Early experimental COVID-19 therapies: associations with length of hospital stay, mortality and related costs

{ 'indexed': {'date-parts': [[2024, 2, 9]], 'date-time': '2024-02-09T07:31:20Z', 'timestamp': 1707463880067}, 'reference-count': 0, 'publisher': 'SMW Supporting Association', 'issue': '5153', 'license': [ { 'start': { 'date-parts': [[2020, 12, 31]], 'date-time': '2020-12-31T00:00:00Z', 'timestamp': 1609372800000}, 'content-version': 'unspecified', 'delay-in-days': 0, 'URL': 'https://creativecommons.org/licenses/by-nc-sa/4.0'}], 'content-domain': {'domain': [], 'crossmark-restriction': False}, 'abstract': '<jats:p>AIMS OF THE STUDY\n' ' Hydroxychloroquine and lopinavir/ritonavir have been used as experimental therapies ' 'to treat COVID-19 during the first wave of the pandemic. Randomised controlled trials have ' 'recently shown that there are no meaningful benefits of these two therapies in hospitalised ' 'patients. Uncertainty remains regarding the potential harmful impact of these therapies as ' 'very early treatments and their burden to the health care system. The present study ' 'investigated the length of hospital stay (LOS), mortality, and costs of hydroxychloroquine, ' 'lopinavir/ritonavir or their combination in comparison with standard of care among patients ' 'hospitalised for coronavirus disease 2019 (COVID-19).\n' ' \n' ' \n' ' METHODS\n' ' This retrospective observational cohort study took place in the Geneva University ' 'Hospitals, Geneva, Switzerland (n = 840) between 26 February and 31 May 2020. Demographics, ' 'treatment regimens, comorbidities, the modified National Early Warning Score (mNEWS) on ' 'admission, and contraindications to COVID-19 treatment options were assessed. Outcomes ' 'included LOS, in-hospital mortality, and drug and LOS costs.\n' ' \n' ' \n' ' RESULTS\n' ' After successful propensity score matching, patients treated with (1) ' 'hydroxychloroquine, (2) lopinavir/ritonavir or (3) their combination had on average 3.75 ' 'additional hospitalisation days (95% confidence interval [CI] 1.37–6.12, p = 0.002), 1.23 ' 'additional hospitalisation days (95% CI −1.24 – 3.51, p = 0.319), and 4.19 additional ' 'hospitalisation days (95% CI 1.52–5.31, p &lt;0.001), respectively, compared with patients ' 'treated with the standard of care. Neither experimental therapy was significantly associated ' 'with mortality. These additional hospital days amounted to 1010.77 additional days for ' 'hydroxychloroquine and hydroxychloroquine combined with lopinavir/ritonavir, resulting in an ' 'additional cost of US$ 2,492,214 (95%CI US$ 916,839–3,450,619).\n' ' \n' ' \n' ' CONCLUSIONS\n' ' Prescribing experimental therapies for COVID-19 was not associated with a reduced ' 'LOS and might have increased the pressure put on healthcare systems.</jats:p>', 'DOI': '10.4414/smw.2020.20446', 'type': 'journal-article', 'created': { 'date-parts': [[2020, 12, 31]], 'date-time': '2020-12-31T16:40:38Z', 'timestamp': 1609432838000}, 'page': 'w20446', 'source': 'Crossref', 'is-referenced-by-count': 20, 'title': 'Early experimental COVID-19 therapies: associations with length of hospital stay, mortality and ' 'related costs', 'prefix': '10.57187', 'volume': '150', 'author': [ {'given': 'Nathalie', 'family': 'Vernaz', 'sequence': 'first', 'affiliation': []}, {'given': 'Thomas', 'family': 'Agoritsas', 'sequence': 'additional', 'affiliation': []}, {'given': 'Alexandra', 'family': 'Calmy', 'sequence': 'additional', 'affiliation': []}, {'given': 'Angèle', 'family': 'Gayet-Ageron', 'sequence': 'additional', 'affiliation': []}, {'given': 'Gabriel', 'family': 'Gold', 'sequence': 'additional', 'affiliation': []}, {'given': 'Arnaud', 'family': 'Perrier', 'sequence': 'additional', 'affiliation': []}, {'given': 'Fabienne', 'family': 'Picard', 'sequence': 'additional', 'affiliation': []}, {'given': 'Virginie', 'family': 'Prendki', 'sequence': 'additional', 'affiliation': []}, {'given': 'Jean-Luc', 'family': 'Reny', 'sequence': 'additional', 'affiliation': []}, {'given': 'Caroline', 'family': 'Samer', 'sequence': 'additional', 'affiliation': []}, {'given': 'Jérôme', 'family': 'Stirnemann', 'sequence': 'additional', 'affiliation': []}, {'given': 'Pauline', 'family': 'Vetter', 'sequence': 'additional', 'affiliation': []}, {'given': 'Marie-Céline', 'family': 'Zanella', 'sequence': 'additional', 'affiliation': []}, {'given': 'Dina', 'family': 'Zekry', 'sequence': 'additional', 'affiliation': []}, {'given': 'Stéphanie', 'family': 'Baggio', 'sequence': 'additional', 'affiliation': []}], 'member': '36756', 'published-online': {'date-parts': [[2020, 12, 31]]}, 'container-title': 'Swiss Medical Weekly', 'original-title': [], 'link': [ { 'URL': 'https://smw.ch/index.php/smw/article/download/2919/4793', 'content-type': 'application/pdf', 'content-version': 'vor', 'intended-application': 'text-mining'}, { 'URL': 'https://smw.ch/index.php/smw/article/download/2919/4794', 'content-type': 'text/html', 'content-version': 'vor', 'intended-application': 'text-mining'}, { 'URL': 'https://smw.ch/index.php/smw/article/download/2919/4794', 'content-type': 'unspecified', 'content-version': 'vor', 'intended-application': 'similarity-checking'}], 'deposited': { 'date-parts': [[2023, 1, 26]], 'date-time': '2023-01-26T22:38:25Z', 'timestamp': 1674772705000}, 'score': 1, 'resource': {'primary': {'URL': 'https://smw.ch/index.php/smw/article/view/2919'}}, 'subtitle': [], 'short-title': [], 'issued': {'date-parts': [[2020, 12, 31]]}, 'references-count': 0, 'journal-issue': {'issue': '5153', 'published-online': {'date-parts': [[2020, 12, 14]]}}, 'URL': 'http://dx.doi.org/10.4414/smw.2020.20446', 'relation': {}, 'ISSN': ['1424-3997'], 'subject': ['General Medicine'], 'container-title-short': 'Swiss Med Wkly', 'published': {'date-parts': [[2020, 12, 31]]}}