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Assessment of outcomes following implementation of antiviral treatment guidelines for COVID-19 during the first wave in Thailand

Sawanpanyalert et al., Southeast Asian Journal of Tropical Medicine and Public Health, 52:4
Sep 2021  
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Death, ICU, intubation, or h.. 42% Improvement Relative Risk HCQ  Sawanpanyalert et al.  EARLY TREATMENT Is early treatment with HCQ + combined treatments beneficial for COVID-19? Retrospective study in Thailand Lower progression with HCQ + combined treatments (not stat. sig., p=0.37) c19hcq.org Sawanpanyalert et al., Southeast Asian.., Sep 2021 FavorsHCQ Favorscontrol 0 0.5 1 1.5 2+
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 110 treatments. c19hcq.org
Retrospective 744 hospitalized patients in Thailand, showing lower risk of a poor outcome for favipiravir treatment within 4 days of symptom onset. Early treatment with CQ/HCQ and lopinavir/ritonavir or darunavir/ritonavir also showed lower risk, but without statistical significance. Sample sizes for the number of patients treated within 4 days of symptom onset are not provided.
Study covers favipiravir and HCQ.
risk of death, ICU, intubation, or high-flow oxygen, 42.0% lower, OR 0.58, p = 0.37, within 4 days of symptom onset, RR approximated with OR.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Sawanpanyalert et al., 9 Sep 2021, retrospective, Thailand, peer-reviewed, 11 authors, dosage varies, this trial uses multiple treatments in the treatment arm (combined with lopinavir/ritonavir or darunavir/ritonavir) - results of individual treatments may vary.
This PaperHCQAll
ASSESSEMENT OF OUTCOMES FOLLOWING IMPLEMENTATION OF ANTIVIRAL TREATMENT GUIDELINES FOR COVID-19 DURING THE FIRST WAVE IN THAILAND
Narumol Sawanpanyalert, Rujipas Sirijatuphat, Piamlarp Sangsayunh, Opass Putcharoen, Weerawat Manosuthi, Poj Intalapaporn, Nattawan Palavutitotai, Worawan Samritmanoporn, Nattapong Jitrungruengnij, Alan Maleesatharn
Thailand encountered its first coronavirus disease 2019 outbreak in March 2020 and the Thailand Ministry of Public Health rapidly developed COVID-19 treatment guidelines. In this study we aimed to describe the outcomes among patients treated following those initial guidelines and determine factors significantly associated with poor outcomes in order to inform efforts to improve COVID-19 treatment guidelines for Thailand. Nine hospitals in Bangkok submitted data from their COVID-19 patients using standardized case record forms. A poor outcome was defined as death, ICU admission, requiring intubation or requiring high-flow oxygen. Factors associated with these outcomes were assessed. A total of 744 patients (48.8% male) were included in the study. The median (interquartile range) age of study subjects was 37 (27-48) years; 8.4% were aged >60 years, 5.6% of subjects were obese and 16.5% had underlying conditions: obesity, immunocompromised status, diabetes, chronic conditions of lungs, kidneys, liver, cardiovascular or cerebrovascular systems or had an absolute lymphocyte count <1,000 cells/mm 3 . Among symptomatic patients, factors significantly independently associated with a poor outcome were: age >60 years (adjusted odds ratio (
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