Background and Importance Pharmacotherapeutic management of SARS-CoV-2 infection from the beginning of COVID-19 pandemic to now has evolved in accordance with research and clinical experience, improving treatments and thus clinical outcomes.
Aim and Objectives Our aim is to analyse the changes in the epidemiology and prevalence of use of the different treatments used against COVID-19 and its clinical outcomes throughout the pandemic (from March 2020 to May 2021) in a retrospective unicentre study. We present the data of a university tertiary hospital.
Material and Methods We identified all COVID-19 patients admitted to our hospital >48h through the electronic medical records (SAP Medication®). We evaluated demographic data (age and sex), clinical features (number of admissions/month in ICU or regular wards, mean length of stay and deaths including those <48h) as well as monthly drug consumption of remdesivir, hydroxychloroquine, lopinavir/ritonavir, beta-interferon, tocilizumab, baricitinib, anakinra, corticoids (dexamethasone 6 mg/day and >20 mg/day, methylprednisolone >40 mg/day, prednisone >30 mg/day, hydrocortisone>100 mg/day) and antibiotics.
Results A total of 4406 patients with SARS-CoV-2 infection were admitted of which 3723 met the inclusion criteria. The median age was 66 years, with higher percentage of men (59%). The number of patients admitted to ICU, semi critical care or a regular ward was, respectively 20%, 5,3% and 74,7%. The percentage of deaths after the large peak of mortality (15,2%) in March progressively decreased to 7,7% in the first trimester 2021. The median length of stay for ICU/semi critical care or regular care was 26,2 and 8,7 days. Trends in monthly use of the most frequent drugs are shown in the figure below. More than 80% of inpatients took lopinavir/ritonavir and hydroxychloroquine at the beginning, but consumption was drastically reduced after. The use of beta interferon was anecdotical after first months. The most used antimicrobials were ceftriaxone (45,5%) and azithromycin (34,9%), followed by levofloxacin (8,9%), amoxicillin/clavulanate (7,1%) and ceftaroline (6,0%).
Conclusion and Relevance The use of drugs during the pandemic of COVID-19 has shown a clear evolution over months towards more standardised treatments, with remdesivir as antiviral and dexamethasone, tocilizumab and baricitinib standing out as anti-inflammatory drugs in our centre. Homogenisation and standardisation of COVID-19 treatments have been managed as a reflection of the scientific evidence accumulated throughout the pandemic.
Conflict of Interest No conflict of interest
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