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2020 ; 160
(ä): 105036
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Effect of combination antiviral therapy on hematological profiles in 151 adults
hospitalized with severe coronavirus disease 2019
#MMPMID32565309
Li X
; Yang Y
; Liu L
; Yang X
; Zhao X
; Li Y
; Ge Y
; Shi Y
; Lv P
; Zhang J
; Bai T
; Zhou H
; Luo P
; Huang S
Pharmacol Res
2020[Oct]; 160
(ä): 105036
PMID32565309
show ga
OBJECTIVES: The current diagnosis and medicines approach in coronavirus disease
2019 (COVID-19) does not reflect the heterogeneous characteristics of this
disease. This study aims to find a new antiviral combination regimen by
investigating the frequency of clinically relevant and objectively identified
comorbidities, and the clustering of these clinical syndromes and varying results
of treatment with antiviral drugs in patients hospitalized with severe COVID-19.
METHODS: This study recruited 151 severe COVID-19 infection cases diagnosed in
our hospital examination and illustrated the clinical potential during a
consecutive 25-day medication period. Potential differences in disease severity
and clinical characteristics, hematological profile, and current pharmacologic
treatments (single agent, double or triple combinations, and the combined
antiviral drugs plus Lianhua Qingwen) among comorbidity clusters were explored.
RESULTS: Although disease severity was comparable among three clusters, it was
markedly different in terms of laboratory test status. Coagulable abnormality was
mainly present in cluster 1 and cluster 2. Other indicators were normal, except
for a significant increase of neutrophils presented in cluster 2. Patients showed
the most complicated haematological results in cluster 3, including severe
coagulation abnormalities, leukocytosis, neutrophilic granulocytosis, and
lymphopenia. Our results for the first time suggest that a quadruple combination
therapy (Ribavirin, Lopinavir/ritonavir, Umifenovir, and Lianhua Qingwen) can be
considered as a preferred treatment approach to severe COVID-19 patients. After
treatment, abnormal coagulation and leukocyte had markedly improved with a better
prognosis. CONCLUSION: This study expands the understanding of the co-occurrence
of combination therapy in patients with COVID-19, which provides the probability
of developing novel combined therapy. Furthermore, explore clinical trials of
variable antivirus treatments based on subgroup analyses or on using subgroups in
the selection criteria would be the next step.