Use of repurposed and adjuvant drugs in hospital patients with covid-19: multinational network cohort study

Abstract

Objective To investigate the use of repurposed and adjuvant drugs in patients admitted to hospital with covid-19 across three continents. Design Multinational network cohort study. Setting Hospital electronic health records from the United States, Spain, and China, and nationwide claims data from South Korea. Participants 303 264 patients admitted to hospital with covid-19 from January 2020 to December 2020. Main outcome measures Prescriptions or dispensations of any drug on or 30 days after the date of hospital admission for covid-19. Results Of the 303 264 patients included, 290 131 were from the US, 7599 from South Korea, 5230 from Spain, and 304 from China. 3455 drugs were identified. Common repurposed drugs were hydroxychloroquine (used in from <5 (<2%) patients in China to 2165 (85.1%) in Spain), azithromycin (from 15 (4.9%) in China to 1473 (57.9%) in Spain), combined lopinavir and ritonavir (from 156 (<2%) in the VA-OMOP US to 2,652 (34.9%) in South Korea and 1285 (50.5%) in Spain), and umifenovir (0% in the US, South Korea, and Spain and 238 (78.3%) in China). Use of adjunctive drugs varied greatly, with the five most used treatments being enoxaparin, fluoroquinolones, ceftriaxone, vitamin D, and corticosteroids. Hydroxychloroquine use increased rapidly from March to April 2020 but declined steeply in May to June and remained low for the rest of the year. The use of dexamethasone and corticosteroids increased steadily during 2020. Conclusions Multiple drugs were used in the first few months of the covid-19 pandemic, with substantial geographical and temporal variation. Hydroxychloroquine, azithromycin, lopinavir-ritonavir, and umifenovir (in China only) were the most prescribed repurposed drugs. Antithrombotics, antibiotics, H2 receptor antagonists, and corticosteroids were often used as adjunctive treatments. Research is needed on the comparative risk and benefit of these treatments in the management of covid-19.

Coadministration of AYUSH 64 as an adjunct to Standard of Care in mild and moderate COVID-19: A randomised, controlled, multicentric clinical trial

“…The recent data on the use of repurposed and adjuvant drugs in hospital patients with COVID-19 did not make any mention of herbal drugs or other CAM therapies (51). It is likely that the use of Ayurveda and other CAM therapies such as AYUSH 64, both in the hospital and community setting, was several folds more and we need more suitable data (18).…”

A standardized analytics pipeline for reliable and rapid development and validation of prediction models using observational health data

“…Observational Health Data Sciences and Informatics (OHDSI) is an international, multi-stakeholder collaboration that has developed open-source solutions for large-scale analytics [7] . The OHDSI community has used these open-source solutions to generate observational evidence for COVID-19 and has impacted international clinical guidelines [8] , [9] , [10] , [11] , [12] , [13] , [14] , [15] , [16] , [17] , [18] , [19] , [20] , [21] , [22] .…”

Extracorporeal membrane oxygenation (ECMO) for critically ill patients with coronavirus disease 2019 (COVID‐19): A retrospective cohort study

“…stage. For the anticoagulation protocol, heparin was used.The antiviral drug was arbidol hydrochloride (umifenovir), a broadspectrum antiviral compound, using a gastric feeding tube (200 mg tid) 10,11. LI ET AL.5 | STATISTICAL ANALYSISContinuous variables, expressed as means (with SD) or medians (with interquartile ranges), were compared with independent t test.…”