Comprehensive evaluation of six interventions for hospitalized patients with COVID-19: A propensity score matching study

Alshamrani et al., Saudi Pharmaceutical Journal, doi:10.1016/j.jsps.2023.02.004

Feb 2023

Source PDF All Studies Meta AnalysisMeta

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.

1. Gérard et al., Remdesivir and Acute Renal Failure: A Potential Safety Signal From Disproportionality Analysis of the WHO Safety Database, Clinical Pharmacology & Therapeutics, doi:10.1002/cpt.2145.wiley.com, doi.org.

2. Wu et al., Acute Kidney Injury Associated With Remdesivir: A Comprehensive Pharmacovigilance Analysis of COVID-19 Reports in FAERS, Frontiers in Pharmacology, doi:10.3389/fphar.2022.692828.frontiersin.org, doi.org.

3. Zhou et al., Acute Kidney Injury and Drugs Prescribed for COVID-19 in Diabetes Patients: A Real-World Disproportionality Analysis, Frontiers in Pharmacology, doi:10.3389/fphar.2022.833679.frontiersin.org, doi.org.

Important missing comments or errors? Let us know.

This study includes convalescent plasma, remdesivir, favipiravir, and HCQ.

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.

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.

ICU time, 42.6% higher, relative time 1.43, p = 0.003, treatment 245, control 995, propensity score matching.

hospitalization time, 7.4% lower, relative time 0.93, p = 0.25, treatment 246, control 1,078, propensity score matching.

Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates

Alshamrani et al., 15 Feb 2023, retrospective, Saudi Arabia, peer-reviewed, 3 authors, study period March 2020 - January 2021.

All Studies Meta Analysis Submit Updates or Corrections

This Paper Remdesivir All

Comprehensive evaluation of six interventions for hospitalized patients with COVID-19: A propensity score matching study

BPharm Ali A Alshamrani, Ahmed M Assiri, Omar A Almohammed

Saudi Pharmaceutical Journal, doi:10.1016/j.jsps.2023.02.004

This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

Authors' contributions: OAA designed the study, analyzed the data and revised and edited the manuscript. AAA and AMA contributed to the study design and writing the first draft of the manuscript. All authors read and approved the final manuscript.

References

Almohammed, Pharmd, None

Almutairi, Assiri, Almohammed, Predictors of Poor Outcome among Critically Ill COVID-19 Patients: A Nationally Representative Sample of the Saudi Arabian Population, Journal of Clinical Medicine, doi:10.3390/jcm11102818

Arabi, Asiri, Assiri, Balkhy, Al Bshabshe et al., Interferon Beta-1b and Lopinavir-Ritonavir for Middle East Respiratory Syndrome, N Engl J Med, doi:10.1056/NEJMoa2015294

Beigel, Tomashek, Dodd, Mehta, Zingman et al., Remdesivir for the Treatment of Covid-19 -Final Report, N Engl J Med, doi:10.1056/NEJMoa2007764

Bosaeed, Alharbi, Mahmoud, Alrehily, Bahlaq et al., Efficacy of favipiravir in adults with mild COVID-19: a randomized, double-blind, multicentre, placebo-controlled clinical trial, Clin Microbiol Infect, doi:10.1016/j.cmi.2021.12.026

Cao, Ming, Chen, Zhu, Shi, The Effectiveness of Convalescent Plasma for the Treatment of Novel Corona Virus Disease 2019: A Systematic Review and Meta-Analysis, Front Med, doi:10.3389/fmed.2021.641429

Casadevall, Pirofski, The convalescent sera option for containing COVID-19, J Clin Invest, doi:10.1172/JCI138003

Chen, Chan, Jiang, Kao, Lu et al., In vitro susceptibility of 10 clinical isolates of SARS coronavirus to selected antiviral compounds, J Clin Virol, doi:10.1016/j.jcv.2004.03.003

Consortium, Pan, Peto, Henao-Restrepo, Preziosi et al., Repurposed Antiviral Drugs for Covid-19 -Interim WHO Solidarity Trial Results, N Engl J Med, doi:10.1056/NEJMoa2023184

Di Castelnuovo, Costanzo, Cassone, Cauda, De Gaetano et al., Hydroxychloroquine and mortality in COVID-19 patients: a systematic review and a meta-analysis of observational studies and randomized controlled trials, Pathog Glob Health, doi:10.1080/20477724.2021.1936818

Doi, Hibino, Hase, Yamamoto, Kasamatsu et al., A Prospective, Randomized, Open-Label Trial of Early versus Late Favipiravir Therapy in Hospitalized Patients with COVID-19, Antimicrob Agents Chemother, doi:10.1128/AAC.01897-20

Elsawah, Elsokary, Abdallah, Elshafie, Efficacy and safety of remdesivir in hospitalized Covid-19 patients: Systematic review and meta-analysis including network meta-analysis, Rev Med Virol, doi:10.1002/rmv.2187

