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Clinical and treatment factors associated with the mortality of COVID-19 patients admitted to a referral hospital in Indonesia

Hartantri et al., The Lancet Regional Health - Southeast Asia, doi:10.1016/j.lansea.2023.100167
Feb 2023  
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Mortality, mild/moderate 11% Improvement Relative Risk Mortality, severe 24% Remdesivir  Hartantri et al.  LATE TREATMENT Is late treatment with remdesivir beneficial for COVID-19? Retrospective study in Indonesia (March - December 2020) No significant difference in mortality c19early.org Hartantri et al., The Lancet Regional .., Feb 2023 Favorsremdesivir Favorscontrol 0 0.5 1 1.5 2+
Retrospective 689 hospitalized patients in Indonesia, showing no significant difference in mortality with remdesivir treatment.
Gérard, Zhou, Wu, Kamo, Choi 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 followup6. 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 November 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, 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
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.
This PaperRemdesivirAll
Clinical and treatment factors associated with the mortality of COVID-19 patients admitted to a referral hospital in Indonesia
Yovita Hartantri, Josephine Debora, Leonardus Widyatmoko, Gezy Giwangkancana, Hendarsyah Suryadinata, Evan Susandi, Elisabeth Hutajulu, Assica Permata Amalya Hakiman, Yesy Pusparini, Bachti Alisjahbana
The Lancet Regional Health - Southeast Asia, doi:10.1016/j.lansea.2023.100167
This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.
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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Late treatment
is less effective
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