Evaluation of the Pharmacologic Treatment of COVID-19 Pandemic in Iraq

Abstract

The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, or COVID-19) has been detrimental to human health, economy, and wellbeing. Little information is known on the epidemiology and outcome of the disease in a localized community within Iraq. We carried out an audit of confirmed cases of COVID-19 in the Kirkuk General Hospital. Data from the 20th of June to the 31st of July, 2020, were collected and analyzed. Suspected COVID-19 cases were confirmed by real-time polymerase chain reaction (RT-PCR). Data on clinical symptoms, age, and treatment protocols were analyzed concerning the outcome. Our study included a total of 200 individual confirmed COVID-19 patients. The majority of cases 55% (n = 110) displayed severe symptoms, while 32.5% (65 cases) and 12.5% (25 cases) of patients displayed moderate to mild symptoms, respectively. The rate of death in the referred patients was 5%. Most patients admitted to the hospital for treatment recovered and were discharged from the hospital within 5 to 30 days post-diagnosis. Statistical analysis revealed that patients treated with oseltamivir, hydroxychloroquine, and azithromycin in combination with vitamins C and D have shorter hospital stay compared to patients receiving the same therapeutic protocol in combination with steroids. Moreover, a higher mortality rate (4.5%) was observed in patients treated with oseltamivir, hydroxychloroquine, ceftriaxone, and steroids. This study highlights a significant relationship between age, secondary ailments, and the choice of medications as simple predictors of the outcome of COVID-19.

Effects of Hydroxychloroquine on markers of oxidative stress and antioxidant reserve in rheumatoid arthritis patients

“…Finally, the current study shows that HCQ was a highly significant improvement in oxidative stress parameter (MDA), and TG concentrations in the serum patients with RA compared with RA patients on conventional therapy and control and was a highly significant improvement in MDA and TG levels in comparison with conventional therapy. It is worthy to mention that hydroxychloroquine is used in COVID-19 with an obscure mechanism of action [45][46][47][48][49], either alone or with zinc as a cofactor for potential therapy [50]. While the proposed mechanism also involved reduced oxidative and pro-inflammatory damage, nonetheless, these data need further confirmation at a molecular level to confirm the therapeutic activities.…”

Evaluation of the Therapeutic Effects Of combined Hydroxychloroquine And azithromycine in Patients With Covid-19

“…The azithromycin dosage used in the study was significantly lower than the hydroxychloroquine dosage used in the research, despite the fact that the hydroxychloroquine was obtained from our hospital. For the therapeutic remedies of severe COVID-19 infection in individuals who are apparently free from cardiovascular risk factors, the combination of hydroxychloroquine and azithromycin was investigated (5). In laboratory animals, hydroxychloroquine, either alone or combined with azithromycin, was shown to reduce COVID-19 mortality (18).…”

“…When 1561 COVID-19 patients were brought to the hospital for treatment, researchers from RECOVERY found that large dosages of hydroxychloroquine didn't have any impact on 28-day mortality, but they did have detrimental consequences on their health (Increased length of stay in the hospital, progression to invasive mechanical ventilation, and eventual death) (9). Furthermore, it was shown that hydroxychloroquine was unsuccessful in COVID-19 patients who were admitted to the hospital, independent of the dosage administered (5). Patients with moderate to severe COVID-19 related dyspnea who received hydroxychloroquine and azithromycin did not experience a reduction in mortality, a reduction in the need for invasive oxygen treatment, a reduction in the rate of ICU transfers, or a reduction in the length of hospital stay, according to the findings of our study.…”

“…Large number of drugs from different classes has been proposed as a therapy for COVID-19 (5); including azithromycin and hydroxychloroquine. Beyond its antiviral and immunomodulatory characteristics, hydroxychloroquine has a well-established safety profile as a result of its application in the management of malaria and autoimmune disorders, among other indications (6,7).…”

The Correlation between Age and Coronavirus Infections

“…or patients' history of previous medications should be considered from the point of view of polypharmacy and its impact on geriatric patients [55][56][57][58], moreover, some drugs are tonic multivitamins [59][60][61]or zinc [62][63][64]which cud be used as add-on therapy for patients with other diseases and greatly impact the disease outcome or pathogenicity.…”