglione, Vincenzo; Rotundo, Salvatore; Marascio, Nadia; De Marco, Carmela; Lionello, Rosaria; Veneziano, Claudia; Berardelli, Lavinia; Quirino, Angela; Olivadese, Vincenzo; Serapide, Francesca; Tassone, Bruno; Morrone, Helen Linda; Davoli, Chiara; La Gamba, Valentina; Bruni, Andrea; Cesana, Bruno Mario; Matera, Giovanni; Russo, Alessandro; Costanzo, Francesco Saverio; Viglietto, Giuseppe; Trecarichi, Enrico Maria; Torti, Carlo; Trecarichi, Enrico Maria; Russo, Alessandro; [...]
Erschienen: Springer Science and Business Media LLC, 2022
Erschienen in: BMC Infectious Diseases
Sprache: Englisch
DOI: 10.1186/s12879-022-07774-9
ISSN: 1471-2334
Schlagwörter: Infectious Diseases
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Beschreibung: <jats:title>Abstract</jats:title><jats:sec> <jats:title>Background</jats:title> <jats:p>Monoclonal antibodies (mAbs) and antivirals have been approved for early therapy of coronavirus disease (COVID-19), however, in the real-life setting, there are difficulties to prescribe these therapies within few days from symptom onset as recommended, and effectiveness of combined use of these drugs have been hypothesised in most-at-risk patients (such as those immunocompromised) but data supporting this strategy are limited.</jats:p> </jats:sec><jats:sec> <jats:title>Methods</jats:title> <jats:p>We describe the real-life experience of SARS-CoV-2 antivirals and/or monoclonal antibodies (mAbs) and focus on the hospitalisation rate due to the progression of COVID-19. Clinical results obtained through our risk-stratification algorithm and benefits achieved through a strategic proximity territorial centre are provided. We also report a case series with an in-depth evaluation of SARS-CoV-2 genome in relationship with treatment strategy and clinical evolution of patients.</jats:p> </jats:sec><jats:sec> <jats:title>Results</jats:title> <jats:p>Two hundred eighty-eight patients were analysed; 94/288 (32.6%) patients were treated with mAb monotherapy, 171/288 (59.4%) patients were treated with antivirals, and 23/288 (8%) patients received both mAbs and one antiviral drug. Haematological malignancies were more frequent in patients treated with combination therapy than in the other groups (p = 0.0003). There was a substantial increase in the number of treated patients since the opening of the centre dedicated to early therapies for COVID-19. The provided disease-management and treatment appeared to be effective since 98.6% patients recovered without hospital admission. Moreover, combination therapy with mAbs and antivirals seemed successful because all patients admitted to the hospital for COVID-19 did not receive such therapies, while none of the most-at-risk patients treated with combination therapy were hospitalized or reported adverse events.</jats:p> </jats:sec><jats:sec> <jats:title>Conclusions</jats:title> <jats:p>A low rate of COVID-19 progression requiring hospital admission was observed in patients included in this study. The dedicated COVID-19 proximity territorial service appeared to strengthen the regional sanitary system, avoiding the overwhelming of other services. Importantly, our results also support early combination therapy: it is possible that this strategy reduces the emergence of escape mutants of SARS-CoV-2, thereby increasing efficacy of early treatment, especially in immunocompromised individuals.</jats:p> </jats:sec>
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