Physiopathology. 2022 Mar 7;29(1):92-105. doi: 10.3390/pathophysiology29010009.

ABSTRACT

The clinical manifestations associated with COVID-19 disease are mainly due to a dysregulated host response related to the overexpression of inflammatory markers. Until recently, only remdesivir had obtained FDA approval for hospitalized patients with COVID-19 and there are currently no evidence-based treatment options or options for the prevention of complications that have been established. Certain medical treatments such as antivirals, antibacterials, antithrombotics, antipyretics, corticosteroids, interleukin inhibitors, monoclonal antibodies, convalescent plasma, immunostimulants and vitamin supplements have been used. However, there is limited data to support their effectiveness. Therefore, this study was attempted to identify and assess the efficacy of antibacterials and antivirals used for COVID-19 using a retrospective cross-sectional approach based on medical records of adult patients at four hospitals. The number of antibacterials was calculated in defined daily dose (DDD) per unit of 100 bed-days. Mixed logit regression and analysis of covariance were used to determine the effectiveness of the above agents in relation to COVID-19 outcomes and patient length of stay. The model was weighted accordingly and covariates (eg, age) were taken into account in the model. Heart disease was found to be the most common preexisting condition of patients hospitalized with COVID-19 in this study. Azithromycin, a Watch Category List antibacterial, was widely used (33-65 DDD per 100 bed-days). Oseltamivir, an FDA-approved antiviral for influenza, was the most prescribed antiviral. Additionally, favipiravir has been shown to be an important factor in improving outcomes for patients with COVID-19 and reducing their length of stay. This study strongly suggests that COVID-19 patients received polypharmacy for their treatment. However, most of the drugs used did not reach statistical significance in improving the condition of the patients or decreasing the length of stay. Further studies supporting drug use are needed.

PMID:35366292 | DO I:10.3390/pathophysiology29010009