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Incidence and predictors of clinical failure after early treatment for mild-to-moderate COVID-19 in high-risk

Ilaria Mastrorosa1, Alessandro Cozzi Lepri2, Cosmo Del Borgo3

  • 1Clinical and Research Infectious Diseases Department, National Institute for Infectious Diseases Lazzaro Spallanzani IRCCS, Rome, Italy.

Journal of Internal Medicine
|November 13, 2024
PubMed

Insights

Early COVID-19 treatment reduced hospitalization and death risk for high-risk patients. However, the elderly, unvaccinated, and immunocompromised individuals still face significant risks.

Area of Science:

  • Infectious Diseases
  • Public Health
  • Epidemiology

Background:

  • High-risk populations require effective early interventions for COVID-19.
  • Understanding risk factors for COVID-19-related hospitalization and death (CovH/D) is crucial for targeted strategies.
  • Early treatments like monoclonal antibodies and antivirals aim to mitigate severe outcomes.

Purpose of the Study:

  • To estimate the risk of COVID-19-related hospitalization and death (CovH/D) in high-risk individuals receiving early treatment.
  • To identify demographic and clinical factors associated with increased CovH/D risk.
  • To assess the impact of different COVID-19 variants and treatment periods on outcomes.

Main Methods:

  • A multicenter cohort study included 12,475 high-risk outpatients treated for mild-to-moderate COVID-19.
  • Data were collected from March 2021 to May 2023 in the Lazio region, Italy.
  • Logistic regression models were used to analyze risk factors for CovH/D, adjusting for confounders.

Main Results:

  • The unadjusted 30-day risk of CovH/D was 3.08%.
  • Increased risk was observed in elderly, unvaccinated, and immunocompromised participants.
  • A decreased risk of CovH/D was noted during Omicron waves compared to the Delta period.

Conclusions:

  • Despite early COVID-19 treatments, elderly, unvaccinated, and immunocompromised individuals remain at high risk for clinical progression.
  • Continued vigilance and tailored interventions are necessary for these vulnerable groups.
  • The evolving landscape of COVID-19 variants influences hospitalization and death risks.
Abstract

Keywords:
COVID‐19 early treatmentCOVID‐19‐related deathCOVID‐19‐related hospitalizationimmunocompromised statusolder age

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