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Effectiveness of different treatment regimens on patients with COVID-19, hospitalized in Sanandaj hospitals: a retrospective cohort study

Asadi et al., Journal of Pharmaceutical Policy and Practice, doi:10.1186/s40545-023-00511-w
Jan 2023  
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HCQ for COVID-19
1st treatment shown to reduce risk in March 2020, now with p < 0.00000000001 from 419 studies, recognized in 46 countries.
No treatment is 100% effective. Protocols combine treatments.
5,100+ studies for 109 treatments. c19hcq.org
Retrospective 660 hospitalized patients in Iran comparing 6 different drug regimens: 1. HCQ or CQ+AZ, 2. interferons (ReciGen/Ziphron) or interferon + Kaletra (lopinavir/ritonavir), 3. atazanavir, 4. remdesivir, 5. favipiravir, and 6. corticosteroids (dexamethasone/methylprednisolone).
Results show lower risk for HCQ/CQ+AZ in 20 of 25 comparisons (5 outcomes and 5 alternate regimens), with statistical significance in only two cases.
Asadi et al., 16 Jan 2023, retrospective, Iran, peer-reviewed, 7 authors, study period February 2020 - February 2021. Contact: moradi_gh@yahoo.com.
This PaperHCQAll
Effectiveness of different treatment regimens on patients with COVID-19, hospitalized in Sanandaj hospitals: a retrospective cohort study
Jalal Asadi, Mohammad Aziz Rasouli, Ebrahim Ghaderi, Daem Roshani, Behzad Mohsenpour, Yousef Moradi, Ghobad Moradi
Journal of Pharmaceutical Policy and Practice, doi:10.1186/s40545-023-00511-w
Objectives Different drugs have different effects on the prognosis of patients with COVID-19. This study aimed to evaluate the effect of different drug regimens on patients with COVID-19, hospitalized in Sanandaj city. Methods In this retrospective cohort study, 660 patients with COVID-19, hospitalized in the Tohid, Kowsar and Besat hospitals located Sanandaj (Kurdistan Province, Iran) were studied from February 2020 to February 2021 with clinical symptoms and positive test results. Results The results of multivariate regression analysis showed the days of hospitalization for patients who had received the drug regimen 2 (Interferons (ReciGen/Ziphron) or Interferon Vectra (lopinavir/ritonavir)) was 1.92 times higher than those who had received the drug regimen 1 (hydroxychloroquine group or a combination of chloroquine and azithromycin) while a significant association was observed (OR = 1.92, 95% CI: 1.16-3.16, P = 0.011). Also, the hospitalization in ICU was longer in patients treated by the drug regimen 2 (Interferons (ReciGen/Ziphron) or Interferon Vectra (lopinavir/ritonavir)) (OR = 4.63, 95% CI: 1.80-11.82, P = 0.001), however, drug regimens did not show a significant effect on mortality and use of ventilator in patients (P > 0.05). Conclusion The study results showed the drug regimens 2 and 5 increased the days of hospitalization and hospitalization in ICU, respectively, while the other drug regimens had no significant effect on mortality and use a ventilator in the studied patients and none of the drug regimens had an effect on reducing mortality compared to other ones.
Abbreviations HIS Declarations Ethics approval and consent to participate The Ethics Committee of Kurdistan University of Medical Sciences (IR.MUK. REC.1399.316) reviewed and approved this study. (All patients provided written informed consents. The relevant guidelines and regulations performed all methods.) Consent for publication Not applicable. Competing interests The authors declare that they have no competing interests. • fast, convenient online submission • thorough peer review by experienced researchers in your field • rapid publication on acceptance • support for research data, including large and complex data types • gold Open Access which fosters wider collaboration and increased citations maximum visibility for your research: over 100M website views per year • At BMC, research is always in progress. Learn more biomedcentral.com/submissions Ready to submit your research Ready to submit your research ? Choose BMC and benefit from: ? Choose BMC and benefit from: Publisher's Note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
