Comparing outcomes of hospitalized patients with moderate and severe COVID-19 following treatment with hydroxychloroquin
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RESEARCH ARTICLE
Comparing outcomes of hospitalized patients with moderate and severe COVID-19 following treatment with hydroxychloroquine plus atazanavir/ritonavir Hamid Rahmani 1 & Effat Davoudi-Monfared 1 & Anahid Nourian 1 & Morteza Nabiee 1 & Setayesh Sadeghi 1 & Hossein Khalili 1 & Ladan Abbasian 2 & Fereshteh Ghiasvand 2 & Arash Seifi 2 & Malihe Hasannezhad 2 & Sara Ghaderkhani 2 & Mostafa Mohammadi 3 & Mir Saeed Yekaninejad 4 Received: 4 July 2020 / Accepted: 11 August 2020 # Springer Nature Switzerland AG 2020
Abstract Background The role of the antiviral therapy in treatment of COVID-19 is still a matter to be investigated. Also efficacy and safety of antiviral regimens were not compared according severity of the disease. In this study the efficacy and safety of hydroxychloroquine plus atazanavir/ritonavir was compared in patients with moderate and severe COVID-19. Methods We prospectively evaluated the clinical outcomes of 213 patients with COVID-19 during the hospitalization course and up to 56 days after the hospital discharge. The disease was categorized to moderate and severe based on the severity of pneumonia and peripheral oxygen saturation (SpO2). The patients received the national treatment protocol containing hydroxychloroquine (400 mg BD in first day and then 200 mg BD) plus atazanavir/ritonavir (300/100 mg daily) for 7 days. Main outcomes included discharge rates at day 7, 14 and 28, 28-day mortality, rate of intensive care unit (ICU) admission and intubation, length of hospital and ICU stay and incidence of adverse events. Results The mean (SD) age of patients was 60(14) years and 53% were male. According to WHO definition, 51.64% and 48.36% of the patients had moderate (SpO2 ≥ 90%) and severe disease (SpO2 < 90%) at baseline, respectively. The discharge rate of the moderate group was significantly higher than the severe group at day 7, 14 and 28 (HR = 0.49; 95% CI: 0.35–0.69, p = < 0.001 at day 7, HR = 0.48; 95% CI: 0.35–0.66, p = < 0.001 at day 14 and HR = 0.49; 95% CI: 0.36–0.67, p = < 0.001at day 28). The 28day mortality of the severe group was six times higher than the moderate group (HR = 6.00; 95% CI: 2.50–14.44), p = < 0.001).
* Hossein Khalili [email protected]; [email protected]
Malihe Hasannezhad [email protected]
Hamid Rahmani [email protected]
Sara Ghaderkhani [email protected]
Effat Davoudi-Monfared [email protected]
Mostafa Mohammadi [email protected]
Anahid Nourian [email protected]
Mir Saeed Yekaninejad [email protected]
Morteza Nabiee [email protected]
1
Setayesh Sadeghi [email protected]
Department of Pharmacotherapy, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
2
Ladan Abbasian [email protected]
Department of Infectious Diseases, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
3
Department of Intensive Care Unit, Imam Khomeini Hospital Complex, Faculty of Medicine, Tehran University of Medical Sciences, Tehran,
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