Lack of effect on in-hospital mortality of drugs used during COVID-19 pandemic: Findings of the retrospective multicenter COVOCA study

PLoS One. 2021 Sep 14;16(9):e0256903. doi: 10.1371/journal.pone.0256903. eCollection 2021.

Abstract

Introduction: During COVID-19 pandemic, the use of several drugs has represented the worldwide clinical practice. However, though the current increase of knowledge about the disease, there is still no effective treatment for the usage of drugs. Thus, we retrospectively assessed use and effects of therapeutic regimens in hospitalized patients on in-hospital mortality.

Methods: COVOCA is a retrospective observational cohort study on 18 COVID centres throughout Campania Region Hospitals. We included adult patients with confirmed SARS-CoV-2 infection, discharged/dead between March/June 2020.

Results: 618 patients were included, with an overall in-hospital cumulative mortality incidence of 23.1%. Most prescribed early treatments were antivirals (72%), antibiotics (65%) and hydroxychloroquine/anticoagulants (≈50%). Tocilizumab, indeed, was largely prescribed late during hospitalization. Multivariable models, with a cut-off at day 2 for early COVID-19 therapy administration, did not disclose any significant association of a single drug administration on the clinical outcome.

Discussion: COVOCA represents the first multicenter database in Campania region. None drug class used during the pandemic significantly modified the outcome, regardless of therapy beginning, both overall and net of those already in non-invasive ventilation (NIV)/ orotracheal intubation (OTI) at hospitalization. Our cumulative incidence of mortality seems lower than other described during the same period, particularly in Northern Italy.

Publication types

  • Multicenter Study
  • Observational Study

MeSH terms

  • Aged
  • Antiviral Agents / therapeutic use*
  • COVID-19 / epidemiology
  • COVID-19 / mortality*
  • COVID-19 Drug Treatment*
  • Female
  • Hospital Mortality
  • Humans
  • Italy / epidemiology
  • Male
  • Middle Aged
  • Pandemics
  • Respiratory Therapy
  • Retrospective Studies

Substances

  • Antiviral Agents

Grants and funding

The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. The authors received no specific funding for this work.