The Treatment and Outcomes of Patients with COVID-19 in Hubei, China: A Multi-Centered, Retrospective, Observational Study

Shang, Jin; Du, Ronghui; Lu, Qiaofa; Wu, Jianhong; Xu, Shabei; Ke, Zhenghua; Cai, Zhifang; Gu, Yiya; Huang, Qian; Zhan, Yuan; Yang, Jie; Liu, Yumei; Hu, Yi; Zhang, Haiying; Huang, Huxiang; Xie, Zhibin; Li, Xin; Hu, Weihua; Gong, Jianhua; Ke, Wenbing; Shao, Zhilin; Liu, Zheng; Xie, Jungang

doi:10.2139/ssrn.3546060

Cited by 18 publications

(31 citation statements)

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“…5 For further investigation, the researchers of the present study evaluated all the existing reports on treatment of COVID-19 patients, which led to finding one clinical trial 4 and 12 case-report/ case-series studies. 1,3,[20][21][22][23][24][25][26][27][28][29][30][31][32][33][34] There was no mention of prescribing NSAIDs in any of these studies. This might be because of no NSAID being prescribed, which is very unlikely; or it might just be that the In this study, use of ibuprofen has been suggested for controlling the patients' fever (fever over 38.5° Celsius).…”

Section: Discussionmentioning

confidence: 99%

Non‐steroidal anti‐inflammatory drugs in management of COVID‐19; A systematic review on current evidence

et al. 2020

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Background Since there is still no definitive conclusion regarding which non‐steroidal anti‐inflammatory drugs (NSAIDs) are most effective and safe in viral respiratory infections, we decided to evaluate the efficacy and safety of various NSAIDs in viral respiratory infections so that we can reach a conclusion on which NSAID is best choice for coronavirus disease 2019 (COVID‐19). Methods A search was performed in Medline (via PubMed), Embase and CENTRAL databases until 23 March 2020. Clinical trials on application of NSAIDs in viral respiratory infections were included. Results Six clinical trials were included. No clinical trial has been performed on COVID‐19, Severe Acute Respiratory Syndrome and Middle East Respiratory Syndrome infections. Studies show that ibuprofen and naproxen not only have positive effects in controlling cold symptoms, but also do not cause serious side effects in rhinovirus infections. In addition, it was found that clarithromycin, naproxen and oseltamivir combination leads to decrease in mortality rate and duration of hospitalisation in patients with pneumonia caused by influenza. Conclusion Although based on existing evidence, NSAIDs have been effective in treating respiratory infections caused by influenza and rhinovirus, since there is no clinical trial on COVID‐19 and case‐reports and clinical experiences are indicative of elongation of treatment duration and exacerbation of the clinical course of patients with COVID‐19, it is recommended to use substitutes such as acetaminophen for controlling fever and inflammation and be cautious about using NSAIDs in management of COVID‐19 patients until there are enough evidence. Naproxen may be a good choice for future clinical trials.

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Section: Discussionmentioning

confidence: 99%

Non‐steroidal anti‐inflammatory drugs in management of COVID‐19; A systematic review on current evidence

et al. 2020

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“…Fei Zhou [12] The Lancet 2020 2019/12/29-2020/01/31 Wuhan, China Dawei Wang [19] Research Square 2020 2020/02/10 Wuhan, China Qiurong Ruan [20] Intensive Care Med 2020 NA Wuhan, China Yan Deng [21] National Medical Journal of China 2020 2020/01/01-2020/2/21 Wuhan, China Min Chen [22] Herald of Medicine 2020 2020/01/24-2020/02/08 Wuhan, China Xiaoxiong Liu [23] The Lancet Respiratory Medicine 2020 2020/01/01-2020/01/31 Wuhan, China Jin Shang [24] The Lancet 2020 2019/12/27-2020/02/17 Hubei, China Meng Luo [25] Chinese Traditional and Herbal Drugs 2020 2020/01/17-2020/02/25 Wuhan, China…”

Section: Search Resultsmentioning

confidence: 99%

Risk factors associated with fatal outcomes of novel coronavirus infection pneumonia (COVID-19): A systematic review and meta-analysis

