Antiviral treatment could not provide clinical benefit in management of mild COVID-19: A Retrospective Experience from Field hospital

Natsuda Aumpan; Ratha-Korn Vilaichone; Sarita Ratana-Amornpin; Surat Teerakapibal; Pisanu Toochinda; Gasinee Witoonchart; Surapon Nitikraipot

doi:10.1016/j.jiph.2021.07.019

Antiviral treatment could not provide clinical benefit in management of mild COVID-19: A Retrospective Experience from Field hospital

J Infect Public Health. 2021 Sep;14(9):1206-1211. doi: 10.1016/j.jiph.2021.07.019. Epub 2021 Jul 31.

Authors

Natsuda Aumpan¹, Ratha-Korn Vilaichone², Sarita Ratana-Amornpin¹, Surat Teerakapibal³, Pisanu Toochinda⁴, Gasinee Witoonchart⁵, Surapon Nitikraipot⁶

Affiliations

¹ Center of Excellence in Digestive Diseases and Gastroenterology Unit, Department of Medicine, Thammasat University Hospital, Pathumthani, Thailand.
² Center of Excellence in Digestive Diseases and Gastroenterology Unit, Department of Medicine, Thammasat University Hospital, Pathumthani, Thailand; Chulabhorn International College of Medicine (CICM) at Thammasat University, Pathumthani, Thailand; Division of Gastroentero-Hepatology, Department of Internal Medicine, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia. Electronic address: Vilaichone@hotmail.co.th.
³ Thammasat Business School, Thammasat University, Bangkok, Thailand.
⁴ Sirindhorn International Institute of Technology, Thammasat University, Pathumthani, Thailand.
⁵ Rector of Thammasat University, Bangkok, Thailand.
⁶ Chairman of the Executive Committee, Thammasat University Hospital, Pathumthani, Thailand.

Abstract

Background: Coronavirus disease 2019 (COVID-19) has affected over 145 million infected people and 3 million deaths worldwide. There has been limited data to recommend either for or against use of antiviral regimens in mild COVID-19 patients. This study aimed to compare clinical outcomes between mild COVID-19 patients receiving antiviral drugs and those without.

Method: Thai patients diagnosed with COVID-19 at field hospital affiliated to Thammasat University Hospital, Thailand were evaluated between January 1, 2020 and April 13, 2021. Patients' data, clinical presentation, past medical history, laboratory results, and treatment outcomes were extensively reviewed.

Results: Five hundred patients with positive tests were included in the study. The mean age was 35.9 years; 46% males. There were 225 (45%), 207 (41.4%), 44 (8.8%), 18 (3.6%), 6 (1.2%) patients with asymptomatic, mild, moderate, severe, and critical COVID-19, respectively. Of 207 mild COVID-19 patients, 9 (4.3%) received lopinavir/ritonavir or darunavir/ritonavir, 17 (8.2%) received favipiravir, while 175 (84.5%) had only supportive care. Mild COVID-19 patients receiving antiviral treatment had longer median length of hospital stay [13 days (IQR 11-14) vs. 10 days (IQR 8-12), p < 0.001] than patients having only supportive treatment. Antiviral drug use was significantly associated with longer hospital stay (>10 days) in mild COVID-19 patients (OR 5.52; 95%CI 2.12-14.40, p < 0.001). Adverse drug reactions such as diarrhea, abdominal pain, and hepatitis were also demonstrated in our COVID-19 patients with antiviral treatments. Majority of patients (97.6%) recovered without any complications and were discharged home. Two deaths were caused by acute respiratory distress syndrome from severe COVID-19 pneumonia.

Conclusion: Antiviral treatment could not provide superior clinical outcomes to supportive care in mild COVID-19 patients. Mild COVID-19 patients receiving antiviral medication had longer length of hospital stay than those without. Standard supportive care and regular monitoring of disease progression might be keys for successful management of mild COVID-19.

Keywords: COVID-19; Darunavir-ritonavir; Lopinavir-ritonavir.

Publication types

Retracted Publication

MeSH terms

Adult
Antiviral Agents* / therapeutic use
COVID-19*
Female
Humans
Male
Mobile Health Units
Retrospective Studies
SARS-CoV-2
Treatment Outcome

Substances

Antiviral Agents