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COVID-19 related treatment and outcomes among COVID-19 ICU patients: A retrospective cohort study

Assiri et al., Journal of Infection and Public Health, doi:10.1016/j.jiph.2021.08.030
Aug 2021  
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Mortality -79% Improvement Relative Risk Favipiravir for COVID-19  Assiri et al.  ICU PATIENTS Is very late treatment with favipiravir beneficial for COVID-19? Retrospective 118 patients in Saudi Arabia Higher mortality with favipiravir (not stat. sig., p=0.5) c19early.org Assiri et al., J. Infection and Public.., Aug 2021 Favorsfavipiravir Favorscontrol 0 0.5 1 1.5 2+
Retrospective 118 ICU patients in Saudi Arabia showing no significant differences in unadjusted results with zinc, vitamin D, and favipiravir treatment.
Potential risks include the creation of dangerous variants, and mutagenicity, carcinogenicity, teratogenicity, and embryotoxicity1-5.
This study is excluded in the after exclusion results of meta analysis: unadjusted results with no group details; very late stage, ICU patients.
Study covers favipiravir, zinc, and vitamin D.
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.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Assiri et al., 28 Aug 2021, retrospective, Saudi Arabia, peer-reviewed, 8 authors.
This PaperFavipiravirAll
COVID-19 related treatment and outcomes among COVID-19 ICU patients: A retrospective cohort study
Abdullah Assiri, Mir J Iqbal, Atheer Mohammed, Abdulrhman Alsaleh, Ahmed Assiri, Adeeb Noor, Redhwan Nour, Moteb Khobrani
Journal of Infection and Public Health, doi:10.1016/j.jiph.2021.08.030
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.
Competing interests None declared. Ethical approval Not required.
References
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Late treatment
is less effective
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