Therapeutic agents tested in 238 COVID-19 hospitalized patients and their relationship with mortality

Med Clin (Barc). 2020 Nov 13;155(9):375-381. doi: 10.1016/j.medcli.2020.06.025. Epub 2020 Jul 9.
[Article in English, Spanish]

Abstract

Background and objectives: In the last months great efforts have been developed to evaluate the more efficient therapeutic agents in the management of patients with COVID-19. Currently, no specific drug combination has consistently demonstrated an association with mortality. The aim of this study was to assess the pattern of associations observed between the different in-hospital treatments administered to a series of 238 patients admitted for COVID-19 and their relationship with mortality.

Methods: The electronic medical records of patients that discharged or died from COVID-19 in the Hospital Universitario San Cecilio (Granada, Spain) between March 16 and April 10, 2020 were analysed. From these records, information was obtained on sex, age, comorbidities at admission, clinical information, analytical parameters, imaging tests and empirical treatments used. The outcome variable was the in-hospital mortality. To estimate the associations between the different therapeutic alternatives and the risk of mortality, hazard ratios adjusted for age, sex, previous pathologies and severity at discharge were estimated using Cox regression models.

Results: The most frequently used combination of drugs was low molecular weight heparins, hydroxychloroquine, and ritonavir/lopinavir. None of the analysed treatments showed independent association with mortality. The drugs that showed a greater inverse association with mortality were tocilizumab and corticoids.

Conclusions: The observed association patterns are consistent with previous literature. It seems necessary to design randomized controlled clinical trials that evaluate the possible protector effect of tocilizumab and corticoids in the risk of mortality for some subgroups of COVID-19 hospitalized patients.

Keywords: COVID; Hospitalizados; Hospitalized; Mortalidad; Mortality; SARS-CoV-2; Tratamientos; Treatments.

MeSH terms

  • Adrenal Cortex Hormones / therapeutic use
  • Angiotensin II Type 1 Receptor Blockers / therapeutic use
  • Angiotensin-Converting Enzyme Inhibitors / therapeutic use
  • Antibodies, Monoclonal, Humanized / therapeutic use
  • Antiviral Agents / therapeutic use
  • Azithromycin / therapeutic use
  • Betacoronavirus* / drug effects
  • COVID-19
  • COVID-19 Drug Treatment
  • Comorbidity
  • Coronavirus Infections / drug therapy*
  • Coronavirus Infections / mortality
  • Drug Therapy, Combination
  • Female
  • Humans
  • Hydroxychloroquine / therapeutic use
  • Inpatients / statistics & numerical data
  • Lopinavir / therapeutic use
  • Male
  • Pandemics
  • Pneumonia, Viral / drug therapy*
  • Pneumonia, Viral / mortality
  • Proportional Hazards Models
  • Retrospective Studies
  • Ritonavir / therapeutic use
  • SARS-CoV-2
  • Spain
  • Treatment Outcome

Substances

  • Adrenal Cortex Hormones
  • Angiotensin II Type 1 Receptor Blockers
  • Angiotensin-Converting Enzyme Inhibitors
  • Antibodies, Monoclonal, Humanized
  • Antiviral Agents
  • Lopinavir
  • Hydroxychloroquine
  • Azithromycin
  • tocilizumab
  • Ritonavir