Chen

Yan

Zhou

et al. 2020

Preprint

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Background: The COVID-19 infection has caused 111652 deaths worldwide as of 13 April 2020. Risk factors for fatal outcomes of COVID-19 have varied across studies due to limited samples and have lacked effective qualitative and quantitative measurements. We performed a meta-analysis to evaluate risk factors for fatal outcomes of COVID-19.Methods: Data on demographic, clinic, laboratory findings and complications were extracted. Quantitative and qualitative synthesis was conducted for weighted-mean-difference (WMD) and odds-ratio (OR).Results: A total of 30 studies involving 5741 survivors and 1670 deaths were included. The death cases were significantly older than survivors (WMD=15.36, 95% CI: 12.90-17.82), male and smoking history showed higher risk to develop fatal outcome (OR=3.37, 95% CI: 2.27-5.01; OR=1.37, 95% CI: 1.02-1.83, respectively). The clinical symptoms including dyspnea (OR=4.63, 95% CI: 2.85-7.54), hemoptysis (OR=3.11, 95% CI: 1.26-7.56), malaise (OR=2.44, 95% CI: 1.49-3.97). comorbidities with coronary heart disease (OR=4.36, 95% CI: 1.91-9.97), COPD (OR=3.70, 95% CI: 2.03-6.73) and cardiovascular disease (OR=3.45, 95% CI: 2.54-4.70). Compared to survivors, many laboratory indexes increased in deaths group, including serum ferritin (WMD=741.47, 95% CI: 566.77-916.16), lactate dehydrogenase (WMD=226.86, 95% CI: 177.08-276.64) and myoglobin (WMD=102.58, 95% CI: 65.12-140.04), and the decreased indexes included PaO2/FiO2 (WMD=-71.61, 95% CI: -134.11 to -9.11), platelets (WMD=-41.09, 95% CI: -47.33 to -34.85) and PaO2 (WMD=-26.09, 95% CI: -38.9 to -13.29). Main complications contributed to the fatal outcome included sepsis (OR=184.61, 95% CI: 33.43-1019.42), shock (OR=133.76, 95% CI: 36.86-485.34) and respiratory failure (OR=47.37, 95% CI: 20.65-108.66). Conclusion: The main risk factors associated with fatal outcome of COVID-19 involved male, older age, smoking history, chronic medical conditions including coronary heart disease, COPD and cardiovascular disease, clinical symptoms including dyspnea, hemoptysis and malaise, the increased laboratory indexes including serum ferritin, lactate dehydrogenase and myoglobin, the decreased indexes including PaO2/FiO2, platelets and PaO2, main complications including sepsis, shock and respiratory failure. These factors could be considered in triaging patients and allocating medical resources when such medical resources are scarce, devising improved protocols for patient diagnosis and management, and developing new drugs and other therapies to treat COVID-19 patients.

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“…Five cohort studies (one on COVID-19, three on SARS, one on severe MERS) with a total of 5872 patients assessed the duration of hospital stay (29,31,35,37,41 Figure 9).…”

Section: Meta-analysesmentioning

confidence: 99%

Effectiveness and Safety of Glucocorticoids to Treat COVID-19: A Rapid Review and Meta-Analysis

Zhou

Huang

et al. 2020

Preprint

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Background: Glucocorticoids are widely used in the treatment of various pulmonary inflammatory diseases, but they are also often accompanied by significant adverse reactions. Published guidelines point out that low dose and short duration systemic glucocorticoid therapy may be considered for patients with rapidly progressing COVID-19 while the evidence is still limited. Methods:We comprehensively searched electronic databases and supplemented the screening by conducting a manual search. We included RCTs and cohort studies evaluating the effectiveness and safety of glucocorticoids in children and adults with COVID-19, SARS and MERS, and conducted meta-analyses of the main indicators that were identified in the studies. Results:Our search retrieved 23 studies, including one RCT and 22 cohort studies, with a total of 13,815 patients. In adults with COVID-19, the use of systemic glucocorticoid did not reduce mortality (RR=2.00, 95% CI: 0.69 to 5.75, I²=90.9%) or the duration of lung inflammation (WMD=-1 days, 95% CI: -2.91 to 0.91), while a significant reduction was found in the duration of fever (WMD=-3.23 days, 95% CI: -3.56 to -2.90). In patients with SARS, glucocorticoids also did not reduce the mortality (RR=1.52, 95% CI: 0.89 to 2.60, I²=84.6%), duration of fever (WMD=0.82 days, 95% CI: -2.88 to 4.52, I²=97.9%) or duration of lung inflammation absorption All rights reserved. No reuse allowed without permission.(which was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity.

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The Treatment and Outcomes of Patients with COVID-19 in Hubei, China: A Multi-Centered, Retrospective, Observational Study

Cited by 18 publications

References 0 publications

Non‐steroidal anti‐inflammatory drugs in management of COVID‐19; A systematic review on current evidence

Non‐steroidal anti‐inflammatory drugs in management of COVID‐19; A systematic review on current evidence

Risk factors associated with fatal outcomes of novel coronavirus infection pneumonia (COVID-19): A systematic review and meta-analysis

Effectiveness and Safety of Glucocorticoids to Treat COVID-19: A Rapid Review and Meta-Analysis

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