Comparison of the Eight Different Treatment Regimens for the Hospitalized Patients with COVID-19: A Retrospective Cohort Study
Journal of Cellular & Molecular Anesthesia,
Vol. 6 No. 4 (2021),
21 January 2022
,
Page 329-338
https://doi.org/10.22037/jcma.v6i4.35553
Abstract
Background: Coronavirus disease 2019 (COVID -19) characterized by a mild to severe respiratory illness, has been affecting the world since late 2019 and leading to an increase in hospitalizations and deaths. There is still no specific highly effective treatment for this disease. This study aimed to compare the efficacy of the eight different treatment regimens for the hospitalized patients with COVID-19.
Methods: This retrospective cohort study was conducted on the hospitalized patients who had laboratory-confirmed COVID-19 by a real-time Reverse Transcriptase Polymerase Chain Reaction (RT-PCR) of nasopharyngeal samples.
Results: Among all patients hospitalized with COVID-19 between March to September 2020, 861 patients were included in the study. This study indicated that treatment protocols included either remdesivir or favipiravir were superior to hydroxychloroquine in reducing the risk of in-hospital mortality of the patients with confirmed COVID-19, especially in critical patients defined as those who were ICU admitted or under mechanical ventilation (HR, 0.43; 95% CI, 0.23 to 0.82; P=0.011 and HR, 0.45; 95% CI, 0.22 to 0.90; P=0.024, respectively). Whereas receiving lopinavir/ritonavir in combination with either hydroxychloroquine plus interferon β and corticosteroids (HR, 1.85; 95% CI, 1.17 to 2.94; P=0.009), hydroxychloroquine plus interferon β (HR, 1.66; 95% CI, 1.01 to 2.74; P=0.046), or interferon β (HR, 1.80; 95% CI, 1.12 to 2.89; P=0.015) was associated with a significant increase in this risk.
Conclusion: Our findings indicate that using remdesivir and favipiravir in combination with interferon β and corticosteroids might be beneficial in hospitalized patients with COVID-19, especially in the critical ones.
- Coronavirus disease 2019, Critically ill, In-hospital mortality, Treatment regimens
How to Cite
References
Acharya D, Liu G, Gack MU. Dysregulation of type I interferon responses in COVID-19. Nat Rev Immunol. 2020;20(7):397-8.
Fani M, Namdar-Ahmadabad H, Azimian A, Ghasemzadeh-Moghaddam H. Predicting microRNAs as Anti-viral Agents in SARS-CoV-2 Infection Based on the Bioinformatics Approach: A Systematic Review. J Cell Mol Anesth. 2021;6(2):141-7.
Hoffmann C, Wolf E. Older age groups and country-specific case fatality rates of COVID-19 in Europe, USA and Canada. Infection. 2021;49(1):111-6.
Guan WJ, Liang WH, Zhao Y, Liang HR, Chen ZS, Li YM, et al. Comorbidity and its impact on 1590 patients with COVID-19 in China: a nationwide analysis. Eur Respir J. 2020;55(5).
Oksanen A, Kaakinen M, Latikka R, Savolainen I, Savela N, Koivula A. Regulation and Trust: 3-Month Follow-up Study on COVID-19 Mortality in 25 European Countries. JMIR Public Health Surveill. 2020;6(2):e19218.
Alamdari NM, Afaghi S, Rahimi FS, Tarki FE, Tavana S, Zali A, et al. Mortality Risk Factors among Hospitalized COVID-19 Patients in a Major Referral Center in Iran. Tohoku J Exp Med. 2020;252(1):73-84.
Rajaei S, Dabbagh A. The immunologic basis of COVID-19: a clinical approach. J Cell Mol Anesth. 2020;5(1):37-42.
MacLean OA, Orton RJ, Singer JB, Robertson DL. No evidence for distinct types in the evolution of SARS-CoV-2. Virus Evol. 2020;6(1):veaa034.
Tang X, Wu C, Li X, Song Y, Yao X, Wu X, et al. On the origin and continuing evolution of SARS-CoV-2. Natl Sci Rev. 2020;7(6):1012-23.