Fda, Coronavirus (COVID-19) Update: FDA Issues Emergency Use Authorization for Potential COVID-19 Treatment

Fda, FDA Authorizes Baricitinib Alone as Treatment for COVID-19 -Drug Information Update

Fda, FDA Authorizes Tocilizumab for Treatment of COVID-19

Gautret, Lagier, Parola, Hoang, Meddeb et al., Hydroxychloroquine and azithromycin as a treatment of COVID-19: results of an open-label non-randomized clinical trial, Int J Antimicrob Agents, doi:10.1016/j.ijantimicag.2020.105949

Geleris, Sun, Platt, Zucker, Baldwin et al., Observational Study of Hydroxychloroquine in Hospitalized Patients with Covid-19, N Engl J Med, doi:10.1056/NEJMoa2012410

Gharbharan, Jordans, Geurtsvankessel, Hollander, Karim et al., Effects of potent neutralizing antibodies from convalescent plasma in patients hospitalized for severe SARS-CoV-2 infection, Nat Commun, doi:10.1038/s41467-021-23469-2

Goldman, Lye, Hui, Marks, Bruno et al., Remdesivir for 5 or 10 Days in Patients with Severe Covid-19, N Engl J Med, doi:10.1056/NEJMoa2015301

Grein, Ohmagari, Shin, Diaz, Asperges et al., Compassionate Use of Remdesivir for Patients with Severe Covid-19, N Engl J Med, doi:10.1056/NEJMoa2007016

Group, Horby, Lim, Emberson, Mafham et al., Dexamethasone in Hospitalized Patients with Covid-19, N Engl J Med, doi:10.1056/NEJMoa2021436

Hajjar, Costa, Rizk, Biselli, Gomes et al., Intensive care management of patients with COVID-19: a practical approach, Ann Intensive Care, doi:10.1186/s13613-021-00820-w

Heimfarth, Serafini, Martins-Filho, Quintans, Quintans-Junior, Drug repurposing and cytokine management in response to COVID-19: A review, Int Immunopharmacol, doi:10.1016/j.intimp.2020.106947

Hoertel, Sanchez-Rico, Vernet, Beeker, Neuraz et al., Dexamethasone use and mortality in hospitalized patients with coronavirus disease 2019: A multicentre retrospective observational study, Br J Clin Pharmacol, doi:10.1111/bcp.14784

Hung, Lung, Tso, Liu, Chung et al., Triple combination of interferon beta-1b, lopinavir-ritonavir, and ribavirin in the treatment of patients admitted to hospital with COVID-19: an open-label, randomised, phase 2 trial, Lancet, doi:10.1016/S0140-6736(20)31042-4

Ivashchenko, Dmitriev, Vostokova, Azarova, Blinow et al., AVIFAVIR for Treatment of Patients With Moderate Coronavirus Disease 2019 (COVID-19): Interim Results of a Phase II/III Multicenter Randomized Clinical Trial, Clin Infect Dis, doi:10.1093/cid/ciaa1176

Janiaud, Axfors, Schmitt, Gloy, Ebrahimi et al., Association of Convalescent Plasma Treatment With Clinical Outcomes in Patients With COVID-19: A Systematic Review and Meta-analysis, JAMA, doi:10.1001/jama.2021.2747

Klassen, Senefeld, Johnson, Carter, Wiggins et al., The Effect of Convalescent Plasma Therapy on Mortality Among Patients With COVID-19: Systematic Review and Meta-analysis, Mayo Clin Proc, doi:10.1016/j.mayocp.2021.02.008

Kloypan, Saesong, Sangsuemoon, Chantharit, Mongkhon, CONVALESCENT plasma for COVID-19: A meta-analysis of clinical trials and real-world evidence, Eur J Clin Invest, doi:10.1111/eci.13663

Kocayigit, Ozmen, Suner, Tomak, Demir et al., Observational study of the effects of Favipiravir vs Lopinavir/Ritonavir on clinical outcomes in critically Ill patients with COVID-19, J Clin Pharm Ther, doi:10.1111/jcpt.13305

Krause, Fleming, Longini, Peto, Briand et al., SARS-CoV-2 Variants and Vaccines, N Engl J Med, doi:10.1056/NEJMsr2105280

Li, Zhang, Hu, Tong, Zheng et al., Effect of Convalescent Plasma Therapy on Time to Clinical Improvement in Patients With Severe and Life-threatening COVID-19: A Randomized Clinical Trial, JAMA, doi:10.1001/jama.2020.10044

Liu, Cao, Xu, Wang, Zhang et al., Hydroxychloroquine, a less toxic derivative of chloroquine, is effective in inhibiting SARS-CoV-2 infection in vitro, Cell Discov, doi:10.1038/s41421-020-0156-0

Liu, Chen, Liu, Nie, Lu, Comorbid Chronic Diseases are Strongly Correlated with Disease Severity among COVID-19 Patients: A Systematic Review and Meta-Analysis, Aging Dis, doi:10.14336/AD.2020.0502

