Impact of the main pharmacological option for COVID-19 disease progression in hospitalized patients in northern Italy: a single-center retrospective study

BACKGROUND: Severe acute respiratory disease syndrome coronavirus 2 has caused a global pandemic. Monoclonal antibodies, antiviral therapy (remdesivir) and immunomodulatory agents represent one of the most promising therapies to prevent disease progression and reduce the relative risk of severe COVID-19. The aim of this study was to evaluate the impact on the disease progression of the main pharmacological options approved for the patients admitted in hospital with acute COVID-19 infection, according to their vaccination status.METHODS: We conducted a study including adult patients with confirmed COVID-19 admitted to the Unit of Infectious Diseases of Alessandria’s Hospital in Italy, from October 2021 to March 2022.RESULTS:102 patients were included in the analysis. The mean age was 69.2±15.4 years, 66.7% were males. According to the internal hospital’s guidelines, 47.1% patients with mild to moderate disease were treated with mAbs, 45.1% were treated with remdesivir, of which 10.8% received combination therapy with mAbs. The most frequently complications were pneumonia (18.6%), respiratory failure (15.7%) and acute respiratory distress syndrome (13.7%). The mean length of hospitalization was 13.42 (±10.90) days, and the mortality rate was 11.8%.CONCLUSIONS: The treatment with mAbs and immunomodulatory therapy for mild to moderate COVID-19 infection seem to be effective to improve the outcome reducing disease progression and mortality. C-reactive protein (CRP) and ferritin could be considered a good inflammatory marker of disease progression.