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Article: Clinical outcomes of different therapeutic options for COVID-19 in two Chinese case cohorts: A propensity-score analysis

TitleClinical outcomes of different therapeutic options for COVID-19 in two Chinese case cohorts: A propensity-score analysis
Authors
KeywordsCovid-19
Antivirals
Corticosteroids
Interferons
Antibiotics
Chinese medicine;mUlti-centre
Population-based cohort
Issue Date2021
PublisherElsevier: Creative Commons Licenses. The Journal's web site is located at https://www.journals.elsevier.com/eclinicalmedicine
Citation
EClinicalMedicine, 2021, v. 32, article no. 100743 How to Cite?
AbstractBackground: The timing of administration of agents and use of combination treatments in COVID-19 remain unclear. We assessed the effectiveness of therapeutics in cohorts in Hong Kong SAR and Anhui, China. Methods: We conducted propensity-score analysis of 4771 symptomatic patients from Hong Kong between 21st January and 6th December 2020, and 648 symptomatic patients from Anhui between 1st January and 27th February 2020. We censored all observations as at 13st December 2020. Time from hospital admission to discharge, and composite outcome of death, invasive mechanical ventilation or intensive care unit admission across 1) all therapeutic options including lopinavir-ritonavir, ribavirin, umifenovir, interferon-alpha-2b, interferon-beta-1b, corticosteroids, antibiotics, and Chinese medicines, and 2) four interferon-beta-1b combination treatment groups were investigated. Findings: Interferon-beta-1b was associated with an improved composite outcome (OR=0.55, 95%CI 0.38, 0.80) and earlier discharge (−8.8 days, 95%CI −9.7, −7.9) compared to those not administered interferon-beta-1b. Oral ribavirin initiated within 7 days from onset was associated with lower risk of the composite outcome in Hong Kong (OR=0.51, 95%CI 0.29, 0.90). Lopinavir-ritonavir, intravenous ribavirin, umifenovir, corticosteroids, interferon-alpha-2b, antibiotics or Chinese medicines failed to show consistent clinical benefit. Interferon-beta-1b co-administered with ribavirin was associated with improved composite outcome (OR=0.50, 95%CI 0.32, 0.78) and earlier discharge (−2.35 days, 95%CI −3.65, −1.06) compared to interferon-beta-1b monotherapy. Interpretation: Our findings support the early administration of interferon-beta-1b alone or in combination with oral ribavirin for COVID-19 patients. Funding: Hong Kong Health and Medical Research Fund; Hong Kong Innovation and Technology Commission; Chinese Fundamental Research Funds for the Central Universities.
Persistent Identifierhttp://hdl.handle.net/10722/297143
ISSN
2023 Impact Factor: 9.6
2023 SCImago Journal Rankings: 3.522
PubMed Central ID
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorWong, CKH-
dc.contributor.authorWan, EYF-
dc.contributor.authorLuo, S-
dc.contributor.authorDing, Y-
dc.contributor.authorLau, EHY-
dc.contributor.authorLing, P-
dc.contributor.authorHu, X-
dc.contributor.authorLau, ECH-
dc.contributor.authorWong, J-
dc.contributor.authorZheng, X-
dc.contributor.authorCowling, BJ-
dc.contributor.authorWeng, J-
dc.contributor.authorLeung, GM-
dc.date.accessioned2021-03-08T07:14:46Z-
dc.date.available2021-03-08T07:14:46Z-
dc.date.issued2021-
dc.identifier.citationEClinicalMedicine, 2021, v. 32, article no. 100743-
dc.identifier.issn2589-5370-
dc.identifier.urihttp://hdl.handle.net/10722/297143-
dc.description.abstractBackground: The timing of administration of agents and use of combination treatments in COVID-19 remain unclear. We assessed the effectiveness of therapeutics in cohorts in Hong Kong SAR and Anhui, China. Methods: We conducted propensity-score analysis of 4771 symptomatic patients from Hong Kong between 21st January and 6th December 2020, and 648 symptomatic patients from Anhui between 1st January and 27th February 2020. We censored all observations as at 13st December 2020. Time from hospital admission to discharge, and composite outcome of death, invasive mechanical ventilation or intensive care unit admission across 1) all therapeutic options including lopinavir-ritonavir, ribavirin, umifenovir, interferon-alpha-2b, interferon-beta-1b, corticosteroids, antibiotics, and Chinese medicines, and 2) four interferon-beta-1b combination treatment groups were investigated. Findings: Interferon-beta-1b was associated with an improved composite outcome (OR=0.55, 95%CI 0.38, 0.80) and earlier discharge (−8.8 days, 95%CI −9.7, −7.9) compared to those not administered interferon-beta-1b. Oral ribavirin initiated within 7 days from onset was associated with lower risk of the composite outcome in Hong Kong (OR=0.51, 95%CI 0.29, 0.90). Lopinavir-ritonavir, intravenous ribavirin, umifenovir, corticosteroids, interferon-alpha-2b, antibiotics or Chinese medicines failed to show consistent clinical benefit. Interferon-beta-1b co-administered with ribavirin was associated with improved composite outcome (OR=0.50, 95%CI 0.32, 0.78) and earlier discharge (−2.35 days, 95%CI −3.65, −1.06) compared to interferon-beta-1b monotherapy. Interpretation: Our findings support the early administration of interferon-beta-1b alone or in combination with oral ribavirin for COVID-19 patients. Funding: Hong Kong Health and Medical Research Fund; Hong Kong Innovation and Technology Commission; Chinese Fundamental Research Funds for the Central Universities.-
dc.languageeng-
dc.publisherElsevier: Creative Commons Licenses. The Journal's web site is located at https://www.journals.elsevier.com/eclinicalmedicine-
dc.relation.ispartofEClinicalMedicine-
dc.rightsThis work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.-
dc.subjectCovid-19-
dc.subjectAntivirals-
dc.subjectCorticosteroids-
dc.subjectInterferons-
dc.subjectAntibiotics-
dc.subjectChinese medicine;mUlti-centre-
dc.subjectPopulation-based cohort-
dc.titleClinical outcomes of different therapeutic options for COVID-19 in two Chinese case cohorts: A propensity-score analysis-
dc.typeArticle-
dc.identifier.emailWong, CKH: carlosho@hku.hk-
dc.identifier.emailWan, EYF: yfwan@hku.hk-
dc.identifier.emailLau, EHY: ehylau@hku.hk-
dc.identifier.emailCowling, BJ: bcowling@hku.hk-
dc.identifier.emailLeung, GM: gmleung@hku.hk-
dc.identifier.authorityWong, CKH=rp01931-
dc.identifier.authorityWan, EYF=rp02518-
dc.identifier.authorityLau, EHY=rp01349-
dc.identifier.authorityCowling, BJ=rp01326-
dc.identifier.authorityLeung, GM=rp00460-
dc.description.naturepublished_or_final_version-
dc.identifier.doi10.1016/j.eclinm.2021.100743-
dc.identifier.pmid33615206-
dc.identifier.pmcidPMC7881744-
dc.identifier.scopuseid_2-s2.0-85101039649-
dc.identifier.hkuros321472-
dc.identifier.volume32-
dc.identifier.spagearticle no. 100743-
dc.identifier.epagearticle no. 100743-
dc.identifier.isiWOS:000645894000028-
dc.publisher.placeUnited Kingdom-

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