Outcome of noncritical COVID-19 patients with early hospitalization and early antiviral treatment outside the ICU

Abstract

Background/aim: Despite the COVID-19 pandemic has been going on over 5 months, there is yet to be a standart management policy for all patients including to those mild-to-moderate cases. We evaluated the role of early hospitalization in combination with early antiviral therapy with COVID-19 patients in a tertiary care university hospital. Materials and Methods: This was a prospective, observational, single center study on probable/confirmed COVID-19 patients hospitalized in a tertiary care hospital COVID-19 wards between March 20-April 30, 2020. The demographic, laboratory, and clinical data were collected. Results: We included 174 consecutive probable/confirmed COVID-19 adult patients hospitalized in the Internal Medicine wards of the University Adult Hospital between March 20 and April 30, 2020. The median age was 45.5 (19-92) years and 91 patients (52.3%) were male. 120 (69%) were confirmed microbiologically, 41 (23.5%) radiologically diagnosed and, 13 (7.5%) were clinically suspected (negative microbiological and radiological findings compatible with COVID-19); 35 (20.1%) had mild, 107 (61.5%) moderate disease, and 32 (18.4%) had severe pneumonia. Of 130/171 (74.3%) showed pneumonia; 80 were typical, 50 indeterminate infiltration for COVID-19. Patients admitted within a median of 3 days (0-14 days) after symptoms appear. The median duration of hospitalization was 4 days (0-28 days). In this case series, 13.2% patients were treated with hydroxychloroquine alone, 64.9% with hydroxychloroquine plus azithromycin, and 18.4% with regimens including favipiravir. A total of 15 patients (8.5%) were transferred to the ICU. Four patients died (2.2%). 2 Conclusion: In our series, early of 174 patients admitted to the hospital wards for COVID-19, 69% confirmed with PCR and/or antibody test. On the admission nearly one fifth of the patients had severe diseases. 95.4% of the patients received HQ alone or in combination. The overall case fatality rate was 2.2%.

Evaluation of the Characteristics and Clinical Results of the Patients Hospitalized With Covid-19 Pneumonia in the Province of Mus: A State Hospital Experience

“…This can be explained by the fact that, unlike others, mild patients without pneumonia were not included in our study. The ratio of the patients aged over 65 years was also higher than the ratio in previous studies, which scrutinized clinical outcomes of the patients from China and Turkey (11)(12)(13)(14). The mean age of the patients and the ratio of the patients' aged over 65 years were found to be significantly higher in patients with severe disease similar to other studies (11,14,15).…”

“…However, this could be due to the fact that they included the patients without pneumonia in their analyses and also the comorbidity rate was lower in these studies (14,15). Hypertension and diabetes mellitus were the leading comorbidities in our study as shown in previous studies, also the frequency of chronic obstructive pulmonary disease (COPD) was higher than all (11,13,16,(19)(20)(21)(22). Unlike other studies, the frequency of obesity and malignancy was lower (7,(23)(24)(25).…”

“…The incidence of severe and critically ill patients was higher than the incidence in similarly designed studies (11)(12)(13). This can be explained by the fact that, unlike others, mild patients without pneumonia were not included in our study.…”

Favipiravir for the treatment of patients with COVID-19: a systematic review and meta-analysis

“…Among the 11 studies, three studies were RCTs [16,[18][19][20], one study was a non-randomized controlled study [17], one study was a before and after nonrandomized controlled study [21], and six studies were observational studies or case series [22][23][24][25][26]. Among the comparative studies, the comparators included umifenovir [17], baloxavir marboxil [18], standard of care (SOC) [19], lopinavir/ritonavir [21], and HQ alone or in combination with azithromycin [25]. An RCT that examined the early or late initiation of favipiravir treatment was the only study investigating asymptomatic or mildly ill patients [19].…”

Assessment and management of the SARS-CoV-2 infection: A secondary center experience

“…The rate of patients who needed intensive care has been reported to be 5-15.7% in different studies. 2,3,18,22,25,41,42 Mortality varies from 2.08% to 78% in patients with COVID-19 disease 12,14,15,21,24,41,42 , and from 1.4% to 72% among ICU patients with COVID-19. 3,4,16,17,27 In the studies conducted in our country, mortality rates between 2.08 and 10.5% 26,27,41,42 have been reported.…”