COVID-19 related treatment and outcomes among COVID-19 ICU patients: A retrospective cohort study

Abdullah Assiri; Mir J Iqbal; Atheer Mohammed; Abdulrhman Alsaleh; Ahmed Assiri; Adeeb Noor; Redhwan Nour; Moteb Khobrani

doi:10.1016/j.jiph.2021.08.030

COVID-19 related treatment and outcomes among COVID-19 ICU patients: A retrospective cohort study

J Infect Public Health. 2021 Sep;14(9):1274-1278. doi: 10.1016/j.jiph.2021.08.030. Epub 2021 Aug 28.

Authors

Abdullah Assiri¹, Mir J Iqbal², Atheer Mohammed², Abdulrhman Alsaleh², Ahmed Assiri³, Adeeb Noor⁴, Redhwan Nour⁵, Moteb Khobrani²

Affiliations

¹ Department of Clinical Pharmacy, College of Pharmacy, King Khalid University, Abha 62529, Saudi Arabia. Electronic address: aalabdullah@kku.edu.sa.
² Department of Clinical Pharmacy, College of Pharmacy, King Khalid University, Abha 62529, Saudi Arabia.
³ Department of Pharmacy Services, Asir Central Hospital, Abha 62529, Saudi Arabia.
⁴ Department of Information Technology, Faculty of Computing and Information Technology, King Abdulaziz University, Jeddah 80221, Saudi Arabia.
⁵ Department of Computer Science, Taibah University, Medina 42353, Saudi Arabia.

Abstract

Background: The COVID-19 pandemic remains an immediate and present concern, yet as of now there is still no approved therapeutic available for the treatment of COVID-19.This study aimed to investigate and report evidence concerning demographic characteristics and currently-used medications that contribute to the ultimate outcomes of COVID-19 ICU patients.

Methods: A retrospective cohort study was conducted among all COVID-19 patients in the Intensive Care Unit (ICU) of Asir Central Hospital in Saudi Arabia between the 1st and 30th of June 2020. Data extracted from patients' medical records included their demographics, home medications, medications used to treat COVID-19, treatment durations, ICU stay, hospital stay, and ultimate outcome (recovery or death).Descriptive statistics and regression modelling were used to analyze and compare the results. The study was approved by the Institutional Ethics Committees at both Asir Central Hospital and King Khalid University.

Results: A total of 118 patients with median age of 57 years having definite clinical and disease outcomes were included in the study. Male patients accounted for 87% of the study population, and more than 65% experienced at least one comorbidity. The mean hospital and ICU stay was 11.4 and 9.8 days, respectively. The most common drugs used were tocilizumab (31.4%), triple combination therapy (45.8%), favipiravir (56.8%), dexamethasone (86.7%), and enoxaparin (83%). Treatment with enoxaparin significantly reduced the length of ICU stay (p = 0.04) and was found to be associated with mortality reduction in patients aged 50-75 (p = 0.03), whereas the triple regimen therapy and tocilizumab significantly increased the length of ICU stay in all patients (p = 0.01, p = 0.02 respectively).

Conclusion: COVID-19 tends to affect males more significantly than females. The use of enoxaparin is an important part of COVID-19 treatment, especially for those above 50 years of age, while the use of triple combination therapy and tocilizumab in COVID-19 protocols should be reevaluated and restricted to patients who have high likelihood of benefit.

Keywords: COVID-16; ICU patients; Mortality; Outcome; Treatment.

MeSH terms

COVID-19 Drug Treatment*
Female
Humans
Intensive Care Units
Male
Middle Aged
Pandemics
Retrospective Studies
SARS-CoV-2
Treatment Outcome