ISSN: 2639-2038
Authors: Valerio Pascua F, Baires F, Diaz O, Sierra M, Palou E, Alvarado T, Hernández CI, Lewis AS, Durón M, Valenzuela HD, Flores A, Alvarenga LF, Diaz T, Chajtur DG, Benítez LG, Pineda E, Vargas M, Caraccioli GG, Garay J, Godoy J, Matamoros D, Larios J, Lara R, Deras P, Leon V, Videa EO, Stevens ML, Eberhard D, Singh J, Sekhon AK* and Sierra Hoffman M
Background: Early treatment of COVID-19 disease with repurposed drugs has been controversial. Most guidelines in the developed world recommend monoclonal antibodies or Ritonavir/Nirmatrelvir therapies for patients at risk of clinical deterioration, but accessibility to these in developing countries is a big challenge. The primary purpose of this study is to Epidemiology International Journal 2 Sekhon AK, et al. Repurposing Drugs for Covid-19 by a Developing Country. Epidemol Int J 2022, 6(2): 000234. Copyright© Sekhon AK, et al. review the impact of early treatment of COVID-19 with repurposed drugs on hospitalizations, oxygen requirement, and mortality in a limited resource setting. Methods: This observational cohort study was Institutional Review Board (IRB) approved. Data was collected from medical records from November 2020 until October 2021. A multiphasic multidrug protocol of repurposed drugs was used as COVID-19 outpatient therapy in Honduras. Patients within 7 days of disease onset and mild symptoms received Ivermectin, Aspirin, Colchicine, Fluvoxamine, and Famotidine. On day 7, patients received Prednisolone and Apixaban if CT-chest showed pulmonary infiltrates and inflammatory markers were elevated. Patients were followed every 24-72 hours, and pulse doses of methylprednisolone were given for clinical deterioration. Results: Of 415 patients, 208 were men (50.1%), and 207 women (49.9%). Average age of the cohort was 47.4 years, and 94 patients were above age 60. 414 patients survived (99.7% survival). Twenty-six patients required hospitalization (6.5%, 95% CI: 4.5% - 9.3%). All the hospitalized patients were unvaccinated. Other significant risk factors for hospitalization included age ≥ 60 years, hypertension, diabetes, late Fluvoxamine start (>4 days), and steroid use prior to presentation. Only thirteen patients required oxygen (3.1% 95% CI: 1.8% - 5.3%). Significant risk factors for oxygen requirement included age ≥ 60 years, male gender, and prior steroid usage. All the thirteen patients that required oxygenation were unvaccinated. The average length of hospital stay was 5.9 days. Conclusion: Early outpatient treatment with affordable, easily accessible repurposed drugs focusing on the pathophysiology of COVID-19 disease progression shows promising results vs. the standard of care by WHO, with only one death, 3.1% requiring oxygen, 6.5% hospitalizations, and an average hospital stay of 5.9 days in a developing country.
Keywords: COVID-19; Repurposed Drugs; Fluvoxamine; Developing Country; Early Outpatient Treatment; Prednisolone; Colchicine