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N Engl J Med. 2020;382(25):2411–8.', 'journal-title': 'N Engl J Med'}, { 'key': '511_CR25', 'doi-asserted-by': 'publisher', 'first-page': '396', 'DOI': '10.1016/j.ijid.2020.06.099', 'volume': '97', 'author': 'S Arshad', 'year': '2020', 'unstructured': 'Arshad S, Kilgore P, Chaudhry ZS, Jacobsen G, Wang DD, Huitsing K, et ' 'al. Treatment with hydroxychloroquine, azithromycin, and combination in ' 'patients hospitalized with COVID-19. Int J Infect Dis. 2020;97:396–403.', 'journal-title': 'Int J Infect Dis'}, { 'issue': '3', 'key': '511_CR26', 'doi-asserted-by': 'publisher', 'first-page': 'e213071', 'DOI': '10.1001/jamanetworkopen.2021.3071', 'volume': '4', 'author': 'BT Garibaldi', 'year': '2021', 'unstructured': 'Garibaldi BT, Wang K, Robinson ML, Zeger SL, Bandeen-Roche K, Wang M-C, ' 'et al. Comparison of time to clinical improvement with vs without ' 'remdesivir treatment in hospitalized patients with COVID-19. JAMA Netw ' 'Open. 2021;4(3):e213071.', 'journal-title': 'JAMA Netw Open'}, { 'issue': '3', 'key': '511_CR27', 'doi-asserted-by': 'publisher', 'DOI': '10.1016/j.ijantimicag.2020.106114', 'volume': '56', 'author': 'S Tong', 'year': '2020', 'unstructured': 'Tong S, Su Y, Yu Y, Wu C, Chen J, Wang S, et al. Ribavirin therapy for ' 'severe COVID-19: a retrospective cohort study. Int J Antimicrob Agents. ' '2020;56(3): 106114.', 'journal-title': 'Int J Antimicrob Agents'}, { 'issue': '6', 'key': '511_CR28', 'doi-asserted-by': 'publisher', 'first-page': '1593', 'DOI': '10.1007/s11739-021-02655-6', 'volume': '16', 'author': 'A Bahl', 'year': '2021', 'unstructured': 'Bahl A, Johnson S, Chen N-W. Timing of corticosteroids impacts mortality ' 'in hospitalized COVID-19 patients. Intern Emerg Med. ' '2021;16(6):1593–603.', 'journal-title': 'Intern Emerg Med'}, { 'issue': '2', 'key': '511_CR29', 'doi-asserted-by': 'publisher', 'first-page': '215', 'DOI': '10.1097/SHK.0000000000001738', 'volume': '56', 'author': 'J Li', 'year': '2021', 'unstructured': 'Li J, Liao X, Zhou Y, Wang L, Yang H, Zhang W, et al. Comparison of ' 'associations between glucocorticoids treatment and mortality in COVID-19 ' 'patients and SARS patients: a systematic review and meta-analysis. ' 'Shock. 2021;56(2):215–28.', 'journal-title': 'Shock'}, { 'key': '511_CR30', 'doi-asserted-by': 'publisher', 'DOI': '10.1016/j.phrs.2020.104872', 'volume': '157', 'author': 'H Zhong', 'year': '2020', 'unstructured': 'Zhong H, Wang Y, Zhang Z-L, Liu Y-X, Le K-J, Cui M, et al. Efficacy and ' 'safety of current therapeutic options for COVID-19-lessons to be learnt ' 'from SARS and MERS epidemic: a systematic review and meta-analysis. ' 'Pharmacol Res. 2020;157: 104872.', 'journal-title': 'Pharmacol Res'}, { 'issue': '1', 'key': '511_CR31', 'doi-asserted-by': 'publisher', 'first-page': '1', 'DOI': '10.1038/s41598-021-90551-6', 'volume': '11', 'author': 'S Hassanipour', 'year': '2021', 'unstructured': 'Hassanipour S, Arab-Zozani M, Amani B, Heidarzad F, Fathalipour M, ' 'Martinez-de-Hoyo R. The efficacy and safety of Favipiravir in treatment ' 'of COVID-19: a systematic review and meta-analysis of clinical trials. ' 'Sci Rep. 2021;11(1):1–11.', 'journal-title': 'Sci Rep'}, { 'issue': '2', 'key': '511_CR32', 'doi-asserted-by': 'publisher', 'first-page': 'e445', 'DOI': '10.1093/cid/ciaa954', 'volume': '73', 'author': 'EC Somers', 'year': '2021', 'unstructured': 'Somers EC, Eschenauer GA, Troost JP, Golob JL, Gandhi TN, Wang L, et al. ' 'Tocilizumab for treatment of mechanically ventilated patients with ' 'COVID-19. Clin Infect Dis. 2021;73(2):e445–54.', 'journal-title': 'Clin Infect Dis'}, { 'issue': '3', 'key': '511_CR33', 'doi-asserted-by': 'publisher', 'first-page': '365', 'DOI': '10.1016/j.jiph.2020.12.017', 'volume': '14', 'author': 'R Guner', 'year': '2021', 'unstructured': 'Guner R, Hasanoglu I, Kayaaslan B, Aypak A, Akinci E, Bodur H, et al. ' 'Comparing ICU admission rates of mild/moderate COVID-19 patients treated ' 'with hydroxychloroquine, favipiravir, and hydroxychloroquine plus ' 'favipiravir. J Infect Public Health. 