Atorvastatin versus placebo in patients with covid-19 in intensive care: randomized controlled trial. BMJ (Clinical research ed). 2022;376:e068407.
Ziaie S, Koucheck M, Miri M, Salarian S, Shojaei S, Haghighi M, et al. Review of Therapeutic Agents for Treatment of COVID-19. J Cell Mol Anesth. 2020;5(1):32-6.
Haji Aghajani M, Moradi O, Amini H, Azhdari Tehrani H, Pourheidar E, Rabiei MM, et al. Decreased in-hospital mortality associated with aspirin administration in hospitalized patients due to severe COVID-19. J Med Virol. 2021;93(9):5390-5.
Haji Aghajani M, Moradi O, Azhdari Tehrani H, Amini H, Pourheidar E, Hatami F, et al. Promising effects of atorvastatin on mortality and need for mechanical ventilation in patients with severe COVID-19; a retrospective cohort study. Int J Clin Pract. 2021;75(9):e14434.
Jorge A. Hydroxychloroquine in the prevention of COVID-19 mortality. Lancet Rheumatol. 2021;3(1):e2-e3.
Schluger NW. The Saga of Hydroxychloroquine and COVID-19: A Cautionary Tale. Ann Intern Med. 2020;173(8):662-3.
Wu Z, McGoogan JM. Characteristics of and Important Lessons From the Coronavirus Disease 2019 (COVID-19) Outbreak in China: Summary of a Report of 72 314 Cases From the Chinese Center for Disease Control and Prevention. JAMA. 2020;323(13):1239-42.
Saidijam M, Khaksarimehr N, Rezaei-Tavirani M, Taherkhani A. Bioinformatics Prediction of Potential Inhibitors For the SARS-CoV-2 NTPase/Helicase Using Molecular Docking and Dynamics Simulation From Organic Phenolic Compounds. J Cell Mol Anesth. 2021;6(3):222-39.
Arshad S, Kilgore P, Chaudhry ZS, Jacobsen G, Wang DD, Huitsing K, et al. Treatment with hydroxychloroquine, azithromycin, and combination in patients hospitalized with COVID-19. Int J Infect Dis. 2020;97:396-403.
Gao J, Tian Z, Yang X. Breakthrough: Chloroquine phosphate has shown apparent efficacy in treatment of COVID-19 associated pneumonia in clinical studies. Biosci Trends. 2020;14(1):72-3.
Gautret P, Lagier JC, Parola P, Hoang VT, Meddeb L, Mailhe M, et al. Hydroxychloroquine and azithromycin as a treatment of COVID-19: results of an open-label non-randomized clinical trial. Int J Antimicrob Agents. 2020;56(1):105949.
Wang Y, Zhang D, Du G, Du R, Zhao J, Jin Y, et al. Remdesivir in adults with severe COVID-19: a randomised, double-blind, placebo-controlled, multicentre trial. Lancet. 2020;395(10236):1569-78.
Tang W, Cao Z, Han M, Wang Z, Chen J, Sun W, et al. Hydroxychloroquine in patients with mainly mild to moderate coronavirus disease 2019: open label, randomised controlled trial. BMJ. 2020;369:m1849.
Sands K, Wenzel R, McLean L, Korwek K, Roach J, Miller K, et al. No clinical benefit in mortality associated with hydroxychloroquine treatment in patients with COVID-19. Int J Infect Dis. 2021;104:34-40.
Pathak DSK, Salunke DAA, Thivari DP, Pandey A, Nandy DK, Harish VKRD, et al. No benefit of hydroxychloroquine in COVID-19: Results of Systematic Review and Meta-Analysis of Randomized Controlled Trials". Diabetes Metab Syndr. 2020;14(6):1673-80.
Lammers AJJ, Brohet RM, Theunissen REP, Koster C, Rood R, Verhagen DWM, et al. Early hydroxychloroquine but not chloroquine use reduces ICU admission in COVID-19 patients. Int J Infect Dis. 2020;101:283-9.