Ma, Xu, Liu, Sun, Li et al., Efficacy and safety of systematic corticosteroids among severe COVID-19 patients: a systematic review and meta-analysis of randomized controlled trials, Signal Transduct Target Ther, doi:10.1038/s41392-021-00521-7

Malhani, Enani, Sharif-Askari, Alghareeb, Bin-Brikan et al., Combination of (interferon beta-1b, lopinavir/ritonavir and ribavirin) versus favipiravir in hospitalized patients with non-critical COVID-19: A cohort study, PLoS One, doi:10.1371/journal.pone.0252984

Martins-Filho, Ferreira, Heimfarth, Araujo, Quintans-Junior, Efficacy and safety of hydroxychloroquine as pre-and post-exposure prophylaxis and treatment of COVID-19: A systematic review and meta-analysis of blinded, placebo-controlled, randomized clinical trials, Lancet Reg Health Am, doi:10.1016/j.lana.2021.100062

Million, Gautret, Colson, Roussel, Dubourg et al., Clinical efficacy of chloroquine derivatives in COVID-19 infection: comparative meta-analysis between the big data and the real world, New Microbes New Infect, doi:10.1016/j.nmni.2020.100709

Moh, Saudi MoH Protocol for Patients Suspected of/Confirmed with COVID-19

Pan, Bai, Propensity score methods for causal inference: an overview, Behaviormetrika, doi:10.1007/s41237-018-0058-8

Simonovich, Burgos Pratx, Scibona, Beruto, Vallone et al., A Randomized Trial of Convalescent Plasma in Covid-19 Severe Pneumonia, N Engl J Med, doi:10.1056/NEJMoa2031304

Singh, Parida, Lingaraju, Kesavan, Kumar et al., Drug repurposing approach to fight COVID-19, Pharmacol Rep, doi:10.1007/s43440-020-00155-6

Snow, Saleem, Ambler, Nastouli, Mccoy et al., Convalescent plasma for COVID-19: a meta-analysis, trial sequential analysis, and metaregression, Br J Anaesth, doi:10.1016/j.bja.2021.07.033

Spinner, Gottlieb, Criner, Lopez, Cattelan 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, doi:10.1001/jama.2020.16349

Tay, Poh, Renia, Macary, Ng, The trinity of COVID-19: immunity, inflammation and intervention, Nat Rev Immunol, doi:10.1038/s41577-020-0311-8

Tomazini, Maia, Cavalcanti, Berwanger, Rosa et al., Effect of Dexamethasone on Days Alive and Ventilator-Free in Patients With Moderate or Severe Acute Respiratory Distress Syndrome and COVID-19: The CoDEX Randomized Clinical Trial, JAMA, doi:10.1001/jama.2020.17021

Tortajada, Colomer, Andreu-Ballester, Esparcia, Oltra et al., Corticosteroids for COVID-19 patients requiring oxygen support? Yes, but not for everyone: Effect of corticosteroids on mortality and intensive care unit admission in patients with COVID-19 according to patients' oxygen requirements, J Med Virol, doi:10.1002/jmv.26635

Troxel, Petkova, Goldfeld, Liu, Tarpey et al., Association of Convalescent Plasma Treatment With Clinical Status in Patients Hospitalized With COVID-19: A Meta-analysis, JAMA Netw Open, doi:10.1001/jamanetworkopen.2021.47331

Udwadia, Singh, Barkate, Patil, Rangwala et al., Efficacy and safety of favipiravir, an oral RNA-dependent RNA polymerase inhibitor, in mild-to-moderate COVID-19: A randomized, comparative, open-label, multicenter, phase 3 clinical trial, Int J Infect Dis, doi:10.1016/j.ijid.2020.11.142

Vecchie, Batticciotto, Tangianu, Bonaventura, Pennella et al., Highdose dexamethasone treatment for COVID-19 severe acute respiratory distress syndrome: a retrospective study, Intern Emerg Med, doi:10.1007/s11739-021-02800-1

Wang, Cao, Zhang, Yang, Liu et al., Remdesivir and chloroquine effectively inhibit the recently emerged novel coronavirus (2019-nCoV) in vitro, Cell Res, doi:10.1038/s41422-020-0282-0

Wang, Zhang, Du, Du, Zhao et al., Remdesivir in adults with severe COVID-19: a randomised, double-blind, placebo-controlled, multicentre trial, Lancet, doi:10.1016/S0140-6736(20)31022-9

Late treatment
is less effective

Please send us corrections, updates, or comments. Vaccines and treatments are complementary. All practical, effective, and safe means should be used based on risk/benefit analysis. No treatment, vaccine, or intervention is 100% available and effective for all current and future variants. We do not provide medical advice. Before taking any medication, consult a qualified physician who can provide personalized advice and details of risks and benefits based on your medical history and situation. FLCCC and WCH provide treatment protocols.

Submit

@CovidAnalysis

FAQ

Public domain CC0 1.0