De Rosa Francesco Giuseppe, Palazzo Annagloria, Rosso Tiziana, Shbaklo Nour, Mussa Marco, Boglione Lucio, Borgogno Enrica, Rossati Antonella, Mornese Pinna Simone, Scabini Silvia, Chichino Guido, Borrè Silvio, Del Bono Valerio, Garavelli Pietro Luigi, Barillà Diego, Cattel Francesco, Di Perri Giovanni, Ciccone Giovannino, Lupia Tommaso, Corcione Silvia
Department of Medical Sciences, University of Turin, 10126 Turin, Italy.
Infectious Diseases Unit, Cardinal Massaia Hospital, 14100 Asti, Italy.
J Clin Med. 2021 May 1;10(9):1951. doi: 10.3390/jcm10091951.
CORACLE is a retrospective and prospective, regional multicenter registry, developed to evaluate risk factors for mortality in a cohort of patients admitted with SARS-CoV-2 infection within non-intensive wards.
The primary objective was to estimate the role of several prognostic factors on hospital mortality in terms of adjusted Odds Ratios (aOR) with multivariable logistic regression models.
A total of 1538 patients were enrolled; 42% were female, and 58% were >70 years old. Deceased patients were 422 (27%), with a median age of 83 years (IQR (Inter Quartile Range) 76-87). Older age at admission (aOR 1.07 per year, 95%CI 1.06-1.09), diabetes (1.41, 1.02-1.94), cardiovascular disease (1.79, 1.31-2.44), immunosuppression (1.65, 1.04-2.62), estimated glomerular filtration rate (eGFR) <30 mL/min/1.73 m (3.53, 2.26-5.51), higher C-reactive protein values and a decreased PaO/FiO ratio at admission were associated with a higher risk of hospital mortality. Amongst patients still alive on day 7, only hydroxychloroquine (HCQ) treatment was associated with reduced mortality (0.57, 0.36-0.90).
Several risk factors were associated with mortality in SARS-CoV-2 positive patients. Although HCQ seems to be the only factor significantly associated with reduced mortality, this result is in contrast with evidence from randomized studies. These results should be interpreted in light of the study limitations.
CORACLE是一项回顾性和前瞻性的区域性多中心注册研究，旨在评估非重症病房收治的感染严重急性呼吸综合征冠状病毒2（SARS-CoV-2）患者队列中的死亡风险因素。
主要目的是通过多变量逻辑回归模型，以调整后的优势比（aOR）来估计几种预后因素对医院死亡率的作用。
共纳入1538例患者；42%为女性，58%年龄大于70岁。死亡患者422例（27%），中位年龄为83岁（四分位间距（IQR）76 - 87）。入院时年龄较大（每年aOR 1.07，95%置信区间1.06 - 1.09）、糖尿病（1.41，1.02 - 1.94）、心血管疾病（1.79，1.31 - 2.44）、免疫抑制（1.65，1.04 - 2.62）、估计肾小球滤过率（eGFR）<30 mL/min/1.73 m²（3.53，2.26 - 5.51）、入院时较高的C反应蛋白值以及降低的动脉血氧分压/吸入氧分数值与较高的医院死亡风险相关。在第7天仍存活的患者中，只有羟氯喹（HCQ）治疗与死亡率降低相关（0.57，0.36 - 0.90）。
几种风险因素与SARS-CoV-2阳性患者的死亡率相关。尽管羟氯喹似乎是唯一与死亡率降低显著相关的因素，但这一结果与随机研究的证据相悖。应根据研究局限性来解释这些结果。
