Direct costs of hospital care according to coinfection in adult COVID-19 patients

Objective: To estimate the direct costs of hospital care according to coinfection in adult COVID-19 patients. Material(s) and Method(s): A retrospective follow-up study of adult patients hospitalized for COVID-19 between March and August 2020 at the San Vicente Foundation Hospitals (Medellin and Rionegro, Colombia). Patients whose diagnosis of SARS-Cov2 pneumonia was confirmed by RT-PCR test were included. Death from any cause and length of stay were considered outcome variables. Costs were estimated in 20 20 US dollars. Result(s): 365 patients with an average age of 60 years (IQR: 46-71), 40% female, were analyzed. 60.5% required an Intensive Care Unit (ICU). All-cause mortality was 2.87 per 100 patient-days. Patients admitted to the ICU who developed coinfection had an average length of stay of 27.8 days (SD:17.1) and an average cost of $23,935.7 (SD: $16,808.2);patients admitted to the ICU who did not develop a coinfection had an average length of stay of 14.7 days (SD:8.6) and an average cost of $9,968.5 (SD: $8,054.0). Conclusion(s): A high percentage of patients required intensive care, and there was a high mortality due to COVID-19. In addition, a higher cost of care was observed for those patients who developed coinfection and were admitted to ICU.Copyright © 2023 Asociacion Colombiana de Infectologia. All rights reserved.

Clinical efficacy and safety of ivermectin (400 mug/kg, single dose) in patients with severe COVID-19: a randomized clinical trial

Purpose: To evaluate the clinical efficacy of including Ivermectin (single dose on day 1 of 400 mug/kg PO) in the standard of care in hospitalized adults with severe COVID-19. Method(s): Double-blinded, parallel, placebo-controlled, single-center, randomized clinical trial. Seventy-five patients were randomly assigned (1:1) to receive standard of care plus ivermectin or placebo and were followed up for 21 days. Primary outcome measure was admission to ICU and secondary outcomes were the requirement of intensive mechanical ventilation (IMV) and in-hospital death. Intention-to-treat analyses, estimated risk differences (RD), and Hazard ratios (HR) with Cox regression were performed. Result(s): Enrollment stopped due to the lack of eligible patients. Thirty-seven patients were assigned to intervention and 38 to placebo. Patients in the ivermectin group were 54.5 years on average, 62.2% were male. Comorbidities were more prevalent in the control group (78.9% vs. 56.8%). There was no difference in the 21-day risk of admission to the ICU between ivermectin (21.6%) and placebo (15.8%) (RD= 5.8%;95%CI: -11.8%-23.5%);neither in the risk of requirement of IMV (18.9% vs 13.2%), mortality (5.4% vs 10.5%) or in adverse events (32.4% vs. 28.9%). Discussion(s): Ivermectin showed no significant benefit in reducing the requirement of ICU, IMV, or mortality for severe COVID-19 patients.Copyright © 2022 Asociacion Colombiana de Infectologia. All rights reserved.