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.
Identifieur interne : 000098 ( Main/Exploration ); précédent : 000097; suivant : 000099The Use of Antiviral Agents against SARS-CoV-2: Ineffective or Time and Age Dependent Result? A Retrospective, Observational Study among COVID-19 Older Adults.
Auteurs : Antonio Desai [Italie] ; Giuseppe Caltagirone [Italie] ; Sharon Sari [Italie] ; Daria Pocaterra [Italie] ; Maria Kogan [Italie] ; Elena Azzolini [Italie] ; Victor Savevski [Italie] ; Filippo Martinelli-Boneschi [Italie] ; Antonio Voza [Italie] ; On Behalf Of The Humanitas Covid-Task Force [Italie]Source :
- Journal of clinical medicine [ 2077-0383 ] ; 2021.
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 (
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.
DOI: 10.3390/jcm10040686
PubMed: 33578922
PubMed Central: PMC7916694
Affiliations:
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<author><name sortKey="Martinelli Boneschi, Filippo" sort="Martinelli Boneschi, Filippo" uniqKey="Martinelli Boneschi F" first="Filippo" last="Martinelli-Boneschi">Filippo Martinelli-Boneschi</name>
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<author><name sortKey="On Behalf Of The Humanitas Covid Task Force" sort="On Behalf Of The Humanitas Covid Task Force" uniqKey="On Behalf Of The Humanitas Covid Task Force" last="On Behalf Of The Humanitas Covid-Task Force">On Behalf Of The Humanitas Covid-Task Force</name>
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<front><div type="abstract" xml:lang="en"><p><b>BACKGROUND</b>
</p>
<p>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.</p>
</div>
<div type="abstract" xml:lang="en"><p><b>METHODS</b>
</p>
<p>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).</p>
</div>
<div type="abstract" xml:lang="en"><p><b>RESULTS</b>
</p>
<p>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>
</div>
<div type="abstract" xml:lang="en"><p><b>CONCLUSIONS</b>
</p>
<p>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.</p>
</div>
</front>
</TEI>
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<DateRevised><Year>2021</Year>
<Month>03</Month>
<Day>03</Day>
</DateRevised>
<Article PubModel="Electronic"><Journal><ISSN IssnType="Print">2077-0383</ISSN>
<JournalIssue CitedMedium="Print"><Volume>10</Volume>
<Issue>4</Issue>
<PubDate><Year>2021</Year>
<Month>Feb</Month>
<Day>10</Day>
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</JournalIssue>
<Title>Journal of clinical medicine</Title>
<ISOAbbreviation>J Clin Med</ISOAbbreviation>
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<ArticleTitle>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.</ArticleTitle>
<ELocationID EIdType="pii" ValidYN="Y">686</ELocationID>
<ELocationID EIdType="doi" ValidYN="Y">10.3390/jcm10040686</ELocationID>
<Abstract><AbstractText Label="BACKGROUND" NlmCategory="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.</AbstractText>
<AbstractText Label="METHODS" NlmCategory="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).</AbstractText>
<AbstractText Label="RESULTS" NlmCategory="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 (<i>p</i>
= 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; <i>p</i>
= 0.04).</AbstractText>
<AbstractText Label="CONCLUSIONS" NlmCategory="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.</AbstractText>
</Abstract>
<AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Desai</LastName>
<ForeName>Antonio</ForeName>
<Initials>A</Initials>
<Identifier Source="ORCID">0000-0003-4674-4905</Identifier>
<AffiliationInfo><Affiliation>Emergency Department, Humanitas Clinical and Research Center, IRCCS, 20089 Milan, Italy.</Affiliation>
</AffiliationInfo>
<AffiliationInfo><Affiliation>Department of Biomedical Sciences, Humanitas University, 20090 Pieve Emanuele, Italy.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Caltagirone</LastName>
<ForeName>Giuseppe</ForeName>
<Initials>G</Initials>
<AffiliationInfo><Affiliation>Emergency Department, Humanitas Clinical and Research Center, IRCCS, 20089 Milan, Italy.</Affiliation>
</AffiliationInfo>
<AffiliationInfo><Affiliation>Department of Biomedical Sciences, Humanitas University, 20090 Pieve Emanuele, Italy.</Affiliation>
</AffiliationInfo>
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<Author ValidYN="Y"><LastName>Sari</LastName>
<ForeName>Sharon</ForeName>
<Initials>S</Initials>
<AffiliationInfo><Affiliation>Internal Medicine Department, Geriatrics, Santa Margherita Rehabilitation and Cure Institute, ASP, 27100 Pavia, Italy.</Affiliation>
</AffiliationInfo>
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<Author ValidYN="Y"><LastName>Pocaterra</LastName>
<ForeName>Daria</ForeName>
<Initials>D</Initials>
<AffiliationInfo><Affiliation>Department of Infectious Diseases, Humanitas Clinical and Research Center, IRCCS, 20089 Milan, Italy.</Affiliation>
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