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10.1007/s40265-020-01424-7

http://scihub22266oqcxt.onion/10.1007/s40265-020-01424-7
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33151482!7643089!33151482
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suck abstract from ncbi


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pmid33151482      Drugs 2020 ; 80 (18): 1961-1972
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  • Pharmacotherapy for Hospitalized Patients with COVID-19: Treatment Patterns by Disease Severity #MMPMID33151482
  • Lin KJ; Schneeweiss S; Tesfaye H; D'Andrea E; Liu J; Lii J; Murphy SN; Gagne JJ
  • Drugs 2020[Dec]; 80 (18): 1961-1972 PMID33151482show ga
  • BACKGROUND: Treatment decisions for Coronavirus Disease 2019 (COVID-19) depend on disease severity, but the prescribing pattern by severity and drivers of therapeutic choices remain unclear. OBJECTIVES: The objectives of the study were to evaluate pharmacological treatment patterns by COVID-19 severity and identify the determinants of prescribing for COVID-19. METHODS: Using electronic health record data from a large Massachusetts-based healthcare system, we identified all patients aged >/= 18 years hospitalized with laboratory-confirmed COVID-19 from 1 March to 24 May, 2020. We defined five levels of COVID-19 severity at hospital admission: (1) hospitalized but not requiring supplemental oxygen; (2-4) hospitalized and requiring oxygen /= 5 L per minute, respectively; and (5) intubated or admitted to an intensive care unit. We assessed the medications used to treat COVID-19 or as supportive care during hospitalization. RESULTS: Among 2821 patients hospitalized for COVID-19, we found inpatient mortality increased by severity from 5% for level 1 to 23% for level 5. As compared to patients with severity level 1, those with severity level 5 were 3.53 times (95% confidence interval 2.73-4.57) more likely to receive a medication used to treat COVID-19. Other predictors of treatment were fever, low oxygen saturation, presence of co-morbidities, and elevated inflammatory biomarkers. The use of most COVID-19 relevant medications has dropped substantially while the use of remdesivir and therapeutic anticoagulants has increased over the study period. CONCLUSIONS: Careful consideration of disease severity and other determinants of COVID-19 drug use is necessary for appropriate conduct and interpretation of non-randomized studies evaluating outcomes of COVID-19 treatments.
  • |*COVID-19 Drug Treatment[MESH]
  • |*Hospitalization[MESH]
  • |Adolescent[MESH]
  • |Adrenal Cortex Hormones/therapeutic use[MESH]
  • |Adult[MESH]
  • |Age Factors[MESH]
  • |Aged[MESH]
  • |Aged, 80 and over[MESH]
  • |Anticoagulants/therapeutic use[MESH]
  • |Antiviral Agents/therapeutic use[MESH]
  • |Biological Products/therapeutic use[MESH]
  • |Body Mass Index[MESH]
  • |COVID-19/epidemiology/*mortality[MESH]
  • |Comorbidity[MESH]
  • |Comoros[MESH]
  • |Drug Therapy, Combination[MESH]
  • |Drug Utilization[MESH]
  • |Extracorporeal Membrane Oxygenation/statistics & numerical data[MESH]
  • |Female[MESH]
  • |Humans[MESH]
  • |Male[MESH]
  • |Middle Aged[MESH]
  • |Oxygen Inhalation Therapy/methods[MESH]
  • |Pandemics[MESH]
  • |Racial Groups[MESH]
  • |Respiration, Artificial/statistics & numerical data[MESH]
  • |Retrospective Studies[MESH]
  • |SARS-CoV-2[MESH]
  • |Severity of Illness Index[MESH]
  • |Sex Factors[MESH]
  • |Smoking/epidemiology[MESH]


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