Azvudine efficacy in reducing mortality in COVID-19 patients
Zhen Zhong, Xiao-Feng Liu, Xiao-Zhong Zhou, Jia-Ning Zhong, Li-Cheng Zhou, Rong Li, Xian-Fa Liu
European Journal of Medical Research, doi:10.1186/s40001-024-02220-9
Background Several therapeutic drugs have been authorized for the treatment of patients with Coronavirus disease 2019 . However, further research on the mechanisms of action, efficacy, and target populations of these novel therapeutic drugs are necessary. This study included mild, moderate, severe, and critical COVID-19 patients to evaluate azvudine's effectiveness across different severity levels.
Methods We conducted a retrospective cohort study of patients with COVID-19 admitted to our hospital from December 1, 2022, to March 31, 2023. Patients were divided into retrospective cohorts receiving azvudine antiviral therapy and standard treatment, and were followed-up for up to 28 days.
Results Prior to data processing, azvudine treatment was associated with reduced mortality rates at 7 days (1.09/1000 persons vs. 5.06/1000 persons, P < 0.001) and 14 days (3.35/1000 persons vs. 5.65/1000 persons, P = 0.001). After propensity score matching, a decrease in mortality rates at 7 days (0.8/1000 persons vs. 6.29/1000 persons, P < 0.001), 14 days (3.42/1000 persons vs. 7.26/1000 persons, P < 0.001), and 28 days (4.33/1000 persons vs. 7.29/1000 persons, P = 0.003) were observed following azvudine treatment. After inverse probability of treatment weighting adjustment, the results were consistent with propensity score matching. In the clinical subgroup analysis, azvudine treatment intervention significantly reduced the 7-day (2.49/1000 persons vs. 14.59/1000 persons, P = 0.001 and 11.36/1000 persons vs. 66.99/1000 persons, P < 0.001), 14-day (5.22/1000 persons vs. 17.36/1000 persons, P < 0.001 and 17.08/1000 persons vs. 51.72/1000 persons, P = 0.002), and 28-day (7.58/1000 persons vs. 16.02/1000 persons, P = 0.014 and 20.43/1000 persons vs. 46.51/1000 persons, P = 0.008) mortality rates in hospitalized patients with severe and critical COVID-19.
Conclusions The study suggests that in hospitalized patients with COVID-19, azvudine treatment significantly reduces patient mortality rates in hospitalized COVID-19 infections, wherein the effects are more pronounced in severe and critical patients.
Abbreviations
Supplementary Information The online version contains supplementary material available at https:// doi . org/ 10. 1186/ s40001-024-02220-9. Additional file 1
Author contributions XianfaL and JZ designed the experiments. XiaoL was responsible for clinical assessment of patients. LZ, XZ, LR, and ZZ collected the data. JZ was responsible for data management. JZ and ZZ conducted the statistical analysis. This article was written by ZZ, and reviewed by XianfaL. All the authors have reviewed and approved of the final manuscript.
Declarations Ethics approval and consent to participate There was no direct patient involvement in the conception, design, or implementation of this study. The requirement for patient consent was waived for
Competing interests The authors declare no competing interests.
Publisher's Note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
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'label': 'First Online',
'group': {'name': 'ArticleHistory', 'label': 'Article History'}},
{'order': 1, 'name': 'Ethics', 'group': {'name': 'EthicsHeading', 'label': 'Declarations'}},
{ 'value': 'There was no direct patient involvement in the conception, design, or '
'implementation of this study. The requirement for patient consent was waived '
'for this retrospective study, which utilized data from electronic medical '
'records. This study was approved by the Ethics Committee of the First '
'Affiliated Hospital of the Gannan Medical University Hospital (LLSL-2024065).',
'order': 2,
'name': 'Ethics',
'group': {'name': 'EthicsHeading', 'label': 'Ethics approval and consent to participate'}},
{ 'value': 'Not applicable.',
'order': 3,
'name': 'Ethics',
'group': {'name': 'EthicsHeading', 'label': 'Consent for publication'}},
{ 'value': 'The authors declare no competing interests.',
'order': 4,
'name': 'Ethics',
'group': {'name': 'EthicsHeading', 'label': 'Competing interests'}}],
'article-number': '625'}