Efficacy of Various Treatment Modalities on Patient-related Outcome in Hospitalized COVID-19 Patients – A Retrospective Study
Siraj et al., Indian Journal of Clinical Practice, 32:9
Siraj et al., Efficacy of Various Treatment Modalities on Patient-related Outcome in Hospitalized COVID-19 Patients – A.., Indian Journal of Clinical Practice, 32:9
Retrospective 1,000 COVID+ hospitalized patients in India, showing lower mortality with famotidine and remdesivir in multivariable logistic regression.[Gérard, Wu, Zhou] show significantly increased risk of acute kidney injury with remdesivir.
risk of death, 52.9% lower, RR 0.47, p < 0.001, treatment 108 of 413 (26.2%), control 197 of 587 (33.6%), adjusted per study, inverted to make RR<1 favor treatment, odds ratio converted to relative risk, multivariable.
Abstract: ORIGINAL RESEARCH
Efficacy of Various Treatment Modalities
on Patient-related Outcome in Hospitalized
COVID-19 Patients – A Retrospective Study
FARHANA SIRAJ*, NAZIA MEHFOOZ†, SUHAIL MANTOO*, AFSHAN SHABIR‡, TAJAMUL HUSSAIN#, SYED MUDASIR QADRI¥, UMAR HAFIZ£,
AJAZ NABI KOUL§, MUSHTAQ DANGROO¶, MUZAFFAR BINDROO^, FAYAZ SOFI⇑, SONAULLAH SHAHψ, RAFI JANφ
Abstract
Background: The outbreak of coronavirus disease 2019 (COVID-19) caused by novel severe acute respiratory syndrome
coronavirus 2 (SARS-CoV-2) began in China, in December 2019, and was declared a pandemic by WHO on March 11, 2020.
The treatment is evolving and is mostly supportive in nature. Material and methods: This was a single-center retrospective
study that included confirmed COVID-19 cases treated at our institute (a tertiary care hospital in Jammu and Kashmir, India),
between March 2020 and December 2020. Patients with age more than 18 years were included in the study. Results: On
evaluating the effect of various drug therapies used in management of COVID-19 patients of all severity, use of remdesivir
and famotidine was associated with significantly higher odds of survival. In subgroup of patients with severe disease, use
of systemic steroids was associated with significantly higher odds of survival in addition to remdesivir and famotidine. In
patients with severe COVID-19 illness, likelihood of survival was significantly higher in those who received combination of
systemic steroids plus remdesivir compared to steroids and remdesivir alone. Conclusion: Steroids were effective in severe
COVID-19 illness and the combination of steroids and remdesivir was more effective in severe illness. There is a need to
undertake more large scale prospective randomized trials to determine the most effective drug therapies to treat the sick
patients and prevent worsening of mild cases.
Keywords: Pandemic, COVID-19 illness, SARS-CoV-2, severe COVID-19
T
he outbreak of coronavirus disease 2019
(COVID-19) caused by novel severe acute
respiratory syndrome coronavirus 2 (SARS‑
CoV-2) began in Wuhan, China, in December 2019
and was designated as a pandemic by the World
*Assistant Professor, Dept. of Internal Medicine
†Assistant Professor, Dept. of Pulmonary Medicine
‡Assistant Professor, Dept. of Geriatrics
#Senior Resident, Dept. of Pulmonary Medicine
¥Associate Professor, Dept. of Internal Medicine
£Associate Professor, Dept. of Geriatrics
§Additional Professor, Dept. of Internal Medicine
^Assistant Professor
¶Additional Professor
⇑Professor
Dept. of Rheumatology
ψProfessor
φProfessor and Head
Dept. of Pulmonary Medicine, SK Institute of Medical Sciences, Soura, Srinagar, J&K
Address for correspondence
Dr Farhana Siraj
Assistant Professor, Dept. of Internal Medicine, SK Institute of Medical Sciences,
Srinagar -190 011, J&K
E-mail: bagdadifarhana6@gmail.com
Health Organization (WHO) on March 11, 2020.1,2 The
spectrum of COVID-19 ranges from asymptomatic
infection to mild respiratory tract illness to severe
pneumonia, acute respiratory distress syndrome (ARDS),
multiorgan failure and death.3 A number of clinical
trials have evaluated different treatment modalities
in the management of COVID-19 illness and many
more are under way, primarily assessing the clinical
outcome in terms of accelerating the viral clearance,
reduction in duration of symptoms, progression of
disease, need for mechanical ventilation and mortality.4,5
Only few of these treatment interventions have shown
significant..
Late treatment is less effective
siraj
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