COVID 19 Risk factors and therapies in Italy: results from the CORIST collaboration

Licia Iacoviello1,2 and Augusto Di Castelnuovo3 on behalf of CORIST collaboration.

1Department of Epidemiology and Prevention, IRCCS Neuromed, Pozzilli (IS). Italy

2Department of Medicine and Surgery, University of Insubria, Varese. Italy

3Mediterranea Cardiocentro, Napoli. Italy

As of July 10, 2020, there have been over 12 million of confirmed cases of COVID-19, with 549,247 deaths worldwide. Robust knowledge of correlates and possible predictors of death among patients diagnosed with COVID-19 is crucial to target patients at highest risk through early and more intensive interventions. Since the COVID-19 pandemic outbreak, several studies have evaluated different factors that may predispose individuals to a higher risk of death from COVID-19 and several therapies have been suggested to reduce mortality burden of this disease, but evidence on this is still limited, especially from European countries.

Since the beginning of the pandemic, Italy was one of the most heavily hit countries, with 34,026 deaths recorded as of July 10, 2020, the largest part occurring in Northern regions. Data from small studies conducted in Lombardy during the first wave (February-March 2020) of the Italian pandemic, showed high in-hospital mortality and higher rate of complications in cardiac patients, while older age, obesity and more advanced illness were major risk factors for 30-day mortality.

the CORIST Collaboration is an observational multicentre study including over 4,000 patients with laboratory-confirmed SARS-CoV-2 infection, hospitalized in 33 Italian clinical centres, 41.5% of whom resident in Central/Southern Italian regions.

The CORIST cohort allowed to identify baseline factors associated with a higher risk of in-hospital death in COVID-19 patients and their efficacy as prognostic factors. Moreover, the data analyzed here allowed to assess whether there was a geographic gradient in Italy in the association between predictors and in-hospital death risk and to evaluate whether there was a time-dependent pandemic wave-related difference in the type and/or strength of the associations of risk factors with in-hospital death.

Several therapies for COVID-19 have been assessed in the frame of CORIST collaboration to evaluate their efficacy on in-hospital mortality. The main results we obtained concern the use of hydroxychloroquine, heparin and anti-retroviral treatment with

While HCQ and heparin use were associated with a significant lower risk of death in COVID-19 hospitalized patients, treatment with lopinavir/ritonavir was associated with a null effect, while treatment with darunavir/cobicistat increased the risk of death.