Composite Interventions on Outcomes of Severely and Critically Ill Patients with COVID-19 in Shanghai, China

{ 'indexed': {'date-parts': [[2024, 2, 15]], 'date-time': '2024-02-15T12:02:09Z', 'timestamp': 1707998529374}, 'reference-count': 31, 'publisher': 'MDPI AG', 'issue': '7', 'license': [ { 'start': { 'date-parts': [[2023, 7, 23]], 'date-time': '2023-07-23T00:00:00Z', 'timestamp': 1690070400000}, 'content-version': 'vor', 'delay-in-days': 0, 'URL': 'https://creativecommons.org/licenses/by/4.0/'}], 'funder': [ { 'DOI': '10.13039/501100001809', 'name': 'National Natural Science Foundation of China', 'doi-asserted-by': 'publisher', 'award': ['82127807']}, {'name': 'Shanghai Key Laboratory of Molecular Imaging', 'award': ['18DZ2260400']}, { 'name': 'Shanghai University of Medicine and Health Sciences Clinical Research Centre for ' 'Metabolic Vascular Diseases Project', 'award': ['20MC2020004']}, {'name': 'Science and Technology Commission of Jiading District', 'award': ['JDKW-2021-0022']}], 'content-domain': {'domain': [], 'crossmark-restriction': False}, 'abstract': '<jats:p>Background: The sixty-day effects of initial composite interventions for the ' 'treatment of severely and critically ill patients with COVID-19 are not fully assessed. ' 'Methods: Using a Bayesian piecewise exponential model, we analyzed the 60-day mortality, ' 'health-related quality of life (HRQoL), and disability in 1082 severely and critically ill ' 'patients with COVID-19 between 8 December 2022 and 9 February 2023 in Shanghai, China. The ' 'final 60-day follow-up was completed on 10 April 2023. Results: Among 1082 patients (mean ' 'age, 78.0 years, 421 [38.9%] women), 139 patients (12.9%) died within 60 days. Azvudine had a ' '99.8% probability of improving 2-month survival (adjusted HR, 0.44 [95% credible interval, ' '0.24–0.79]), and Paxlovid had a 91.9% probability of improving 2-month survival (adjusted HR, ' '0.71 [95% credible interval, 0.44–1.14]) compared with the control. IL-6 receptor antagonist, ' 'baricitinib and a-thymosin each had a high probability of benefit (99.5%, 99.4%, and 97.5%, ' 'respectively) compared to their controls, while the probability of trail-defined statistical ' 'futility (HR &gt; 0.83) was high for therapeutic anticoagulation (99.8%; HR, 1.64 [95% CrI, ' '1.06–2.50]) and glucocorticoid (91.4%; HR, 1.20 [95% CrI, 0.71–2.16]). Paxlovid, Azvudine, ' 'and therapeutic anticoagulation showed a significant reduction in disability (p &lt; 0.05) ' 'Conclusions: Among severely and critically ill patients with COVID-19 who received 1 or more ' 'therapeutic interventions, treatment with Azvudine had a high probability of improved 60-day ' 'mortality compared with the control, indicating its potential in a resource-limited scenario. ' 'Treatment with an IL-6 receptor antagonist, baricitinib, and a-thymosin also had high ' 'probabilities of benefit in improving 2-month survival, among which a-thymosin could improve ' 'HRQoL. Treatment with Paxlovid, Azvudine, and therapeutic anticoagulation could significantly ' 'reduce disability at day 60.</jats:p>', 'DOI': '10.3390/microorganisms11071859', 'type': 'journal-article', 'created': {'date-parts': [[2023, 7, 24]], 'date-time': '2023-07-24T05:08:11Z', 'timestamp': 1690175291000}, 'page': '1859', 'source': 'Crossref', 'is-referenced-by-count': 1, 'title': 'Composite Interventions on Outcomes of Severely and Critically Ill Patients with COVID-19 in ' 'Shanghai, China', 'prefix': '10.3390', 'volume': '11', 'author': [ { 'ORCID': 'http://orcid.org/0000-0001-6345-5350', 'authenticated-orcid': False, 'given': 'Jiasheng', 'family': 'Shao', 'sequence': 'first', 'affiliation': [ { 'name': 'Department of Immunology and Rheumatology, Jiading District ' 'Central Hospital Affiliated Shanghai University of Medicine & ' 'Health Sciences, Shanghai 201899, China'}, { 'name': 'Tulane National Primate Research Center, Tulane University ' 'School of Medicine, 18703 Three Rivers Road, Covington, LA ' '70433, USA'}]}, { 'ORCID': 'http://orcid.org/0000-0002-0814-0548', 'authenticated-orcid': False, 'given': 'Rong', 'family': 'Fan', 'sequence': 'additional', 'affiliation': [ { 'name': 'Tulane National Primate Research Center, Tulane University ' 'School of Medicine, 18703 Three Rivers Road, Covington, LA ' '70433, USA'}, { 'name': 'Genomics, Biotechnology Center, Center for Molecular and ' 'Cellular Bioengineering, Technische Universität, 01307 Dresden, ' 'Germany'}]}, { 'given': 'Chengnan', 'family': 'Guo', 'sequence': 'additional', 'affiliation': [ { 'name': 'Shanghai Institute of Infectious Disease and Biosecurity, School ' 'of Public Health, Fudan University, Shanghai 200032, China'}]}, { 'given': 'Xuyuan', 'family': 'Huang', 'sequence': 'additional', 'affiliation': [ { 'name': 'Department of Urology, Renji Hospital, Shanghai JiaoTong ' 'University, Shanghai 200127, China'}]}, { 'given': 'Runsheng', 'family': 'Guo', 'sequence': 'additional', 'affiliation': [ { 'name': 'Department of General Surgery, Jiading District Central Hospital ' 'Affiliated Shanghai University of Medicine & Health Sciences, ' 'Shanghai 201899, China'}]}, { 'given': 'Fengdi', 'family': 'Zhang', 'sequence': 'additional', 'affiliation': [ { 'name': 'Department of Infectious Disease, Shanghai East Hospital, Tongji ' 'University School of Medicine, Shanghai 200120, China'}]}, { 'given': 'Jianrong', 'family': 'Hu', 'sequence': 'additional', 'affiliation': [ { 'name': 'Department of Respiratory Medicine, Jiading District Central ' 'Hospital Affiliated Shanghai University of Medicine & Health ' 'Sciences, Shanghai 201899, China'}]}, { 'given': 'Gang', 'family': 'Huang', 'sequence': 'additional', 'affiliation': [ { 'name': 'Shanghai Key Laboratory of Molecular Imaging, Shanghai ' 'University of Medicine and Health Sciences, Shanghai 201318, ' 'China'}]}, { 'given': 'Liou', 'family': 'Cao', 'sequence': 'additional', 'affiliation': [ { 'name': 'Department of Nephrology, Molecular Cell Lab for Kidney Disease, ' 'Shanghai Peritoneal Dialysis Research Center, Ren Ji Hospital, ' 'Uremia Diagnosis and Treatment Center, Shanghai Jiao Tong ' 'University School of Medicine, Shanghai 200127, China'}]}], 'member': '1968', 'published-online': {'date-parts': [[2023, 7, 23]]}, 'reference': [ { 'key': 'ref_1', 'doi-asserted-by': 'crossref', 'first-page': 'e13956', 'DOI': '10.1111/eci.13956', 'article-title': 'Estimates of COVID-19 deaths in Mainland China after abandoning zero ' 'COVID policy', 'volume': '53', 'author': 'Ioannidis', 'year': '2023', 'journal-title': 'Eur. 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