Alkhunaizi Lama, Almutairi Jawza A, Almanea Sarah H, Alzahuf Shuruq M, Fehaid Mohammed, Alharthi Abdulaziz, Alhebs Tameem, Alshuqayfi Sarah M, Alotaibi Rana, Alharbi Meshari, Alsamir Abdulrhman F, Aljohani Abrar T, Abdalwahab Zahra E, Kharaba Ayman M
Medical School, Imam Abdulrahman Bin Faisal University, Dammam, SAU.
Ophthalmology, King Khaled Hospital, Majmaah, SAU.
Cureus. 2024 Jan 11;16(1):e52096. doi: 10.7759/cureus.52096. eCollection 2024 Jan.
Background The COVID-19 pandemic has posed an unprecedented challenge to the global healthcare system, necessitating effective therapeutic strategies to mitigate its impact. This study investigates the significance of early antiviral therapy in the context of intensive care units (ICUs) and its potential to influence the progression and outcomes of severe COVID-19 cases. Methodology This retrospective cohort study leveraged a diverse patient population with confirmed severe COVID-19 admitted to ICUs. A total of 1,250 patients were included in the analysis, and their medical records were comprehensively reviewed. The study aimed to assess the impact of early antiviral therapy on patient outcomes, focusing on the administration of remdesivir within the first 48 hours of ICU admission. Results In a study of 1,250 COVID-19 patients, early antiviral therapy with remdesivir significantly reduced ICU admissions by 30% (N = 225) compared to standard care (N = 525). The early therapy group also exhibited a 20% lower mortality rate (N = 120) than the control group (N = 150). Demographic associations with antiviral usage were observed. Kaletra was favored by females, non-Saudi individuals, and healthcare workers, while favipiravir was associated with gender. Remdesivir and ribavirin use were linked to gender and Saudi nationality, while oseltamivir was related to gender, Saudi nationality, and body mass index. Microbiological cure rates were 15.4%, with 84.6% not achieving it. ICU outcomes included 37.7% deaths, 55.7% home discharges, and 6.6% transfers, while hospital outcomes featured 38.5% deaths, 54.4% home discharges, and 7.1% transfers. Conclusions This study presents a comprehensive analysis of COVID-19 patient demographics, antiviral medication associations, and clinical outcomes. The findings highlight the significance of tailoring treatment strategies based on patient characteristics and viral history. These insights contribute to a deeper understanding of COVID-19 management and can inform clinical decision-making and further research in this field.
新冠疫情给全球医疗系统带来了前所未有的挑战,因此需要有效的治疗策略来减轻其影响。本研究调查了在重症监护病房(ICU)背景下早期抗病毒治疗的重要性及其对重症新冠病例进展和结局的影响。
这项回顾性队列研究利用了入住ICU的确诊重症新冠患者的多样化人群。共有1250名患者纳入分析,并对他们的病历进行了全面审查。该研究旨在评估早期抗病毒治疗对患者结局的影响,重点关注在ICU入院后48小时内给予瑞德西韦。
在一项对1250名新冠患者的研究中,与标准治疗(N = 525)相比,使用瑞德西韦进行早期抗病毒治疗使ICU入院人数显著减少了30%(N = 225)。早期治疗组的死亡率也比对照组(N = 150)低20%(N = 120)。观察到了抗病毒药物使用与人口统计学特征之间的关联。洛匹那韦利托那韦受到女性、非沙特人以及医护人员的青睐,而法匹拉韦与性别有关。瑞德西韦和利巴韦林的使用与性别和沙特国籍有关,而奥司他韦与性别、沙特国籍和体重指数有关。微生物学治愈率为15.4%,84.6%未达到治愈。ICU结局包括37.7%死亡、55.7%出院回家以及6.6%转院,而医院结局包括38.5%死亡、54.4%出院回家以及7.1%转院。
本研究对新冠患者的人口统计学特征、抗病毒药物关联以及临床结局进行了全面分析。研究结果突出了根据患者特征和病毒感染史制定治疗策略的重要性。这些见解有助于更深入地理解新冠疫情管理,并为该领域的临床决策和进一步研究提供参考。