The Clinical Value of Two Combination Regimens in the Management of Patients Suffering From Covid-19 Pneumonia: A Single Centered, Retrospective, Observational Study Publisher Pubmed



Vahedi E¹ ; Ghanei M¹ ; Ghazvini A¹ ; Azadi H¹ ; Izadi M² ; Panahi Y³ ; Fathi S⁴ ; Salesi M¹ ; Saadat SH⁵ ; Ghazale AH⁶ ; Rezapour M⁶ ; Mozafari A⁷ ; Zand N⁸ ; Parsaei MR⁶ Show All Authors Show Affiliations
Source: DARU# Journal of Pharmaceutical Sciences Published:2020

Abstract

Background: There is no identified pharmacological therapy for COVID-19 patients, where potential therapeutic strategies are underway to determine effective therapy under such unprecedented pandemic. Therefore, combination therapies may have the potential of alleviating the patient’s outcome. This study aimed at comparing the efficacy of two different combination regimens in improving outcomes of patients infected by novel coronavirus (COVID-19). Methods: This is a single centered, retrospective, observational study of 60 laboratory-confirmed COVID-19 positive inpatients (≥18 years old) at two wards of the Baqiyatallah Hospital, Tehran, Iran. Patient’s data including clinical and laboratory parameters were recorded. According to the drug regimen, the patients were divided into two groups; group I who received regimen I consisting azithromycin, prednisolone, naproxen, and lopinavir/ritonavir and group II who received regimen II including meropenem, levofloxacin, vancomycin, hydroxychloroquine, and oseltamivir. Results: The oxygen saturation (SpO2) and temperature were positively changed in patients receiving regimen I compared to regimen II (P = 0.013 and P = 0.012, respectively). The serum level of C-reactive protein (CRP) changed positively in group I (P < 0.001). Although there was a significant difference in platelets between both groups (75.44 vs 51.62, P < 0.001), their change did not clinically differ between two groups. The findings indicated a significant difference of the average length of stay in hospitals (ALOS) between two groups, where the patients under regimen I showed a shorter ALOS (6.97 vs 9.93, P = 0.001). Conclusion: This study revealed the beneficial effect of the short-term use of low-dose prednisolone in combination with azithromycin, naproxen and lopinavir/ritonavir (regimen I), in decreasing ALOS compared to regimen II. Since there is still lack of evidence for safety of this regimen, further investigation in our ongoing follow-up to deal with COVID-19 pneumonia is underway. [Figure not available: see fulltext.] © 2020, Springer Nature Switzerland AG.