Pharmacoepidemiological research of COVID-19 in the Russian Federation EGIDA-2020

Abstract

Aim. An analysis of coronavirus infection in Russia and evaluation of different AVT regimens effectiveness.
 Materials and methods. The study involved a retrospective analysis of 1082 patient records with laboratory-confirmed COVID-19 in 17 regions of Russia. The number of men and women was equal, mean age 48.718.1 (median 50). Patients with moderate COVID-19 (85%) versus mild COVID-19 (15%) were characterized by higher age (median 54 vs 21 years; p0.001), higher body mass index (27.8 vs 23.4; p0.001), prevalence of chronic diseases (75.3% vs 8.5%; p0.001), including circulatory system diseases (37.8%). Moderate COVID-19 characterized higher intoxication (10.86.1 vs 4.22.7 days; p0.001) and catarrhal symptoms duration (10.25.4 vs 6.14.1 days; p0.001).
 Results. During hospitalization 92% of the patients received AVT, 77% antibiotics, and 16% corticosteroids. Umifenovir therapy resulted in a significant reduction of intoxication (8.75.5 vs 11.75.5 days; p0.001) and catarrhal symptoms duration (8.85.1 vs 12.04.9 days; p0.001) compared to the group without AVT. The usage of INF reduced intoxication symptoms compared with the group without AVT (8.97.5 vs 11.75.5; p0.05). Therapy with hydroxychloroquine, imidazolylethanamide pentandioic acid, and lopinavir + ritonavir combination did not affect the course of COVID-19. Most of adverse reactions were related to antibiotics.
 Conclusion. Umifenovir therapy and inclusion of interferon in AVT regimens was associated improvement in the clinical manifestation of the disease among patients.

Antimicrobial Prescribing Patterns in Patients with COVID-19 in Russian Multi-Field Hospitals in 2021: Results of the Global-PPS Project

“…Prescribing in ICUs was heterogeneous but overall consistently high across healthcare settings (75.6% on average, variations from 52.7% to 100%), while in medical wards, antibiotics were given less commonly (29.7% on average, variations from 19% to 62%). These rates are lower in comparison with the global data (60–100% [ 5 , 6 , 7 , 8 ]) and the data from the Russian EGIDA-2020 study [ 11 ] that revealed 77% antibiotic coverage in COVID-19 inpatients in 2020, which can be explained by the methodological differences of the studies as well as the global trend to restrict antibacterial prescribing in COVID-19 patients. By now, it is a well-known fact that bacterial infections are relatively rare in patients with COVID-19 outside of intensive care [ 9 , 10 ], which makes antibacterial therapy unjustified in certain portion of patients and provides an opportunity for AMS interventions.…”

“…The rate of patients who received antiviral therapy on the day of the PPS (31%) was vastly different from the 92% observed in the retrospective EGIDA-2020 study of 1082 records of patients with laboratory-confirmed COVID-19 in 17 regions of Russia [ 11 ]. This gap can be partially explained by different methodologies of the projects.…”

“…Another matter is the diversity in approaches to COVID-19 management in 2020 and in 2021. The lack of effective options for the treatment in a pandemic with high mortality rates promoted wide use of any potentially effective agents, which was reflected in the guidelines during that time period [ 11 ].…”

“…In the EGIDA-2020 study, only patients with laboratory confirmed SARS-CoV-2 infection were included, and all of them had treatment options that later failed to prove efficacy for the treatment of COVID-19 (hydroxychloroquine, imidazolylethanamide pentandioic acid, lopinavir + ritonavir combination, umifenovir, and interferons) [ 11 ]. In another Russian retrospective study performed in September–December 2020 in the population of hospitalized patients with COVID-19 (46% laboratory confirmed), 40% of patients had received antiviral therapy before admission (umifenovir, interferons, imidazolylethanamide pentandioic acid, favipiravir, etc.…”

“…A similar trend has been observed in Russia. According to a retrospective analysis of 1082 records of patients with laboratory-confirmed COVID-19 in 2020 in 17 regions of Russia (EGIDA-2020 study), up to 77% of hospitalized patients received antibiotics [ 11 ].…”