Efficacy of Various Treatment Therapies on Patient related Outcome in Hospitalized COVID-19 Patients ̶ A Retrospective Study

Abstract

Background: It was in December 2019, when corona virus disease (2019), with causative organism being novel severe acute respiratory syndrome corona virus 2 (SARS CoV 2) was first reported and declared as a pandemic by WHO on March 11, 2020. The treatment is evolving and is mostly supportive in nature. Corticosteroids are considered one of the standards of care in management of COVID-19 patients with severe illness with respiratory failure.

Objectives: To assess the effect of various treatment modalities on patient-related outcome in hospitalized COVID-19 patients, this retrospective study was undertaken.

Material and methods: Single-center retrospective study that included confirmed COVID-19 cases treated at our institute (a tertiary care hospital in Jammu and Kashmir, India) between March 2020 and December 2020. Patients with age more than 18 years were included in the study.

Results: Our study included a  total of 1,000 COVID-19 positive patients . The median age of the study population was 56 years and males outnumbered females. Majority of the patients (n = 658, 65.8%) had severe illness at the time of presentation. On assessing the effect of various drugs used in management of COVID-19 patients of all severity, use of remdesivir and famotidine was associated with significantly higher survival. In subgroup of patients with severe disease, use of systemic steroids was associated with significantly higher survival chances in addition to remdesivir and famotidine. The likelihood of survival was significantly higher in patients with severe COVID 19 illness who received combination of systemic steroids plus remdesivir compared to steroids and remdesivir alone.

Conclusion: Steroids were effective in severe COVID-19 illness and the combination of steroids and remdesivir was more effective in severe illness. There is a need to undertake more large scale prospective randomized trials to determine the most effective drug therapies to treat the sick patients and prevent worsening of mild cases.