Improved outcomes with Trimethoprim or Cotrimoxazole in patients with severe COVID-19: A District Hospital experience

Posted: 26 Jun 2020

See all articles by Rehan Quadery

Rehan Quadery

NHS Foundation Trust - Epsom and St. Helier University Hospitals

Thomas John

NHS Foundation Trust - Epsom and St. Helier University Hospitals

Thomas Samuel

NHS Foundation Trust - Epsom and St. Helier University Hospitals

Shashikiran Ramanna

NHS Foundation Trust - Epsom and St. Helier University Hospitals

Gopal Chattopadhyay

NHS Foundation Trust - Epsom and St. Helier University Hospitals

Chandrashekar Malapanjudi

NHS Foundation Trust - Epsom and St. Helier University Hospitals

Amar Sodha

NHS Foundation Trust - Epsom and St. Helier University Hospitals

Rebecca Lawrence

NHS Foundation Trust - Epsom and St. Helier University Hospitals

Souvik Dutta

Peerless Hospital & B.K.Roy Research Center

Veronica Varney

NHS Foundation Trust - Epsom and St. Helier University Hospitals

Date Written: June 10, 2020

Abstract

Background
COVID-19 may become life-threatening as a result of the host mediated cytokine storm syndrome. There is no proven effective treatment available and the mainstay of management is supportive.

Methods
We retrospectively analysed data from 22 patients with severe COVID-19 treated with oral Trimethoprim (TMP) or Cotrimoxazole (CTX) in addition to standard therapy (ST) and compared these with 22 patients with severe COVID-19 who had received ST alone.

Results
We observed that patients with severe COVID-19 receiving TMP/CTX in addition to ST had better outcomes. These include reduction in mortality (5% versus 32%, p=0.022), need for ventilatory support (3 versus 16 patients, p<0.001) and length of hospital stay (mean: 9 versus 22 days, p<0.001). Clinical parameters improved within 48 hours of starting treatment with TMP/CTX (SpO2/FiO2, p<0.001; C-Reactive Protein, p=0.002).

Discussion
These results may be due to the antimicrobial and anti-inflammatory effects of TMP/CTX. Clinical trials with CTX in patients with severe COVID-19 are ongoing.

Note: Funding: None to declare

Declaration of Interest: None to declare

Keywords: Severe COVID-19, Trimethoprim, Cotrimoxazole, Antibiotic, Anti-inflammatory

Suggested Citation

Quadery, Rehan and John, Thomas and Samuel, Thomas and Ramanna, Shashikiran and Chattopadhyay, Gopal and Malapanjudi, Chandrashekar and Sodha, Amar and Lawrence, Rebecca and Dutta, Souvik and Varney, Veronica, Improved outcomes with Trimethoprim or Cotrimoxazole in patients with severe COVID-19: A District Hospital experience (June 10, 2020). Available at SSRN: https://ssrn.com/abstract=3626443 or http://dx.doi.org/10.2139/ssrn.3626443

Rehan Quadery

NHS Foundation Trust - Epsom and St. Helier University Hospitals ( email )

Surrey
United Kingdom

Thomas John (Contact Author)

NHS Foundation Trust - Epsom and St. Helier University Hospitals ( email )

Surrey
United Kingdom

Thomas Samuel

NHS Foundation Trust - Epsom and St. Helier University Hospitals ( email )

Surrey
United Kingdom

Shashikiran Ramanna

NHS Foundation Trust - Epsom and St. Helier University Hospitals ( email )

Surrey
United Kingdom

Gopal Chattopadhyay

NHS Foundation Trust - Epsom and St. Helier University Hospitals ( email )

Surrey
United Kingdom

Chandrashekar Malapanjudi

NHS Foundation Trust - Epsom and St. Helier University Hospitals ( email )

Surrey
United Kingdom

Amar Sodha

NHS Foundation Trust - Epsom and St. Helier University Hospitals ( email )

Surrey
United Kingdom

Rebecca Lawrence

NHS Foundation Trust - Epsom and St. Helier University Hospitals ( email )

Surrey
United Kingdom

Souvik Dutta

Peerless Hospital & B.K.Roy Research Center ( email )

360 Panchasayar
Kolkata, West Bengal 700 094
India

Veronica Varney

NHS Foundation Trust - Epsom and St. Helier University Hospitals ( email )

Surrey
United Kingdom

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