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Antiviral treatment could not provide clinical benefit in management of mild COVID-19: A Retrospective Experience from Field hospital.
Aumpan, Natsuda; Vilaichone, Ratha-Korn; Ratana-Amornpin, Sarita; Teerakapibal, Surat; Toochinda, Pisanu; Witoonchart, Gasinee; Nitikraipot, Surapon.
  • Aumpan N; Center of Excellence in Digestive Diseases and Gastroenterology Unit, Department of Medicine, Thammasat University Hospital, Pathumthani, Thailand.
  • Vilaichone RK; Center of Excellence in Digestive Diseases and Gastroenterology Unit, Department of Medicine, Thammasat University Hospital, Pathumthani, Thailand; Chulabhorn International College of Medicine (CICM) at Thammasat University, Pathumthani, Thailand; Division of Gastroentero-Hepatology, Department of I
  • Ratana-Amornpin S; Center of Excellence in Digestive Diseases and Gastroenterology Unit, Department of Medicine, Thammasat University Hospital, Pathumthani, Thailand.
  • Teerakapibal S; Thammasat Business School, Thammasat University, Bangkok, Thailand.
  • Toochinda P; Sirindhorn International Institute of Technology, Thammasat University, Pathumthani, Thailand.
  • Witoonchart G; Rector of Thammasat University, Bangkok, Thailand.
  • Nitikraipot S; Chairman of the Executive Committee, Thammasat University Hospital, Pathumthani, Thailand.
J Infect Public Health ; 14(9): 1206-1211, 2021 09.
Article in English | MEDLINE | ID: covidwho-1330981
ABSTRACT

BACKGROUND:

Coronavirus disease 2019 (COVID-19) has affected over 145 million infected people and 3 million deaths worldwide. There has been limited data to recommend either for or against use of antiviral regimens in mild COVID-19 patients. This study aimed to compare clinical outcomes between mild COVID-19 patients receiving antiviral drugs and those without.

METHOD:

Thai patients diagnosed with COVID-19 at field hospital affiliated to Thammasat University Hospital, Thailand were evaluated between January 1, 2020 and April 13, 2021. Patients' data, clinical presentation, past medical history, laboratory results, and treatment outcomes were extensively reviewed.

RESULTS:

Five hundred patients with positive tests were included in the study. The mean age was 35.9 years; 46% males. There were 225 (45%), 207 (41.4%), 44 (8.8%), 18 (3.6%), 6 (1.2%) patients with asymptomatic, mild, moderate, severe, and critical COVID-19, respectively. Of 207 mild COVID-19 patients, 9 (4.3%) received lopinavir/ritonavir or darunavir/ritonavir, 17 (8.2%) received favipiravir, while 175 (84.5%) had only supportive care. Mild COVID-19 patients receiving antiviral treatment had longer median length of hospital stay [13 days (IQR 11-14) vs. 10 days (IQR 8-12), p < 0.001] than patients having only supportive treatment. Antiviral drug use was significantly associated with longer hospital stay (>10 days) in mild COVID-19 patients (OR 5.52; 95%CI 2.12-14.40, p < 0.001). Adverse drug reactions such as diarrhea, abdominal pain, and hepatitis were also demonstrated in our COVID-19 patients with antiviral treatments. Majority of patients (97.6%) recovered without any complications and were discharged home. Two deaths were caused by acute respiratory distress syndrome from severe COVID-19 pneumonia.

CONCLUSION:

Antiviral treatment could not provide superior clinical outcomes to supportive care in mild COVID-19 patients. Mild COVID-19 patients receiving antiviral medication had longer length of hospital stay than those without. Standard supportive care and regular monitoring of disease progression might be keys for successful management of mild COVID-19.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Antiviral Agents / COVID-19 Type of study: Experimental Studies / Observational study / Prognostic study Limits: Adult / Female / Humans / Male Language: English Journal: J Infect Public Health Journal subject: Communicable Diseases / Public Health Year: 2021 Document Type: Article Affiliation country: J.jiph.2021.07.019

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Antiviral Agents / COVID-19 Type of study: Experimental Studies / Observational study / Prognostic study Limits: Adult / Female / Humans / Male Language: English Journal: J Infect Public Health Journal subject: Communicable Diseases / Public Health Year: 2021 Document Type: Article Affiliation country: J.jiph.2021.07.019