Tohoku J. Exp. Med., 2021 September, 255(1)

COVID-19 Outbreak in Italy: Report on the First 124 Consecutive Patients Treated at Home

Luigi Cavanna,1 Gabriele Cremona,1 Chiara Citterio,1 Camilla Di Nunzio,1 Monica Muroni,1 Anna Maria Andena,2 Evelina Cattadori,3 Mirella Gubbelini,4 Lara Muroni,4 Roberta Schiavo,5 Massimo Nolli,6 Mauro Codeluppi,7 Pietro Maniscalco8 and Guido Pedrazzini9

1Oncology and Hematology Department, Oncology Unit, Piacenza General Hospital, Piacenza, Italy
2District Territorial Health Unit, Piacenza General Hospital, Piacenza, Italy
3Research and Innovation Unit, Piacenza General Hospital, Piacenza, Italy
4Nurse Directory Unit, Piacenza General Hospital, Piacenza, Italy
5Pathology Unit, Piacenza General Hospital, Piacenza, Italy
6Emergency Department, Piacenza General Hospital, Piacenza, Italy
7Infectious Diseases Unit, Piacenza General Hospital, Piacenza, Italy
8Orthopedics and Traumatology Department, Piacenza General Hospital, Piacenza, Italy
9Hospital Health Direction, Piacenza General Hospital, Piacenza, Italy

North Italy emerged as an epicenter of COVID-19 in the Western world. The majority of studies of patients with COVID-19 have focused on hospitalized patients, and data on early outpatient treatment are limited. This research retrospectively examines consecutive symptomatic adults who did not present to a hospital but who experience laboratory confirmed (nasopharyngeal swabs) or probable COVID-19 infection. From March 12 to April 12, 2020, 124 consecutive patients with laboratory-confirmed COVID-19 infection (84%) or with epidemiologically linked exposure to a person with confirmed infection (16%) were managed at home. The diagnosis of pneumonia was made with a portable ultrasound. COVID-19 treatment was based on low-dose hydroxychloroquine with or without darunavir/cobicistat or azithromycin and enoxaparine for bedridden patients. The patients were monitored by telemedicine. The primary endpoints were clinical improvement or hospitalization, and the secondary endpoints were mortality at day 30 and at day 60. Forty-seven (37.9%) patients had mild COVID-19 infection, 44 (35.5%) had moderate COVID-19 infection, and 33 (26.6%) had severe COVID-19 infection. Four patients (3.2%) were hospitalized and there were no deaths at day 30 and at day 60. Only mild side effects were reported. Early home treatment of COVID-19 patients resulted in a low hospitalization rate with no deaths, with the limitations of the small sample size and that it was conducted within a single geographic area. We believe that this model may be easily reproduced in both cities and rural areas around the world to treat COVID-19 infection.

Key words —— COVID-19; home care; outpatient; treatment

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Tohoku J. Exp. Med 2021, 255, 61-69.

Correspondence: Luigi Cavanna, Oncology and Hematology Department, Oncology Unit, Piacenza General Hospital, Via Taverna 49, Piacenza 29121, Italy.

e-mail: l.cavanna@ausl.pc.it