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The Use of Antiviral Agents against SARS-CoV-2: Ineffective or Time and Age Dependent Result? A Retrospective, Observational Study among COVID-19 Older Adults.
Desai, Antonio; Caltagirone, Giuseppe; Sari, Sharon; Pocaterra, Daria; Kogan, Maria; Azzolini, Elena; Savevski, Victor; Martinelli-Boneschi, Filippo; Voza, Antonio.
  • Desai A; Emergency Department, Humanitas Clinical and Research Center, IRCCS, 20089 Milan, Italy.
  • Caltagirone G; Department of Biomedical Sciences, Humanitas University, 20090 Pieve Emanuele, Italy.
  • Sari S; Emergency Department, Humanitas Clinical and Research Center, IRCCS, 20089 Milan, Italy.
  • Pocaterra D; Department of Biomedical Sciences, Humanitas University, 20090 Pieve Emanuele, Italy.
  • Kogan M; Internal Medicine Department, Geriatrics, Santa Margherita Rehabilitation and Cure Institute, ASP, 27100 Pavia, Italy.
  • Azzolini E; Department of Infectious Diseases, Humanitas Clinical and Research Center, IRCCS, 20089 Milan, Italy.
  • Savevski V; Emergency Department, Humanitas Clinical and Research Center, IRCCS, 20089 Milan, Italy.
  • Martinelli-Boneschi F; Department of Biomedical Sciences, Humanitas University, 20090 Pieve Emanuele, Italy.
  • Voza A; Health Directorate, Humanitas Clinical and Research Center, IRCCS, 20089 Milan, Italy.
  • On Behalf Of The Humanitas Covid-Task Force; Artificial Intelligence Center, Humanitas Clinical and Research Center, IRCCS, 20089 Milan, Italy.
J Clin Med ; 10(4)2021 Feb 10.
Article in English | MEDLINE | ID: covidwho-1094253
ABSTRACT

BACKGROUND:

Our aim was to investigate the impact of therapeutics with antiviral activity against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on mortality of older adults affected by coronavirus disease 2019 (COVID-19), taking into consideration the time interval from symptoms onset to drugs administration.

METHODS:

Data from 143 COVID-19 patients over 65 years of age admitted to the Humanitas Clinical and Research Center Emergency Department (Milan, Italy) and treated with Lopinavir/ritonavir (LPV/r) or Darunavir/cobicistat (DVR/c) associated to Hydroxychloroquine (HCQ) were retrospectively analyzed. Statistical analysis was performed by using a logistic regression model and survival analysis to assess the role of different predictors of in-hospital mortality, including an early (<6 days from symptoms onset) vs. late treatment onset, signs and symptoms at COVID-19 presentation, type of antiviral treatment (LPV/r or DVR/c) and patients' age (65-80 vs. >80 years old).

RESULTS:

Multivariate analysis showed that an older age (OR 2.54) and dyspnea as presenting symptom (OR 2.01) were associated with higher mortality rate, whereas cough as presenting symptom (OR 0.53) and a timely drug administration (OR 0.44) were associated with lower mortality. Survival analysis demonstrated that the timing of drug administration had an impact on mortality in 65-80 years-old patients (p = 0.02), whereas no difference was seen in those >80 years-old. This impact was more evident in patients with dyspnea as primary symptom of COVID-19, in whom mortality decreased from 57.1% to 38.3% due to timely drug administration (OR 0.5; p = 0.04).

CONCLUSIONS:

There was a significant association between the use of a combined antiviral regimen and HCQ and lower mortality, when timely-administered, in COVID-19 patients aged 65-80 years. Our findings support timely treatment onset as a key component in the treatment of COVID-19.
Keywords

Full text: Available Collection: International databases Database: MEDLINE Type of study: Observational study / Prognostic study Topics: Long Covid Language: English Year: 2021 Document Type: Article Affiliation country: Jcm10040686

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Full text: Available Collection: International databases Database: MEDLINE Type of study: Observational study / Prognostic study Topics: Long Covid Language: English Year: 2021 Document Type: Article Affiliation country: Jcm10040686