Clinical Course and Outcomes among COVID-19 Patients at the Hospitel in Bangkok: A Retrospective Study
et al., Tropical Medicine and Infectious Disease, doi:10.3390/tropicalmed7090238, Sep 2022
Retrospective 514 patients in Thailand, showing higher risk of progression with favipiravir treatment.
Potential risks of favipiravir include kidney injury1-3, liver injury2-4, and mutagenicity, carcinogenicity, teratogenicity, embryotoxicity, and the creation of dangerous variants5-11.
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risk of progression, 227.0% higher, OR 3.27, p = 0.005, adjusted per study, multivariable, RR approximated with OR.
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| Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates |
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El-Fetouh et al., Experimental Studies on Some Drugs Used in Covid-19 Treatment (Favipiravir and Dexamethasone) in Albino Rats, Journal of Advanced Veterinary Research, 13:10, www.advetresearch.com/index.php/AVR/article/view/1635.
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Zhirnov et al., Favipiravir: the hidden threat of mutagenic action, Journal of microbiology, epidemiology and immunobiology, doi:10.36233/0372-9311-114.
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Waters et al., Human genetic risk of treatment with antiviral nucleoside analog drugs that induce lethal mutagenesis: the special case of molnupiravir, Environmental and Molecular Mutagenesis, doi:10.1002/em.22471.
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Hadj Hassine et al., Lethal Mutagenesis of RNA Viruses and Approved Drugs with Antiviral Mutagenic Activity, Viruses, doi:10.3390/v14040841.
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Shum, C., An investigational study into the drug-associated mutational signature in SARS-CoV-2 viruses, The University of Hong Kong, PhD Thesis, hub.hku.hk/handle/10722/344396.
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Bruminhent et al., 10 Sep 2022, retrospective, Thailand, peer-reviewed, 6 authors, study period 26 April, 2021 - 27 May, 2021.
Contact: sasisopin.kie@mahidol.ac.th (corresponding author).
Clinical Course and Outcomes among COVID-19 Patients at the Hospitel in Bangkok: A Retrospective Study
Tropical Medicine and Infectious Disease, doi:10.3390/tropicalmed7090238
A hospitel is a hotel that has been designated as an extension of the healthcare facilities during the COVID-19 pandemic in resource-limited settings. However, the clinical course and outcomes of patients with COVID-19 admitted to this unique type of facility have never been studied. We retrospectively reviewed the medical records of adult patients with COVID-19 who were admitted to a single hospitel in Bangkok, Thailand. Risk factors with respect to chest X-ray progression and clinical progression were analyzed using a logistic regression. A total of 514 patients were recruited, with a mean (standard deviation) age of 35.6 (13.4) years, and 58.6% were women. Patients were admitted after a median (interquartile range) of 3 (2-6) days of illness and were classified with mild (12.3%), moderate (86.6%), and severe (1.1%) conditions. Favipiravir and corticosteroids were prescribed in 26.3% and 14.9% of patients, respectively. Chest X-ray progression was found in 7.6% of patients, and hospital transfer occurred in 2.9%, with no deaths. Favipiravir use (odds ratio (OR) 3.3, 95% confidence interval (CI) 1.4-7.5, p = 0.005), nausea/vomiting after admission (OR 32.3, 95% CI 1.5-700.8, p = 0.03), and higher oxygen saturation on admission (OR 1.99; 95% CI 1.22-3.23, p = 0.005) were factors associated with chest X-ray progression. Additionally, an oxygen requirement on admission was an independent risk factor for hospital transfer (OR 904, 95% CI 113-7242, p < 0.001). In a setting where the hospitel has been proposed as an extension facility for patients with relatively non-severe COVID-19, most patients could achieve a favorable clinical outcome. However, patients who require oxygen supplementation should be closely monitored for disease progression and promptly transferred to a hospital if necessary.
Supplementary Materials: The following supporting information can be downloaded at: https://www. mdpi.com/article/10.3390/tropicalmed7090238/s1, Table S1 : Rama Co-RADS: A tool used as an assessment scheme for chest X-ray findings to diagnose and monitor patients with COVID-19 pneumonia. Author Contributions: Conceptualization, J.B. and S.K.; methodology, J.B. and S.K.; validation, J.B., Y.K., W.J. and S.K.; formal analysis, S.K.; data curation, Y.K., W.J., V.A. and T.S.; writing-original draft preparation, J.B.; writing-review and editing, J.B. and S.K.; All authors have read and agreed to the published version of the manuscript. Funding: This research received no external funding.
Institutional Review Board Statement: The study was conducted in accordance with the Declaration of Helsinki and was approved by the Institutional Review Board of the Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand (approval number: COA. MURA2021/402).
Informed Consent Statement: Not applicable. Data Availability Statement: All relevant data are presented within the manuscript.
Conflicts of Interest: The authors declare no conflict of interest.
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