Analyzing the Difference in the Length of Stay (LOS) in Moderate to Severe COVID-19 Patients Receiving Hydroxychloroquine or Favipiravir

{ 'indexed': { 'date-parts': [[2022, 11, 25]], 'date-time': '2022-11-25T06:13:11Z', 'timestamp': 1669356791483}, 'reference-count': 40, 'publisher': 'MDPI AG', 'issue': '12', 'license': [ { 'start': { 'date-parts': [[2022, 11, 24]], 'date-time': '2022-11-24T00:00:00Z', 'timestamp': 1669248000000}, 'content-version': 'vor', 'delay-in-days': 0, 'URL': 'https://creativecommons.org/licenses/by/4.0/'}], 'funder': [{'name': 'Princess Nourah bint Abdulrahman University', 'award': ['PNURSP2022R299']}], 'content-domain': {'domain': [], 'crossmark-restriction': False}, 'abstract': '<jats:p>Background: The coronavirus 2019 (COVID-19) disease, caused by the severe acute ' 'respiratory syndrome coronavirus 2 (SARS-CoV-2) virus led to a global pandemic. HCQ and FPV ' 'were used early in the pandemic as a treatment modality for COVID-19. Various studies ' 'evaluated the HCQ and FPV effectiveness, based on the mortality endpoint and showed ' 'conflicting results. We hypothesize that analyzing the difference in the LOS as a significant ' 'endpoint would be of a major interest, especially for healthcare providers, to prevent a ' 'lengthy hospitalization and disease progression. Methods: This is a retrospective ' 'observational study, conducted via a medical chart review of COVD-19 patients who were ' 'admitted between April 2020 and March 2021 with a moderate to severe illness. The LOS ' 'endpoint was tested using the paired Wilcoxon signed-rank (WSR) model. Prior to using the WSR ' 'model, the balance between the HCQ and FPV groups, the propensity score matching, the LOS ' 'distribution, and the normality assumptions were tested. Two sensitivity statistical analyses ' 'were conducted to confirm the results (stratified log-rank test and U Welch test after ' 'transforming the LOS by the squared root values). Results: A total of 200 patients were ' 'included for the analysis: 83 patients in the HCQ group and 117 patients in the FPV group. ' 'Thirty-seven patients were matched in each group. The LOS data was positively skewed and ' 'violated the normality (Shapiro–Wilk p &lt; 0.001) and had an unequal variance (Levene’s ' 'test, p = 0.019). The WSR test showed no statistical significance in the LOS endpoint, with a ' 'median of −0.75 days (95% confidence interval: −4.0 to 2.5, p = 0.629), in favor of the HCQ ' 'group (four days), in comparison to seven days of the FPV group. The WSR findings were ' 'further confirmed with the stratified log rank test (p = 740) and the U Welch test (p = 391). ' 'Conclusions: The study concluded that the HCQ and FPV treatments have a comparable ' 'effectiveness in terms of the LOS in the moderate to severe COVID-19 patients. This study ' 'highlights the importance of analyzing the LOS as a relevant endpoint, in order to prevent ' 'the costs of a lengthy hospitalization and disease progression. The current study also ' 'emphasizes the importance of applying the appropriate statistical testing when dealing with ' 'two-sample paired data and analyzing non-parametric data such as the LOS.</jats:p>', 'DOI': '10.3390/ph15121456', 'type': 'journal-article', 'created': { 'date-parts': [[2022, 11, 24]], 'date-time': '2022-11-24T08:24:09Z', 'timestamp': 1669278249000}, 'page': '1456', 'source': 'Crossref', 'is-referenced-by-count': 0, 'title': 'Analyzing the Difference in the Length of Stay (LOS) in Moderate to Severe COVID-19 Patients ' 'Receiving Hydroxychloroquine or Favipiravir', 'prefix': '10.3390', 'volume': '15', 'author': [ { 'ORCID': 'http://orcid.org/0000-0003-4719-2655', 'authenticated-orcid': False, 'given': 'Bandar', 'family': 'Alosaimi', 'sequence': 'first', 'affiliation': []}, { 'ORCID': 'http://orcid.org/0000-0001-5154-7477', 'authenticated-orcid': False, 'given': 'Huda M.', 'family': 'Alshanbari', 'sequence': 'additional', 'affiliation': []}, {'given': 'Muath', 'family': 'Alturaiqy', 'sequence': 'additional', 'affiliation': []}, { 'ORCID': 'http://orcid.org/0000-0001-6761-9519', 'authenticated-orcid': False, 'given': 'Halah Z.', 'family': 'AlRawi', 'sequence': 'additional', 'affiliation': []}, {'given': 'Saad', 'family': 'Alamri', 'sequence': 'additional', 'affiliation': []}, {'given': 'Asma', 'family': 'Albujaidy', 'sequence': 'additional', 'affiliation': []}, {'given': 'Aljawharah', 'family': 'Bin Sabaan', 'sequence': 'additional', 'affiliation': []}, {'given': 'Ahmed A.', 'family': 'Alrashed', 'sequence': 'additional', 'affiliation': []}, { 'ORCID': 'http://orcid.org/0000-0002-2091-1376', 'authenticated-orcid': False, 'given': 'Ahmad', 'family': 'Alamer', 'sequence': 'additional', 'affiliation': []}, { 'ORCID': 'http://orcid.org/0000-0002-1505-3581', 'authenticated-orcid': False, 'given': 'Fayez', 'family': 'Alghofaili', 'sequence': 'additional', 'affiliation': []}, {'given': 'Khaled', 'family': 'Al-Duraymih', 'sequence': 'additional', 'affiliation': []}, {'given': 'Abdulaziz J.', 'family': 'Alshalani', 'sequence': 'additional', 'affiliation': []}, { 'ORCID': 'http://orcid.org/0000-0002-6947-7582', 'authenticated-orcid': False, 'given': 'Wael', 'family': 'Alturaiki', 'sequence': 'additional', 'affiliation': []}], 'member': '1968', 'published-online': {'date-parts': [[2022, 11, 24]]}, 'reference': [ { 'key': 'ref_1', 'unstructured': 'WHO (2022). 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