Comprehensive evaluation of six interventions for hospitalized patients with COVID-19: A propensity score matching study
Alshamrani et al.,
Comprehensive evaluation of six interventions for hospitalized patients with COVID-19: A propensity score..,
Saudi Pharmaceutical Journal, doi:10.1016/j.jsps.2023.02.004
PSM retrospective 29 hospitals in Saudi Arabia, showing lower mortality with remdesivir treatment.
[Gérard, Wu, Zhou] show significantly increased risk of acute kidney injury with remdesivir.
risk of death, 17.3% lower, RR 0.83, p = 0.003, treatment 137 of 246 (55.7%), control 725 of 1,078 (67.3%), NNT 8.6, adjusted per study, odds ratio converted to relative risk, propensity score matching, multivariable.
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risk of progression, 4.3% lower, RR 0.96, p = 0.12, treatment 215 of 246 (87.4%), control 984 of 1,078 (91.3%), NNT 26, adjusted per study, odds ratio converted to relative risk, AKI, ARDS, multi-organ failure, or mortality, propensity score matching, multivariable.
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ICU time, 42.6% higher, relative time 1.43, p = 0.003, treatment 245, control 995, propensity score matching.
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hospitalization time, 7.4% lower, relative time 0.93, p = 0.25, treatment 246, control 1,078, propensity score matching.
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Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
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Alshamrani et al., 15 Feb 2023, retrospective, Saudi Arabia, peer-reviewed, 3 authors, study period March 2020 - January 2021.
Abstract: Journal Pre-proofs
Original article
Comprehensive evaluation of six interventions for hospitalized patients with
COVID-19: A propensity score matching study
Ali A. Alshamrani, Ahmed M. Assiri, Omar A. Almohammed
PII:
DOI:
Reference:
S1319-0164(23)00034-8
https://doi.org/10.1016/j.jsps.2023.02.004
SPJ 1580
To appear in:
Saudi Pharmaceutical Journal
Received Date:
Revised Date:
Accepted Date:
30 August 2022
10 February 2023
12 February 2023
Please cite this article as: Alshamrani, A.A., Assiri, A.M., Almohammed, O.A., Comprehensive evaluation of six
interventions for hospitalized patients with COVID-19: A propensity score matching study, Saudi
Pharmaceutical Journal (2023), doi: https://doi.org/10.1016/j.jsps.2023.02.004
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Comprehensive evaluation of six interventions for hospitalized patients with
COVID-19: A propensity score matching study
Abstract
Purpose
The purpose of this study was to evaluate the effectiveness of either
hydroxychloroquine, triple combination therapy (TCT), favipiravir, dexamethasone,
remdesivir, or COVID-19 convalescent plasma (CCP) in comparison with standard-of-care
for hospitalized patients with COVID-19 using real-world data from Saudi Arabia.
Patients and methods
A secondary database analysis was conducted using the Saudi Ministry of Health
database for patients with COVID-19. Adult (≥ 18 years) hospitalized patients with
COVID-19 between March 2020 and January 2021 were included in the analysis. A
propensity score matching technique was used to establish comparable groups for each
therapeutic approach. Lastly, an independent t-test and chi-square test were used to
compare the matching groups in the aspects of the duration of hospitalization, length of
stay (LOS) in intensive care units (ICU), in-hospital mortality, and composite poor
outcome. Multilevel logistic regression model was used to assess the association between
the severity stage of COVID-19 and the outcomes while using the medication or
intervention used as a grouping variable in the model.
Results
The mean duration of hospitalization was significantly longer for patients who received
TCT, favipiravir, dexamethasone, or CCP compared to patients who did not receive these
therapies, with a mean difference ranging between 2.2 and 4.9 days for dexamethasone and
CCP, respectively. Furthermore, the use of favipiravir or CCP was associated with a longer
stay in ICU. Remdesivir was the only agent associated with in-hospital mortality benefit.
A higher risk of mortality and poorer composite outcome were associated with the use of
favipiravir or dexamethasone. However, the logistic regression model reveled that the
difference between the two matched cohorts was due to the severity stage not the
medication. Additionally, the use of hydroxychloroquine, TCT, or CCP had no impact on
the incidence of in-hospital mortality or..
Late treatment
is less effective
alshamrani
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