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Medication Patterns and Disease Progression Among 165 Patients with Coronavirus Disease 2019 (COVID-19) in Wuhan, China: A Single-Centered, Retrospective, Observational Study

37 Pages Posted: 17 Mar 2020

See all articles by Feng Sun

Feng Sun

Peking University - Department of Epidemiology and Biostatistics

Hao Kou

Wuhan University - Department of Pharmacy

Shengfeng Wang

Peking University - Department of Epidemiology and Biostatistics

Yun Lu

Wuhan University - Department of Pharmacy

Houyu Zhao

Peking University - Department of Epidemiology and Biostatistics

Wenjing Li

Wuhan University - Department of Pharmacy

Qingxin Zhou

Peking University - Department of Epidemiology and Biostatistics

Qiaoli Jiang

Wuhan University - Department of Pharmacy

Yinchu Cheng

Peking University - Department of Pharmacy

Kun Yang

Wuhan University - Department of Pharmacy

Lin Zhuo

Peking University - Research Center of Clinical Epidemiology

Yang Xu

Karolinska Institutet - Department of Medical Epidemiology and Biostatistics

Dongfang Wu

Wuhan University - Department of Pharmacy

Siyan Zhan

Peking University - Department of Epidemiology and Biostatistics

Hong Cheng

Wuhan University - Department of Pharmacy

More...

Abstract

Background: The epidemic of coronavirus disease 2019 (COVID-19) has been lasting for nearly three months. Although several treatments have been introduced to the clinical practice, the information on medication patterns and disease progression of patients is still limited. We aimed to describe medication patterns and disease progression of COVID-19 and to explore a potential therapeutic time window for preventing the deterioration of non-severe patients.

Methods: A retrospective, single-center case series study enrolled consecutive hospitalized COVID-19 patients from a designated hospital in Wuhan who were followed up until February 12, 2020. Patients were grouped on a baseline degree of severity: non-severe group (mild and general condition) and severe group (severe and critical severe condition). The medication patterns and potential 72 hours therapeutic time window were linked to disease progression (unchanged/improved vs deteriorated), and were further compared across the two groups.

Findings: Of 165 COVID-19 cases included, the median age was 55 years, 84 (50·9%) had comorbidity, and 26 (15·2%) were in the severe subgroup at admission. Antivirals, antibacterials, glucocorticoids, and traditional Chinese medicine were administered to 92·7%, 98·8%, 68·5% and 55·2% of patients, respectively. A median of 17 (IQR, 10-27) kinds of drugs were prescribed to each patient, and combination patterns were quite diverse. During the follow-up, 11·5% (19/165) died and 32·4% (45/139) non-severe cases deteriorated. Compared with the unchanged/improved group, the deteriorated group was less likely to take medications within 72 hours since the onset of the first symptoms and signs, especially antivirals (8·9% vs 21·3%, P = 0·07). Only 24 patients took antivirals within 72 hours, in which 4 (16·7%) deteriorated. After adjusting age, sex and number of comorbidities, administering medications within 72 hours still significantly decreased the risk of death or deterioration with an odds ratio of 0·3 (95% CI 0·1-0·9; P = 0·04). Besides, 12 patients (7·3%) had a high level of myocardial enzymes, and seven patients (4·2%) presented worsen kidney function.

Interpretation: Medication patterns for COVID-19 were diverse but generally complied with the existing guideline. A potential therapeutic time window of 72 hours might exist in non-severe patients, especially for antiviral drugs. Additionally, the safety issue should not be ignored. Funding National Natural Science Foundation of China.

Funding Statement: This study was supported by the National Natural Science Foundation of China (grant 81973146 to Prof. Zhan).

Declaration of Interests: The authors declare no competing interests.

Ethics Approval Statement: This study was approved by the institutional ethics board of Zhongnan Hospital of Wuhan University (No. 2020014). Written informed consent was waived for emerging infectious diseases.

Keywords: Coronavirus disease 2019 (COVID-19); Medication pattern; Disease progression; Therapeutic time window

Suggested Citation

Sun, Feng and Kou, Hao and Wang, Shengfeng and Lu, Yun and Zhao, Houyu and Li, Wenjing and Zhou, Qingxin and Jiang, Qiaoli and Cheng, Yinchu and Yang, Kun and Zhuo, Lin and Xu, Yang and Wu, Dongfang and Zhan, Siyan and Cheng, Hong, Medication Patterns and Disease Progression Among 165 Patients with Coronavirus Disease 2019 (COVID-19) in Wuhan, China: A Single-Centered, Retrospective, Observational Study (3/4/2020). Available at SSRN: https://ssrn.com/abstract=3551323 or http://dx.doi.org/10.2139/ssrn.3551323

Feng Sun

Peking University - Department of Epidemiology and Biostatistics

No. 38 Xueyuan Road
Haidian District
Beijing, Beijing 100871
China

Hao Kou

Wuhan University - Department of Pharmacy

Wuhan
China

Shengfeng Wang

Peking University - Department of Epidemiology and Biostatistics

No. 38 Xueyuan Road
Haidian District
Beijing, Beijing 100871
China

Yun Lu

Wuhan University - Department of Pharmacy

Wuhan
China

Houyu Zhao

Peking University - Department of Epidemiology and Biostatistics

No. 38 Xueyuan Road
Haidian District
Beijing, Beijing 100871
China

Wenjing Li

Wuhan University - Department of Pharmacy

Wuhan
China

Qingxin Zhou

Peking University - Department of Epidemiology and Biostatistics

No. 38 Xueyuan Road
Haidian District
Beijing, Beijing 100871
China

Qiaoli Jiang

Wuhan University - Department of Pharmacy

Wuhan
China

Yinchu Cheng

Peking University - Department of Pharmacy

Beijing
China

Kun Yang

Wuhan University - Department of Pharmacy

Wuhan
China

Lin Zhuo

Peking University - Research Center of Clinical Epidemiology

Beijing
China

Yang Xu

Karolinska Institutet - Department of Medical Epidemiology and Biostatistics

SE-171 82 Solna
Sweden

Dongfang Wu

Wuhan University - Department of Pharmacy

Wuhan
China

Siyan Zhan (Contact Author)

Peking University - Department of Epidemiology and Biostatistics ( email )

No. 38 Xueyuan Road
Haidian District
Beijing, Beijing 100871
China

Hong Cheng

Wuhan University - Department of Pharmacy ( email )

Wuhan
China

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