COVID-19 related treatment and outcomes among COVID-19 ICU patients: A retrospective cohort study
Assiri et al.,
COVID-19 related treatment and outcomes among COVID-19 ICU patients: A retrospective cohort study,
Journal of Infection and Public Health, doi:10.1016/j.jiph.2021.08.030
Retrospective 118 ICU patients in Saudi Arabia showing no significant differences in unadjusted results with zinc, vitamin D, and favipiravir treatment.
This study is excluded in the after exclusion results of meta
analysis:
unadjusted results with no group details; very late stage, ICU patients.
risk of death, 79.3% higher, RR 1.79, p = 0.50, treatment 11 of 67 (16.4%), control 3 of 51 (5.9%), inverted to make RR<1 favor treatment, odds ratio converted to relative risk.
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Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
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Assiri et al., 28 Aug 2021, retrospective, Saudi Arabia, peer-reviewed, 8 authors.
Abstract: Journal of Infection and Public Health 14 (2021) 1274–1278
Contents lists available at ScienceDirect
Journal of Infection and Public Health
journal homepage: http://www.elsevier.com/locate/jiph
Original Article
COVID-19 related treatment and outcomes among COVID-19 ICU
patients: A retrospective cohort study
Abdullah Assiri a,∗ , Mir J. Iqbal a , Atheer Mohammed a , Abdulrhman Alsaleh a ,
Ahmed Assiri b , Adeeb Noor c , Redhwan Nour d , Moteb Khobrani a
a
Department of Clinical Pharmacy, College of Pharmacy, King Khalid University, Abha 62529, Saudi Arabia
Department of Pharmacy Services, Asir Central Hospital, Abha 62529, Saudi Arabia
c
Department of Information Technology, Faculty of Computing and Information Technology, King Abdulaziz University, Jeddah 80221, Saudi Arabia
d
Department of Computer Science, Taibah University, Medina 42353, Saudi Arabia
b
a r t i c l e
i n f o
Article history:
Received 20 November 2020
Received in revised form 2 August 2021
Accepted 25 August 2021
Keywords:
COVID-16
Treatment
ICU patients
Outcome
Mortality
a b s t r a c t
Background: The COVID-19 pandemic remains an immediate and present concern, yet as of now there is
still no approved therapeutic available for the treatment of COVID-19.This study aimed to investigate and
report evidence concerning demographic characteristics and currently-used medications that contribute
to the ultimate outcomes of COVID-19 ICU patients.
Methods: A retrospective cohort study was conducted among all COVID-19 patients in the Intensive
Care Unit (ICU) of Asir Central Hospital in Saudi Arabia between the 1st and 30th of June 2020. Data
extracted from patients’ medical records included their demographics, home medications, medications
used to treat COVID-19, treatment durations, ICU stay, hospital stay, and ultimate outcome (recovery or
death).Descriptive statistics and regression modelling were used to analyze and compare the results. The
study was approved by the Institutional Ethics Committees at both Asir Central Hospital and King Khalid
University.
Results: A total of 118 patients with median age of 57 years having definite clinical and disease outcomes
were included in the study. Male patients accounted for 87% of the study population, and more than 65%
experienced at least one comorbidity. The mean hospital and ICU stay was 11.4 and 9.8 days, respectively.
The most common drugs used were tocilizumab (31.4%), triple combination therapy (45.8%), favipiravir
(56.8%), dexamethasone (86.7%), and enoxaparin (83%). Treatment with enoxaparin significantly reduced
the length of ICU stay (p = 0.04) and was found to be associated with mortality reduction in patients aged
50−75 (p = 0.03), whereas the triple regimen therapy and tocilizumab significantly increased the length
of ICU stay in all patients (p = 0.01, p = 0.02 respectively).
Conclusion: COVID-19 tends to affect males more significantly than females. The use of enoxaparin is
an important part of COVID-19 treatment, especially for those above 50 years of age, while the use of
triple combination therapy and tocilizumab in COVID-19 protocols should be reevaluated and restricted
to patients who have high likelihood of benefit.
© 2021 The Author(s). Published by Elsevier Ltd on behalf of King Saud Bin Abdulaziz University for
Health Sciences. This is an open access article under the CC BY-NC-ND license (http://creativecommons.
org/licenses/by-nc-nd/4.0/).
Late treatment
is less effective
assiri
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