Combination therapy with methylprednisolone and rivaroxaban for mild COVID-19 in Vietnam: laboratory and clinical insights.

OBJECTIVE

To assess the efficacy and safety of methylprednisolone combined with rivaroxaban versus rivaroxaban monotherapy in mild cases of COVID-19.

METHODS

This quasi-experimental study was conducted at three hospitals in Ho Chi Minh City, Vietnam, from September 2021 to March 2022. Patients received either rivaroxaban 10 mg/day (Regimen 1) or methylprednisolone 16 mg/day plus rivaroxaban 10 mg/day (Regimen 2) for 7 days. Outcomes included progression to severe disease, adverse events, and changes in clinical and laboratory parameters. Statistical analysis employed Fisher's exact test and Generalized Estimating Equations (GEE).

RESULTS

Among 108 patients, no progression to severe disease or deaths occurred. Regimen 2 significantly improved laboratory markers, including white blood cell counts (+0.290; p<0.001), platelet counts (+0.102; p=0.032), aspartate aminotransferase (+0.335; p=0.013), alanine aminotransferase (+0.397; p=0.006) and CD4 cells (+0.458; p<0.001), and reduced activated partial thromboplastin time (-0.083; p=0.003) compared to Regimen 1. No significant differences in clinical symptoms were observed. Adverse events were rare, with one non-serious event reported in Regimen 1.

CONCLUSION

Combination therapy with methylprednisolone and rivaroxaban enhanced immune and coagulation parameters without increasing adverse events. These findings suggest potential benefits of early intervention in mild COVID-19, warranting further research.