Ko WC, Rolain JM, Lee NY, Chen PL, Huang CT, Lee PI, et al. Arguments in favour of remdesivir for treating SARS-CoV-2 infections. Int J Antimicrob Agents. 2020;55(4):105933.
Spinner CD, Gottlieb RL, Criner GJ, Arribas López JR, Cattelan AM, Soriano Viladomiu A, et al. Effect of Remdesivir vs Standard Care on Clinical Status at 11 Days in Patients With Moderate COVID-19: A Randomized Clinical Trial. JAMA. 2020;324(11):1048-57.
Wang M, Cao R, Zhang L, Yang X, Liu J, Xu M, et al. Remdesivir and chloroquine effectively inhibit the recently emerged novel coronavirus (2019-nCoV) in vitro. Cell Res. 2020;30(3):269-71.
Byléhn F, Menéndez CA, Perez-Lemus GR, Alvarado W, de Pablo JJ. Modeling the Binding Mechanism of Remdesivir, Favilavir, and Ribavirin to SARS-CoV-2 RNA-Dependent RNA Polymerase. ACS Cent Sci. 2021;7(1):164-74.
Beigel JH, Tomashek KM, Dodd LE, Mehta AK, Zingman BS, Kalil AC, et al. Remdesivir for the Treatment of Covid-19 - Final Report. N Engl J Med. 2020;383(19):1813-26.
Hosseini P, Dehghan A, Haghi Navand A, Moghadami M, Soltani S, Zandi M. Coronavirus Disease 2019 (COVID-19): Immune Responses, Transmission and Clinical features: An Update. J Cell Mol Anesth. 2020;5(4):266-8.
Ghasemnejad-Berenji M, Pashapour S. Favipiravir and COVID-19: A Simplified Summary. Drug Res (Stuttg). 2021;71(3):166-70.
Joshi S, Parkar J, Ansari A, Vora A, Talwar D, Tiwaskar M, et al. Role of favipiravir in the treatment of COVID-19. International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases. 2021;102:501-8.
Darabi P, Bagherpour Kalo M, Mohamed Ali K, Safari S, Yousefifard M, Hosseini M. COVID-19: Features, clinical course and concerns. J Cell Mol Anesth. 2020;5(2):102-13.
Doi Y, Hibino M, Hase R, Yamamoto M, Kasamatsu Y, Hirose M, et al. A Prospective, Randomized, Open-Label Trial of Early versus Late Favipiravir Therapy in Hospitalized Patients with COVID-19. Antimicrob Agents Chemother. 2020;64(12).
Cai Q, Yang M, Liu D, Chen J, Shu D, Xia J, et al. Experimental Treatment with Favipiravir for COVID-19: An Open-Label Control Study. Engineering (Beijing). 2020;6(10):1192-8.
Molina JM, Ait-Khaled M, Rinaldi R, Penco G, Baril JG, Cauda R, et al. Fosamprenavir/ritonavir in advanced HIV disease (TRIAD): a randomized study of high-dose, dual-boosted or standard dose fosamprenavir/ritonavir in HIV-1-infected patients with antiretroviral resistance. J Antimicrob Chemother. 2009;64(2):398-410.
Uzunova K, Filipova E, Pavlova V, Vekov T. Insights into antiviral mechanisms of remdesivir, lopinavir/ritonavir and chloroquine/hydroxychloroquine affecting the new SARS-CoV-2. Biomed Pharmacother. 2020;131:110668.
Cao B, Wang Y, Wen D, Liu W, Wang J, Fan G, et al. A Trial of Lopinavir-Ritonavir in Adults Hospitalized with Severe Covid-19. N Engl J Med. 2020;382(19):1787-99.
Lopinavir-ritonavir in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial. Lancet. 2020;396(10259):1345-52.
Owa AB, Owa OT. Lopinavir/ritonavir use in Covid-19 infection: is it completely non-beneficial? J Microbiol Immunol Infect. 2020;53(5):674-5.
- Abstract Viewed: 212 times
- PDF Downloaded: 160 times