Effects of Immune System-Related Medications on COVID-19 Outcome in a Cohort of Iranian Patients: Preliminary Report of a Data Mining Study

Abstract

Background. Regulation of the immune system is critical for fighting against viral infections. Both suppression and hyperactivity of the immune system result in failure of treatment. The present study was designed to show the effects of immune system-related medications on mortality and length of stay (LOS) in a cohort of Iranian patients with coronavirus disease 2019 (COVID-19). Methods. A data mining study was performed on 6417 cases of COVID-19 covered by 17 educational hospitals of Iran University of Medical Sciences, Tehran. Association of a researcher-designed drug list with death and LOS was studied. For death outcome, logistic regression was used reporting odds ratio (OR) with 95% confidence interval (CI). For LOS, right censored Poisson regression was used reporting incidence rate ratio (IRR) with 95% CI. Results. Among the corticosteroids, prednisolone was a risk factor on death ( OR = 1.41 , 95 % CI = 1.03 − 1.94 ). This association was increased after adjustment of age interactions ( OR = 3.45 , 95 % CI = 1.01 − 11.81 ) and was removed after adjustment of ICU admission interactions ( OR = 2.64 , 95 % CI = 0.70 − 9.92 ). Hydroxychloroquine showed a protecting effect on death ( OR = 0.735 , 95 % CI = 0.627 − 0.862 ); however, this association was removed after adjustment of age interactions ( OR = 0.76 , 95 % CI = 0.41 − 1.40 ). Among the antivirals, oseltamivir showed a protecting effect on death ( OR = 0.628 , 95 % CI = 0.451 − 0.873 ); however, this association was removed after adjustment of age interactions ( OR = 0.45 , 95 % CI = 0.11 − 1.82 ). For reduction of LOS, the only significant association was for hydroxychloroquine ( IRR = 0.85 , 95 % CI = 0.79 − 0.92 ). Conclusion. The results of such data mining studies can be used in clinics until completing the evidence. Hydroxychloroquine may reduce mortality in some specific groups; however, its association may be confounded by some latent variables and unknown interactions. Administration of corticosteroids should be based on the conditions of each case.

A near real-time electronic health record-based COVID-19 surveillance system: An experience from a developing country

“…In addition, the machine learning platform enables researchers to analyse the data. For example, many university researchers are working on such data to predict future trends of the disease or to develop models to predict length of stay, ICU admissions, and deaths, or to investigate treatments ( Yahyavi et al, 2021 ; Bitaraf et al, 2021a ).…”

Digital Healthcare Tools in Nigeria: Strengthening Public Health and Pandemic Preparedness - Insights from the COVID-19 Crisis

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Clinical characteristics and risk factors for a prolonged length of stay of patients with asymptomatic and mild COVID-19 during the wave of Omicron from Shanghai, China

“…Since the average LOS of the 151,018 patients discharged before May 8, 2022 (admission started on April 7, 2022) from the same hospital was 7.03 days (released by the information center of the hospital), the patients with a LOS of more than 7 days (> 7 days) were included in the Prolonged group, and those with a LOS of no more than 7 days (≤ 7 days) were included in the Control group. Patients were excluded if they (1) had severe and complex comorbidities that may cause unspecific symptoms and affect viral shedding, including malignant tumors, immunosuppression, mental disorders, hematological diseases, and chronic hepatic and renal dysfunction [16][17][18][19][20][21]; (2) failed to be discharged due to any personal reasons when the discharge criteria were met (e.g., staying for taking care of their relatives in the same hospital, etc.). This study was approved by the Institutional Review Board of the Daping Hospital of Army Medical University (2022-165).…”