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https://hdl.handle.net/11499/47740
Title: | The association of antiviral drugs with COVID-19 morbidity: The retrospective analysis of a nationwide COVID-19 cohort | Authors: | Babayigit C. Kokturk N. Kul S. Cetinkaya P.D. Atis Nayci S. Argun Baris S. Karcioglu O. Aysert, Pinar Irmak, Ilim Yuksel, Aycan Akbas Sekibag, Yonca Toprak, Oya Baydar Azak, Emel Mulamahmutoglu, Sait Cuhadaroglu, Caglar Demirel, Aslihan Kerget, Bugra Ketencioglu, Burcu Baran Ozger, Hasan Selcuk Ozkan, Gulcihan Ture, Zeynep Ergan, Begum Oguz, Vildan Avkan Kilinc, Oguz Ercelik, Merve Ciftci, Tansu Ulukavak Alici, Ozlem Temel, Esra Nurlu Ataoglu, Ozlem Aydin, Asena Bahcetepe, Dilek Cetiner Gullu, Yusuf Taha Fakili, Fusun Deveci, Figen Kose, Neslihan Tor, Muge Meltem Gunluoglu, Gulsah Altin, Sedat Turgut, Teyfik Tuna, Tibel Ozturk, Onder Dikensoy, Oner Gulhan, Pinar Yildiz Basyigit, Ilknur Boyaci, Hasim Oguzulgen, Ipek Kivilcim Borekci, Sermin Gemicioglu, Bilun Bayraktar, Firat Elbek, Osman Hanta, Ismail Kuzu Okur, Hacer Sagcan, Gulseren Uzun, Oguz Akgun, Metin Altinisik, Goksel Dursun, Berna Edis, Ebru Cakir Eyuboglu, Fusun Oner Gultekin, Okkes Havlucu, Yavuz Ozkan, Metin Coskun, Aysin Sayiner, Abdullah Kalyoncu, A. Fuat Itil, Oya Bayram, Hasan |
Keywords: | antiviral agents COVID-19 morbidity ICU requirement invasive mechanical ventilation length of hospitalization |
Publisher: | Frontiers Media S.A. | Abstract: | Background and objectives: Although several repurposed antiviral drugs have been used for the treatment of COVID-19, only a few such as remdesivir and molnupiravir have shown promising effects. The objectives of our study were to investigate the association of repurposed antiviral drugs with COVID-19 morbidity. Methods: Patients admitted to 26 different hospitals located in 16 different provinces between March 11–July 18, 2020, were enrolled. Case definition was based on WHO criteria. Patients were managed according to the guidelines by Scientific Board of Ministry of Health of Turkey. Primary outcomes were length of hospitalization, intensive care unit (ICU) requirement, and intubation. Results: We retrospectively evaluated 1,472 COVID-19 adult patients; 57.1% were men (mean age = 51.9 ± 17.7years). A total of 210 (14.3%) had severe pneumonia, 115 (7.8%) were admitted to ICUs, and 69 (4.7%) were intubated during hospitalization. The median (interquartile range) of duration of hospitalization, including ICU admission, was 7 (5–12) days. Favipiravir (n = 328), lopinavir/ritonavir (n = 55), and oseltamivir (n = 761) were administered as antiviral agents, and hydroxychloroquine (HCQ, n = 1,382) and azithromycin (n = 738) were used for their immunomodulatory activity. Lopinavir/ritonavir (? [95% CI]: 4.71 [2.31–7.11]; p = 0.001), favipiravir (? [95% CI]: 3.55 [2.56–4.55]; p = 0.001) and HCQ (? [95% CI]: 0.84 [0.02–1.67]; p = 0.046) were associated with increased risk of lengthy hospital stays. Furthermore, favipiravir was associated with increased risks of ICU admission (OR [95% CI]: 3.02 [1.70–5.35]; p = 0.001) and invasive mechanical ventilation requirement (OR [95% CI]: 2.94 [1.28–6.75]; p = 0.011). Conclusion: Our findings demonstrated that antiviral drugs including lopinavir, ritonavir, and favipiravir were associated with negative clinical outcomes such as increased risks for lengthy hospital stay, ICU admission, and invasive mechanical ventilation requirement. Therefore, repurposing such agents without proven clinical evidence might not be the best approach for COVID-19 treatment. Copyright © 2022 Babayigit, Kokturk, Kul, Cetinkaya, Atis Nayci, Argun Baris, Karcioglu, Aysert, Irmak, Akbas Yuksel, Sekibag, Baydar Toprak, Azak, Mulamahmutoglu, Cuhadaroglu, Demirel, Kerget, Baran Ketencioglu, Ozger, Ozkan, Ture, Ergan, Avkan Oguz, Kilinc, Ercelik, Ulukavak Ciftci, Alici, Nurlu Temel, Ataoglu, Aydin, Cetiner Bahcetepe, Gullu, Fakili, Deveci, Kose, Tor, Gunluoglu, Altin, Turgut, Tuna, Ozturk, Dikensoy, Yildiz Gulhan, Basyigit, Boyaci, Oguzulgen, Borekci, Gemicioglu, Bayraktar, Elbek, Hanta, Kuzu Okur, Sagcan, Uzun, Akgun, Altinisik, Dursun, Cakir Edis, Gulhan, Oner Eyuboglu, Gultekin, Havlucu, Ozkan, Sakar Coskun, Sayiner, Kalyoncu, Itil and Bayram. | URI: | https://doi.org/10.3389/fmed.2022.894126 https://hdl.handle.net/11499/47740 |
ISSN: | 2296-858X |
Appears in Collections: | PubMed İndeksli Yayınlar Koleksiyonu / PubMed Indexed Publications Collection Scopus İndeksli Yayınlar Koleksiyonu / Scopus Indexed Publications Collection Tıp Fakültesi Koleksiyonu WoS İndeksli Yayınlar Koleksiyonu / WoS Indexed Publications Collection |
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