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Antiviral Drugs Have No Effect on Mortality in COVID-19

FRIDAY, Dec. 4, 2020 -- For hospitalized patients with COVID-19, remdesivir, hydroxychloroquine, lopinavir, and interferon regimens seem to have little to no effect on mortality, according to a study published online Dec. 2 in the New England Journal of Medicine.

Hongchao Pan, Ph.D., from the University of Oxford in the United Kingdom, and colleagues examined in-hospital mortality in four pairwise comparisons of each of four trial drugs (remdesivir, hydroxychloroquine, lopinavir, and interferon beta-1a) and its control among inpatients with COVID-19. A total of 11,330 adults at 405 hospitals in 30 countries were randomly assigned to treatment.

The researchers found that at midway through treatment, adherence was 94 to 96 percent. In total, there were 1,253 deaths reported. The Kaplan-Meier 28-day mortality was 11.8 percent: 39.0 and 9.5 percent if the patient was or was not receiving ventilation at randomization, respectively. The rate ratios for deaths were 0.95 (95 percent confidence interval, 0.81 to 1.11; P = 0.50) for patients receiving remdesivir versus control; 1.19 (95 percent confidence interval, 0.89 to 1.59; P = 0.23) for patients receiving hydroxychloroquine versus control; 1.00 (95 percent confidence interval, 0.79 to 1.25; P = 0.97) for patients receiving lopinavir versus control; and 1.16 (95 percent confidence interval, 0.96 to 1.39; P = 0.11) for patients receiving interferon versus control. None of the trial drugs reduced in-hospital mortality, initiation of ventilation, or duration of hospitalization.

"The unpromising overall findings from the regimens tested suffice to refute early hopes, based on smaller or nonrandomized studies, that any of these regimens will substantially reduce inpatient mortality, the initiation of mechanical ventilation, or hospitalization duration," the authors write.

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Posted: December 2020

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