2021;14(3):365–70.', 'journal-title': 'J Infect Public Health'}, { 'issue': '8', 'key': '511_CR34', 'first-page': '675', 'volume': '23', 'author': 'M Adeli', 'year': '2021', 'unstructured': 'Adeli M, Fesharaki MG. Evaluation of COVID-19 treatment outcomes in a ' 'military hospital and its comparison with a nonmilitary hospital. ' 'Journal Mil Med. 2021;23(8):675–83.', 'journal-title': 'Journal Mil Med'}, { 'issue': '8', 'key': '511_CR35', 'doi-asserted-by': 'publisher', 'first-page': '489', 'DOI': '10.12788/jhm.3497', 'volume': '15', 'author': 'MJ Keller', 'year': '2020', 'unstructured': 'Keller MJ, Kitsis EA, Arora S, Chen JT, Agarwal S, Ross MJ, et al. ' 'Effect of systemic glucocorticoids on mortality or mechanical ' 'ventilation in patients with COVID-19. J Hosp Med. 2020;15(8):489–93.', 'journal-title': 'J Hosp Med'}, { 'issue': '12', 'key': '511_CR36', 'doi-asserted-by': 'publisher', 'first-page': '1877', 'DOI': '10.1016/j.jsps.2020.09.019', 'volume': '28', 'author': 'SH Almazrou', 'year': '2020', 'unstructured': 'Almazrou SH, Almalki ZS, Alanazi AS, Alqahtani AM, Alghamd SM. Comparing ' 'the impact of Hydroxychloroquine based regimens and standard treatment ' 'on COVID-19 patient outcomes: a retrospective cohort study. Saudi ' 'Pharmaceutical Journal. 2020;28(12):1877–82.', 'journal-title': 'Saudi Pharmaceutical Journal'}], 'container-title': 'Journal of Pharmaceutical Policy and Practice', 'original-title': [], 'language': 'en', 'link': [ { 'URL': 'https://link.springer.com/content/pdf/10.1186/s40545-023-00511-w.pdf', 'content-type': 'application/pdf', 'content-version': 'vor', 'intended-application': 'text-mining'}, { 'URL': 'https://link.springer.com/article/10.1186/s40545-023-00511-w/fulltext.html', 'content-type': 'text/html', 'content-version': 'vor', 'intended-application': 'text-mining'}, { 'URL': 'https://link.springer.com/content/pdf/10.1186/s40545-023-00511-w.pdf', 'content-type': 'application/pdf', 'content-version': 'vor', 'intended-application': 'similarity-checking'}], 'deposited': { 'date-parts': [[2023, 1, 16]], 'date-time': '2023-01-16T12:11:36Z', 'timestamp': 1673871096000}, 'score': 1, 'resource': {'primary': {'URL': 'https://joppp.biomedcentral.com/articles/10.1186/s40545-023-00511-w'}}, 'subtitle': [], 'short-title': [], 'issued': {'date-parts': [[2023, 1, 16]]}, 'references-count': 36, 'journal-issue': {'issue': '1', 'published-online': {'date-parts': [[2023, 12]]}}, 'alternative-id': ['511'], 'URL': 'http://dx.doi.org/10.1186/s40545-023-00511-w', 'relation': {}, 'ISSN': ['2052-3211'], 'subject': ['Pharmacy', 'Health Policy'], 'container-title-short': 'J of Pharm Policy and Pract', 'published': {'date-parts': [[2023, 1, 16]]}, 'assertion': [ { 'value': '5 July 2022', 'order': 1, 'name': 'received', 'label': 'Received', 'group': {'name': 'ArticleHistory', 'label': 'Article History'}}, { 'value': '4 January 2023', 'order': 2, 'name': 'accepted', 'label': 'Accepted', 'group': {'name': 'ArticleHistory', 'label': 'Article History'}}, { 'value': '16 January 2023', 'order': 3, 'name': 'first_online', 'label': 'First Online', 'group': {'name': 'ArticleHistory', 'label': 'Article History'}}, {'order': 1, 'name': 'Ethics', 'group': {'name': 'EthicsHeading', 'label': 'Declarations'}}, { 'value': 'The Ethics Committee of Kurdistan University of Medical Sciences ' '(IR.MUK.REC.1399.316) reviewed and approved this study. (All patients provided ' 'written informed consents. The relevant guidelines and regulations performed ' 'all methods.)', 'order': 2, 'name': 'Ethics', 'group': {'name': 'EthicsHeading', 'label': 'Ethics approval and consent to participate'}}, { 'value': 'Not applicable.', 'order': 3, 'name': 'Ethics', 'group': {'name': 'EthicsHeading', 'label': 'Consent for publication'}}, { 'value': 'The authors declare that they have no competing interests.', 'order': 4, 'name': 'Ethics', 'group': {'name': 'EthicsHeading', 'label': 'Competing interests'}}], 'article-number': '4'}
Late treatment
is less effective
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