Department of Infectious Disease and Clinical Microbiology, Ankara Yildirim Beyazit University, Ankara City Hospital, Ankara, Turkey.
Department of Infectious Disease and Clinical Microbiology, Ankara City Hospital, Ankara, Turkey.
J Infect Public Health. 2021 Mar;14(3):365-370. doi: 10.1016/j.jiph.2020.12.017. Epub 2020 Dec 29.
In this study, we aimed to compare the intensive care unit (ICU) admission rate of hospitalized mild/moderate COVID-19 patients treated with hydroxychloroquine (HCQ), favipiravir, and HCQ plus favipiravir.
Single center retrospective designed observational study conducted in Ankara City Hospital. Patients who were hospitalized between March 15, 2020 and June 1, 2020 in COVID-19 inpatient clinics with laboratory confirmed diagnosis of COVID-19 were included in the study. An inverse probability of treatment weighting (IPTW) for multiple treatment groups approach was used to balance the differences in several variables on admission.
Among 2441 patients hospitalized with diagnosis of COVID-19 during the study period, 824 were eligible for the analysis. Median age of patients was 42 (18-93 years). Among all, 347 (43.2%) of the patients had mild disease, 470 (56.8%) had pneumonia. Propensity scores ranged from 0.1841 to 0.9381 in the HCQ group, from 0.03643 to 0.29885 in the favipiravir group, and from 0.03542 to 0.56184 in the HCQ plus favipiravir group. After IPTW for multiple treatment groups was applied, all the covariates in the planned propensity score had weighted standardized effect sizes below 10% which were ranged from 0.005 to 0.092. Multivariate analysis of treatment effect (adjusted effect of treatment) was indicated that there is no statistically significant difference between HCQ, favipiravir, and HCQ plus favipiravir treatment. After using combination of SMOTE and Bootstrap resampling approach, we found no statistically significant difference between HCQ and HCQ plus favipiravir groups in terms of ICU admission. However, compared with the HCQ group, ICU admission rate was statistically significantly higher in the favipiravir group. We obtained the similar results after the sensitivity analysis.
HCQ with or without favipiravir treatment is associated with reduced risk of ICU admission compared to favipiravir alone in mild to moderate COVID-19 adult patients.
本研究旨在比较羟氯喹（HCQ）、法匹拉韦和 HCQ 联合法匹拉韦治疗住院的轻症/中度 COVID-19 患者的 ICU 入住率。
这是一项在安卡拉城市医院进行的单中心回顾性观察性研究。研究纳入了 2020 年 3 月 15 日至 2020 年 6 月 1 日期间在 COVID-19 住院病房住院且实验室确诊为 COVID-19 的患者。采用多组治疗的逆概率治疗加权（IPTW）方法来平衡入院时多个变量的差异。
在研究期间，2441 名因 COVID-19 住院的患者中，有 824 名符合分析条件。患者的中位年龄为 42 岁（18-93 岁）。所有患者中，347 例（43.2%）为轻症，470 例（56.8%）患有肺炎。HCQ 组的倾向评分范围为 0.1841 至 0.9381，法匹拉韦组为 0.03643 至 0.29885，HCQ 联合法匹拉韦组为 0.03542 至 0.56184。在对多组治疗进行 IPTW 后，计划倾向评分中的所有协变量的加权标准化效应大小均低于 10%，范围在 0.005 至 0.092 之间。多变量治疗效果分析（治疗调整效果）表明，HCQ、法匹拉韦和 HCQ 联合法匹拉韦治疗之间无统计学显著差异。使用 SMOTE 和 Bootstrap 重采样方法相结合后，我们发现 HCQ 和 HCQ 联合法匹拉韦组在 ICU 入住方面无统计学显著差异。然而，与 HCQ 组相比，法匹拉韦组的 ICU 入住率显著更高。我们在敏感性分析中得到了类似的结果。
与单独使用法匹拉韦相比，在轻至中度 COVID-19 成年患者中，HCQ 联合或不联合法匹拉韦治疗可降低 ICU 入住风险。
