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Evaluation of the Costs and Outcomes of COVID-19 Therapeutic Regimens in Hospitalized Patients in Shiraz

Behboodikhah et al., Iranian Journal of Science and Technology, Transactions A: Science, doi:10.1007/s40995-022-01351-0
Sep 2022  
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Mortality 38% Improvement Relative Risk Remdesivir  Behboodikhah et al.  LATE TREATMENT Is late treatment with remdesivir beneficial for COVID-19? Retrospective 2,174 patients in Iran Lower mortality with remdesivir (not stat. sig., p=0.21) c19early.org Behboodikhah et al., Iranian J. Scienc.., Sep 2022 Favorsremdesivir Favorscontrol 0 0.5 1 1.5 2+
Retrospective 2,174 hospitalized patients showing no significant differences with remdesivir treatment.
Gérard, Zhou, Wu, Kamo, Choi, Kim show significantly increased risk of acute kidney injury with remdesivir.
Remdesivir efficacy disappears with longer followup. Mixed-effects meta-regression of efficacy as a function of followup duration across all remdesivir studies shows decreasing efficacy with longer followup7. This may reflect antiviral efficacy being offset by serious adverse effects of treatment.
Followup duration (days) Efficacy Remdesivir mortality efficacy decreases with longer followup 0 15 30 45 60 75 90 105 -25% 0% 25% 50% c19early.org December 2024 mixed-effects meta-regression slope -0.58 [95% CI -0.92 to -0.24] p=0.00089
Study covers remdesivir and favipiravir.
risk of death, 37.5% lower, OR 0.62, p = 0.21, treatment 1,214, control 960, adjusted per study, multivariable, RR approximated with OR.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Behboodikhah et al., 15 Sep 2022, retrospective, Iran, peer-reviewed, 8 authors.
This PaperRemdesivirAll
Evaluation of the Costs and Outcomes of COVID-19 Therapeutic Regimens in Hospitalized Patients in Shiraz
Hooman Behboodikhah, Eslam Shorafa, Iman Karimzadeh, Mohsen Moghadami, Javad Shahmohammadi, Mohsen Bayati, Khosro Keshavarz, Manica Negahdaripour
doi:10.1007/s40995-022-01351-0(
patients in critical conditions are hospitalized and treated with various protocols including antiviral drugs, which have been updated repeatedly. This study was aimed to analyze the demographics, costs, and outcomes of drug regimens in COVID-19 patients hospitalized in ''Ali Asghar'' hospital, affiliated with Shiraz University of Medical Sciences, from March 2019 to December 2020 as a retrospective study, approved by the ethics committee of Shiraz University of Medical Sciences (IR.SUMS.REC.1399.1003) on Dec. 28, 2020. Using hospital information system (HIS) data, 2174 patients receiving favipiravir, remdesivir, interferon-b, and Kaletra Ò were analyzed. Descriptive, univariate, and regression analyses were used. The costs and consequences of different drug regimens were significantly different (P value \ 0.05); the highest and lowest costs belonged to remdesivir and Kaletra Ò , respectively. The highest and lowest mean length of stay and mortality were related to remdesivir and favipiravir, respectively. Mortality did not differ significantly with various regimens. Length of stay was significantly shorter with favipiravir and Kaletra Ò than interferon-b. Remdesivir had significantly the highest cost. Age presented a significantly positive relationship with mortality and length of stay. Besides, ICU admission significantly increased mortality, length of stay, and costs. Underlying diseases and low blood oxygen saturation contributed to mortality. COVID-19 correlation with age and underlying diseases is accordant with the published data. Given the highest costs and broad usage of remdesivir, besides controversies regarding its outcomes and side effects, a stricter evaluation of remdesivir benefits seems essential. Totally, COVID-19 therapeutic protocols should be selected carefully to optimize costs and outcomes.
Author Contributions KHK and MN: contributed to the study conception and design. HB, KHK, and MN: were involved in data colstatistical analysis, interpretation, manuscript drafting, and final review of the manuscript. MM, ESH, and IK: helped with the research idea, providing the data, and supervision of the research. JSH: helped in data collecting and data cleaning. MB: helped in statistical analysis and interpretation. All authors have read and approved the final manuscript. Declarations Conflict of Interest The authors declare no competing interests. Authors and Affiliations
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Late treatment
is less effective
Please send us corrections, updates, or comments. c19early involves the extraction of 100,000+ datapoints from thousands of papers. Community updates help ensure high accuracy. Treatments and other interventions are complementary. All practical, effective, and safe means should be used based on risk/benefit analysis. No treatment 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.
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