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在 Hospitel 环境下使用法匹拉韦治疗 2019 年冠状病毒病。

Use of Favipiravir for the Treatment of Coronavirus Disease 2019 in the Setting of Hospitel.

机构信息

Department of Pharmacy, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.

Division of Infectious Disease, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.

出版信息

Int J Clin Pract. 2022 Mar 29;2022:3098527. doi: 10.1155/2022/3098527. eCollection 2022.

Abstract

OBJECTIVE

In a setting with a limited capacity for hospitalization, "hospitels" have been developed by using hotels as extension healthcare facilities for patients with mild illness. This study examined the clinical evidence of patients with coronavirus disease 2019 (COVID-19) who were treated with favipiravir, the main medication for treating COVID-19, in the hospitel setting in Thailand.

METHODS

We retrospectively collected demographic and clinical information, medication treatment, and outcome data for all patients who received favipiravir for COVID-19 during admission to a hospitel from April 27, 2021, to July 2, 2021. Risk factors for adults who could not complete treatment in a hospitel and who required hospitel transfer were analyzed.

RESULTS

In total, 421 patients were included in the study. Most patients (94.5%) received favipiravir to treat COVID-19 pneumonia. Adjunctive corticosteroids were prescribed to 42.3% of patients. Concerning the treatment outcome, 83.6% of patients completed treatment at a hospitel, and only two deaths occurred. No serious adverse drug reactions were observed. On multivariate analysis, age (odds ratio (OR) = 1.06; 95% confidence interval (CI) = 1.02-1.10, =0.002), dyspnea (OR = 2.84; 95% CI = 1.25-6.44, =0.013), loss of taste (OR = 107.63; 95% CI = 1.24-9337.39, =0.040), corticosteroid use (OR = 12.56; 95% CI = 3.65-43.18, < 0.001), and an extended duration of favipiravir use (OR = 16.91; 95% CI = 7.29-39.24, < 0.001) were associated with a higher risk of hospitel transfer.

CONCLUSIONS

Low rates of hospitel transfer and mortality were observed in mild-to-moderate COVID-19 patients treated with favipiravir at hospitel. Caution might be required in elderly patients, patients with dyspnea or a loss of taste, and patients receiving a 10-day course of favipiravir or adjunctive corticosteroids because these patients might require further management in the hospitel.

摘要

目的

在医院容纳能力有限的情况下,利用酒店作为轻度疾病患者的扩展医疗设施,开发了“旅医”。本研究考察了在泰国旅医环境中使用治疗 COVID-19 的主要药物——法匹拉韦治疗的 COVID-19 患者的临床证据。

方法

我们回顾性收集了 2021 年 4 月 27 日至 2021 年 7 月 2 日期间入住旅医的所有接受法匹拉韦治疗 COVID-19 的患者的人口统计学和临床信息、药物治疗和结局数据。分析了无法在旅医完成治疗且需要旅医转移的成年患者的危险因素。

结果

共纳入 421 例患者。大多数患者(94.5%)接受法匹拉韦治疗 COVID-19 肺炎。42.3%的患者给予辅助性皮质类固醇治疗。关于治疗结局,83.6%的患者在旅医完成治疗,仅发生 2 例死亡。未观察到严重药物不良反应。多变量分析显示,年龄(比值比(OR)=1.06;95%置信区间(CI)=1.02-1.10,=0.002)、呼吸困难(OR=2.84;95%CI=1.25-6.44,=0.013)、味觉丧失(OR=107.63;95%CI=1.24-9337.39,=0.040)、皮质类固醇使用(OR=12.56;95%CI=3.65-43.18, < 0.001)和法匹拉韦使用时间延长(OR=16.91;95%CI=7.29-39.24, < 0.001)与旅医转科风险增加相关。

结论

在旅医接受法匹拉韦治疗的轻中度 COVID-19 患者中,旅医转科率和死亡率较低。老年患者、呼吸困难或味觉丧失患者以及接受 10 天法匹拉韦或辅助性皮质类固醇治疗的患者可能需要在旅医进一步治疗,对此应谨慎。

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