Patients with comorbidities and obesity are more likely to be hospitalized with coronavirus disease 2019 (COVID-19), to have a higher incidence of severe pneumonia and to also show higher mortality rates. Between 15 March 2020 and 31 December 2021, a retrospective, single-center, observational study was conducted among patients requiring hospitalization for COVID-19 infection. Our aim was to investigate the impact of comorbidities and lifestyle risk factors on mortality, the need for intensive care unit (ICU) admission and the severity of the disease among these patients. Our results demonstrated that comorbidities and obesity increased the risk for all investigated endpoints. Age over 65 years and male sex were identified as independent risk factors, and cardiovascular diseases, cancer, endocrine and metabolic diseases, chronic kidney disease and obesity were identified as significant risk factors. Obesity was found to be the most significant risk factor, associated with considerable odds of COVID-19 mortality and the need for ICU admission in the under-65 age group (aOR: 2.95; p < 0.001 and aOR: 3.49, p < 0.001). In our study, risk factors that increased mortality and morbidity among hospitalized patients were identified. Detailed information on such factors may support therapeutic decision making, the proper targeting of vaccination campaigns and the effective overall management of the COVID-19 epidemic, hence reducing the burden on the healthcare system.

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Absztrakt: Az elmúlt hónapokban pandémiához vezető, Kínából induló, új koronavírus okozta megbetegedés (COVID–19) rámutatott az emberiség kiszolgáltatottságára. Aktuálisan a COVID–19 kezelésére randomizált kontrollált vizsgálattal igazolt hatékonyságú, törzskönyvezett gyógyszer nem áll rendelkezésre. A súlyos akut légúti tünetegyüttest okozó koronavírus-2 (SARS-CoV-2) a jelen munka írásáig – a legóvatosabb becslések szerint is – közel 4 millió fertőzésért és megközelítőleg 300 000 halálesetért felelős. A patomechanizmus mélyebb megismerése fedte fel, hogy a fatális esetek hátterében az immunválasz diszregulációja, a citokinvihar-szindróma (CRS) áll. Eddigi ismereteink alapján a COVID–19-ben kialakuló citokinvihar sarkalatos szereplője az interleukin-6 (IL6). Esetleírások és kis betegcsoportokon végzett vizsgálatok eredményei alapján az IL6 monoklonális antitest gátló terápia (tocilizumab) eredményesnek mutatkozik a citokinvihar kezelésében. A szerzők egy eset leírása kapcsán foglalják össze a legfrissebb ismereteket a COVID–19 terápiájával kapcsolatosan. A jelen esetismertetés súlyos COVID–19-ben szenvedő betegben kialakult CRS sikeres terápiáját mutatja be, melynek során – a szerzők tudomása szerint – hazánkban elsőként került sor tocilizumab alkalmazására infektológiai osztályon. Orv Hetil. 2020; 161(26): 1070–1077.

BackgroundPreliminary data suggests that favipiravir might have a role in COVID-19 treatment. Our aim was to assess the role of favipiravir in the treatment of COVID-19.MethodsA single-center, prospective, observational, sequential cohort study was performed among consecutive adults hospitalized with PCR-confirmed COVID-19 between March– July,2020. Patients were screened for inclusion by a priori criteria, and were included in the favipiravir cohort if SOC+FVP, or the non-favipiravir group if SOC±other antiviral medications without FVP were administered for >48 hours. Treatment allocation was done per national guidelines. For COVID-19 diagnosis and severity, ECDC and WHO definitions were utilized, and daily per protocol hospital follow-up was done. Primary composite end-point was disease progression (14-day all-cause death, need for mechanical ventilation, or immunomodulatory therapy). For statistical comparison, Fisher’s exact test and Mann– Whitney U-test were used.ResultsIn all, 75 patients were included per cohort. In the FVP cohort, chronic heart disease (36/75, 48.0% vs. 16/75, 21.3%, p<0.01) and diabetes mellitus (23/75, 30.7% vs. 10/75, 13.3%, p<0.01) were more prevalent, hospital LOS (18.5±15.5 days vs. 13.0±8.5 days, p<0.01) was higher. Disease progression (17/75, 22.7% vs. 10/75, 13.3%, p=0.13), 14-day all-cause death (9/75, 12.0% vs. 10/75, 13.3%, p=0.8) and need for mechanical ventillation (8/75, 10.7% vs. 4/75, 5.3%, p=0.22) were similar between groups. Immunomodulatory therapies were administered frequently among patients receiving FVP (10/75, 13.3% vs. 1/75, 1.3%, p<0.01).ConclusionsIn this study, favipiravir did not seem to affect disease progression. Further data are needed to position this drug among the anti-SARS-CoV-2 armamentarium.