ISSN: 2639-2038
Authors: Sekhon AK* , 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 , 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
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