Favipiravir Experience in COVID-19 Patients at a Tertiary Center Intensive Care Unit

Objectives The aim of this study was to compare intensive care unit (ICU) and overall hospital mortality in patients treated with favipiravir and lopinavir-ritonavir for COVID-19. Methods Data were collected retrospectively between March 10 and May 10, 2020, from patients’ records admitted to ICU due to COVID-19. Laboratory data, clinical characteristics, ICU and hospital mortality, ICU and hospital length of stay were compared in patients treated with favipiravir and lopinavir-ritonavir. Results A total of 100 patients’ data were investigated. Favipiravir was used as the treatment for 85% of patients, with the rest treated with lopinavir-ritonavir. Clinical and laboratory data of both antiviral treatment groups were similar. Length of hospital stay was 16 (9–24) days with favipiravir and 8.5 (5–12.5) days with lopinavir-ritonavir (p=0.002). Length of ICU stay for favipiravir and lopinavir-ritonavir groups were 8 (5–15) days and 4 (3–9) days, respectively (p=0.011). ICU mortality was 65.9% for the favipiravir and 80% for lopinavir-ritonavir (p=0.002). Hospital mortality for favipiravir and lopinavir-ritonavir was 67.1% and 80%, respectively (p=0.001). Conclusion The mortality in patients treated with favipiravir was less than patients treated with lopinavir-ritonavir. Favipiravir needs more attention and trials for its effect to be confirmed.

Effectiveness of inactivated SARS-CoV-2 vaccine (CoronaVac) on intensive care unit survival.

This study compared the course of coronavirus disease 2019 (COVID-19) in vaccinated and unvaccinated patients admitted to an intensive care unit (ICU) and evaluated the effect of vaccination with CoronaVac on admission to ICU. Patients admitted to ICU due to COVID-19 between 1 April 2021 and 15 May 2021 were enrolled to the study. Clinical, laboratory, radiological parameters, hospital and ICU mortality were compared between vaccinated patients and eligible but unvaccinated patients. Patients over 65 years old were the target population of the study due to the national vaccination schedule. Data from 90 patients were evaluated. Of these, 36 (40.0%) were vaccinated. All patients had the CoronaVac vaccine. Lactate dehydrogenase and ferritin levels were higher in an unvaccinated group than vaccinated group (P = 0.021 and 0.008, respectively). SpO2 from the first arterial blood gas at ICU was 83.71 ± 19.50% in vaccinated, 92.36 ± 6.59% in unvaccinated patients (P = 0.003). Length of ICU and hospital stay were not different (P = 0.204, 0.092, respectively). ICU and hospital mortality were similar between groups (P = 0.11 and 0.70, respectively). CoronaVac vaccine had no effect on survival from COVID-19. CoronaVac's protective effect, especially on new genetic variants, should be investigated further.

Sigara Kullanımının Yoğun Bakım Ünitesindeki COVID-19 Hastalarında Sağkalıma Etkisi

Amaç: Bu çalışmada yoğun bakım ünitemizde (YBÜ) sigara içme sıklığı/ yaygınlığının (prevalansının), sigara kullanımına bağlı kalış süresinin ve COVID-19 mortalitesi üzerine etkilerini görmeyi amaçladık. Gereç ve Yöntem: 16 Mart-16 Mayıs 2020 tarihleri arasında COVID19 hastaları üzerinde yoğun bakım ünitesinde yapılan retrospektif tek merkezli bir çalışmadır. Demografik veriler, komorbidite durumları, kabul edildikleri birimler, klinik semptomlar, solunum desteği, hastaların sigara içme sıklığı/prevalansı, yoğun bakımda kalış süreleri ve mortaliteleri kaydedilmiştir. Sigara içen ve içmeyen olarak iki grup vardı. 1.100 COVID19 hastası vardı ve bunlardan 150’si yoğun bakım ünitesinde tedavi gördü. Doksan beş hastanın verilerine ulaşıldı. Bulgular: Hiç sigara içmemiş hastalar %64,2’di. Bu hastaların %5,3’ü daha önce sigara içmiş, %30,5’i ise aktif içici idi. Sigara içen gruptaki hastaların yaş ortalaması içmeyenlere göre daha az olmuştur. Sigara içenlerde kronik obstrüktif akciğer hastalığı insidansı daha yüksek olmuştur. Sigara içme durumu, yoğun bakımda kalış süresi ve sağkalım arasında ilişki bulunamamıştır. Sigara kullanımı, COVID-19 hastalığında solunum yetmezliğine kadar ilerleyebilen ve ölümle sonuçlanabilen agresif sürece neden olan faktörler arasında yer almaktadır. Sonuç: Bazı araştırmalar da sigaranın koruyucu olabileceğini iddia etmektedir. Bu konu hakkında henüz bir netlik yoktur. COVID-19 pnömonisine bağlı solunum yetmezliği olan YBÜ’de tedavi edilen hastalarda sigara içmenin yoğun bakımda kalış süresi ve mortalite üzerinde etkisi olmadığı ortaya konmuştur. (Turkish) [ FROM AUTHOR] Copyright of Turkish Journal of Intensive Care is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

Effect of Routine Thromboprophylaxis with Low Molecular Weight Heparin in Hospitalized Covid-19 Patients (preprint)

Background: Coronavirus disease 2019 (COVID-19) is commonly complicated with coagulopathy presented with venous thromboembolism and arterial thromboses. The aim of this study was to evaluate the effect of routine thromboprophylaxis with low molecular weight heparin (LMWH) on clinical outcomes including mortality and need for intensive care unit (ICU) admission in hospitalized COVID-19 patients. Methods: All confirmed patients with COVID-19 hospitalized to COVID-19 dedicated wards, from March 15 to May 15, 2020, were included in this retrospective cohort study. Two groups of patients were established, according to the non-routine and routine application of LMWH with therapeutic, weight-based, anticoagulation dosing. Clinical, laboratory and treatment data were collected, analyzed and compared between the two groups. A logistic regression model was developed to assess the factors related to in-hospital adverse outcomes. Results: A total of 1511 patients (797 men, median age 59.0 years) were retrospectively analyzed (Group non-routine LMWH (n=828); group routine LMWH (n=683)). Multivariate logistic regression analysis showed routine use of LMWH, favipiravir administration, extreme values of WBC count, NLR, and troponin I as factors independently associated with in-hospital adverse outcomes (OR=0.25, 95% CI: 0.83-0.91; p<0.001 for routine use of LMWH). Conclusion: Routine thromboprophylaxis with LMWH reduced mortality and ICU admission in patients admitted with COVID-19 infection.