An analytical study of drug utilization, disease progression, and adverse events among 165 COVID-19 patients

Feng Sun; Hao Kou; Shengfeng Wang; Yun Lu; Houyu Zhao; Wenjing Li; Qingxin Zhou; Qiaoli Jiang; Yinchu Cheng; Kun Yang; Lin Zhuo; Yang Xu; Dongfang Wu; Siyan Zhan; Hong Cheng

doi:10.21037/atm-20-4960

An analytical study of drug utilization, disease progression, and adverse events among 165 COVID-19 patients

Ann Transl Med. 2021 Feb;9(4):306. doi: 10.21037/atm-20-4960.

Authors

Feng Sun^{1

2}, Hao Kou¹, Shengfeng Wang², Yun Lu¹, Houyu Zhao², Wenjing Li¹, Qingxin Zhou², Qiaoli Jiang¹, Yinchu Cheng³, Kun Yang¹, Lin Zhuo⁴, Yang Xu⁵, Dongfang Wu¹, Siyan Zhan^{2

4}, Hong Cheng¹

Affiliations

¹ Department of Pharmacy, Zhongnan Hospital of Wuhan University, Wuhan, China.
² Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China.
³ Department of Pharmacy, Peking University Third Hospital, Beijing, China.
⁴ Research Center of Clinical Epidemiology, Peking University Third Hospital, Beijing, China.
⁵ Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden.

Abstract

Background: The coronavirus disease 2019 (COVID-19) epidemic has lasted for nearly 4 months by this study was conducted. We aimed to describe drug utilization, disease progression, and adverse drug events of COVID-19.

Methods: A retrospective, single-center case series study enrolled 165 consecutive hospitalized COVID-19 patients who were followed up until March 25, 2020, from a designated hospital in Wuhan. Patients were grouped by a baseline degree of severity: non-severe and severe. An analytical study of drug utilization, disease progression, and adverse events (AEs) of COVID-19 was conducted.

Results: Of the 165 COVID-19 cases, antivirals, antibacterials, glucocorticoids, and traditional Chinese medicine (TCM) were administered to 92.7%, 98.8%, 68.5%, and 55.2% of patients, respectively. The total kinds of drugs administered to the severe subgroup [26, interquartile range (IQR) 18-39] were 11 more than the non-severe subgroup (15, IQR 10-24), regardless of comorbidities. The 2 most common combinations of medications in the 165 cases were 'antiviral therapy + glucocorticoids + TCM' (81, 49.1%) and 'antiviral therapy + glucocorticoids' (23, 13.9%). Compared with non-severe cases, severe cases received more glucocorticoids (88.5% vs. 66.2%, P=0.02), but less TCM (50.0% vs. 63.3%, P=0.20), and suffered a higher percentage of death (34.6% vs. 7.2%, P=0.001). At the end of the follow-up, 130 (78.8%) patients had been discharged, and 24 (14.5%) died. There were 13 patients (7.9%) who had elevated liver enzymes, and 49 patients (29.7%) presented with worsening kidney function during the follow-up.

Conclusions: Of the 165 COVID-19 patients, the fatality rate remained high (14.5%). Drug utilization for COVID-19 was diverse and generally complied with the existing guidelines. Combination regimens containing antiviral drugs might be beneficial to assist COVID-19 recovery. Additionally, liver and kidney AEs should not be ignored.

Keywords: Novel coronavirus disease (COVID-19); adverse events (AEs); disease progression; drug utilization; fatality.