Service de Pharmacie, Hôpital Européen, Marseille, France.
Service d'Infectiologie et de Médecine Interne, Hôpital Européen, Marseille, France.
PLoS One. 2023 Mar 17;18(3):e0283165. doi: 10.1371/journal.pone.0283165. eCollection 2023.
To evaluate the impact of local therapeutic recommendation updates made by the COVID multidisciplinary consultation meeting (RCP) at the Hôpital Européen Marseille (HEM) through the description of the drug prescriptions for COVID-19 during the first two waves of the epidemic.
This retrospective observational study analysed data from the hospital's pharmaceutical file. We included all patients hospitalized for COVID-19 between February 1, 2020 and January 21, 2021 and extracted specific anti-COVID-19 therapies (ST) from computerized patient record, as well as patients' demographic characteristics, comorbidities and outcome. The evolution of ST prescriptions during the study period was described and put into perspective with the updates of local recommendations made during the first (V1, from 2/24/2020 to 7/27/2020), and second (V2, from 7/28/2020 to 1/21/2021) epidemic waves.
A total of 607 COVID-19 hospitalized patients, 197 during V1 and 410 during V2. Their mean age was 65 years-old, and they presented frequent comorbidities. In total, 93% of hospitalized patients received ST: anticoagulants (90%), glucocorticoids (39%) mainly during V2 (49% vs 17%, P<0.001), and azithromycin (30%) mainly during V1 (71% vs 10%, P<0.001). Lopinavir/ritonavir and hydroxychloroquine were prescribed to 17 and 7 inpatients, respectively, and only during V1. Remdesivir was never administered. A total of 22 inpatients were enrolled into clinical trials.
The effective dissemination of evidence-based and concerted recommendations seems to have allowed an optimized management of COVID-19 drug therapies in the context of this emerging infection with rapidly evolving therapeutic questions.
通过描述 COVID-19 大流行期间前两波疫情中的药物处方，评估欧洲马赛医院（HEM）COVID 多学科咨询会议（RCP）所做的局部治疗建议更新对患者的影响。
这是一项回顾性观察性研究，对医院药剂科档案中的数据进行分析。我们纳入了 2020 年 2 月 1 日至 2021 年 1 月 21 日期间因 COVID-19 住院的所有患者，并从电子病历中提取特定的抗 COVID-19 治疗（ST），以及患者的人口统计学特征、合并症和结局。描述了研究期间 ST 处方的变化，并与第一波（V1，从 2020 年 2 月 24 日至 7 月 27 日）和第二波（V2，从 2020 年 7 月 28 日至 2021 年 1 月 21 日）疫情期间的当地建议更新进行对比。
共有 607 名 COVID-19 住院患者，其中 197 例在 V1 期间，410 例在 V2 期间。他们的平均年龄为 65 岁，且伴有多种合并症。总共，93%的住院患者接受了 ST：抗凝剂（90%）、糖皮质激素（39%，主要在 V2 期间（49% vs 17%，P<0.001）和阿奇霉素（30%，主要在 V1 期间（71% vs 10%，P<0.001）。洛匹那韦/利托那韦和羟氯喹分别被 17 名和 7 名住院患者处方，且仅在 V1 期间。瑞德西韦从未被使用过。共有 22 名住院患者参加了临床试验。
证据基础和协调一致的建议的有效传播，似乎使 COVID-19 药物治疗在这种不断出现的、治疗问题迅速演变的传染病中得到了优化管理。
