Clinical and treatment factors associated with the mortality of COVID-19 patients admitted to a referral hospital in Indonesia
et al., The Lancet Regional Health - Southeast Asia, doi:10.1016/j.lansea.2023.100167, Feb 2023
Retrospective 689 hospitalized patients in Indonesia, showing no significant difference in mortality with remdesivir treatment.
Gérard, Zhou, Wu, Kamo, Choi, Kim show increased risk of acute kidney injury, Leo, Briciu, Muntean, Petrov show increased risk of liver injury, and Negru, Cheng, Mohammed show increased risk of cardiac disorders 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 followup14. This may reflect
antiviral efficacy being offset by serious adverse effects of treatment.
Study covers remdesivir and favipiravir.
|
risk of death, 11.0% lower, HR 0.89, p = 0.84, adjusted per study, mild/moderate, multivariable, Cox proportional hazards.
|
|
risk of death, 24.0% lower, HR 0.76, p = 0.53, adjusted per study, severe, multivariable, Cox proportional hazards.
|
| Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates |
1.
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6.
Kim et al., Investigating the Safety Profile of Fast‐Track COVID‐19 Drugs Using the FDA Adverse Event Reporting System Database: A Comparative Observational Study, Pharmacoepidemiology and Drug Safety, doi:10.1002/pds.70043.
7.
Leo et al., Hepatocellular liver injury in hospitalized patients affected by COVID-19: Presence of different risk factors at different time points, Digestive and Liver Disease, doi:10.1016/j.dld.2021.12.014.
8.
Briciu et al., Evolving Clinical Manifestations and Outcomes in COVID-19 Patients: A Comparative Analysis of SARS-CoV-2 Variant Waves in a Romanian Hospital Setting, Pathogens, doi:10.3390/pathogens12121453.
9.
Muntean et al., Effects of COVID-19 on the Liver and Mortality in Patients with SARS-CoV-2 Pneumonia Caused by Delta and Non-Delta Variants: An Analysis in a Single Centre, Pharmaceuticals, doi:10.3390/ph17010003.
10.
Petrov et al., The Effect of Potentially Hepatotoxic Medicinal Products on Alanine Transaminase Levels in COVID-19 Patients: A Case–Control Study, Safety and Risk of Pharmacotherapy, doi:10.30895/2312-7821-2025-458.
11.
Negru et al., Comparative Pharmacovigilance Analysis of Approved and Repurposed Antivirals for COVID-19: Insights from EudraVigilance Data, Biomedicines, doi:10.3390/biomedicines13061387.
12.
Cheng et al., Cardiovascular Safety of COVID-19 Treatments: A Disproportionality Analysis of Adverse Event Reports from the WHO VigiBase, Infectious Diseases and Therapy, doi:10.1007/s40121-025-01225-z.
Hartantri et al., 9 Feb 2023, retrospective, Indonesia, peer-reviewed, 10 authors, study period 1 March, 2020 - 31 December, 2020.
Contact: b.alisjahbana@unpad.ac.id.
Clinical and treatment factors associated with the mortality of COVID-19 patients admitted to a referral hospital in Indonesia
The Lancet Regional Health - Southeast Asia, doi:10.1016/j.lansea.2023.100167
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Research in context Evidence before this study Before this study, we searched PubMed for articles that assessed factors associated with mortality in COVID-19 inpatients, using search terms ("COVID-19" OR "coronavirus") AND ("mortality" OR "death"), from March until April 2022. We found the mortality studies were mainly from China, America, and Europe that associated mortality with older age, male, and pre-existing comorbidities besides the severity of the disease itself. Indonesia had the second-highest total number of cases and deaths in South-East Asia. However, there were still limited studies and inadequate reliable data about COVID-19 mortality in Indonesia. Previously published studies in Indonesia reported a CFR of around 9.4% to 18%, associated with older age, male, pre-existing comorbidity, immediate ICU admission, and intubation. Laboratory parameters such as NLR, D-dimer, and lymphocyte count were also associated with a greater risk of overall mortality.
Added value of this study This study is a retrospective cohort study of hospitalized COVID-19 patients in a top referral hospital in Bandung of West Java, the largest province in Indonesia, during the first ten months of the epidemic. Our report is the most comprehensive mortality study in our region that analyzed the clinical characteristics, laboratory parameters, and treatments associated with survival outcomes. The case fatality rate of 14.9% was similar to previous..
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