The use of antiviral agents against sars-cov-2: Ineffective or time and age dependent result? a retrospective, observational study among covid-19 older adults

Humanitas COVID-19 Task Force, Antonio Desai, Giuseppe Caltagirone, Sharon Sari, Daria Pocaterra, Maria Kogan, Elena Azzolini, Victor Savevski, Filippo Martinelli-Boneschi, Antonio Voza

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Our aim was to investigate the impact of therapeutics with antiviral activity against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on mortality of older adults affected by coronavirus disease 2019 (COVID-19), taking into consideration the time interval from symptoms onset to drugs administration. Methods: Data from 143 COVID-19 patients over 65 years of age admitted to the Humanitas Clinical and Research Center Emergency Department (Milan, Italy) and treated with Lopinavir/ritonavir (LPV/r) or Darunavir/cobicistat (DVR/c) associated to Hydroxychloroquine (HCQ) were retrospectively analyzed. Statistical analysis was performed by using a logistic regression model and survival analysis to assess the role of different predictors of in-hospital mortality, including an early (<6 days from symptoms onset) vs. late treatment onset, signs and symptoms at COVID-19 presentation, type of antiviral treatment (LPV/r or DVR/c) and patients’ age (65–80 vs. >80 years old). Results: Multivariate analysis showed that an older age (OR: 2.54) and dyspnea as presenting symptom (OR: 2.01) were associated with higher mortality rate, whereas cough as presenting symptom (OR: 0.53) and a timely drug administration (OR: 0.44) were associated with lower mortality. Survival analysis demonstrated that the timing of drug administration had an impact on mortality in 65–80 years-old patients (p = 0.02), whereas no difference was seen in those >80 years-old. This impact was more evident in patients with dyspnea as primary symptom of COVID-19, in whom mortality decreased from 57.1% to 38.3% due to timely drug administration (OR: 0.5; p = 0.04). Conclusions: There was a significant association between the use of a combined antiviral regimen and HCQ and lower mortality, when timely-administered, in COVID-19 patients aged 65–80 years. Our findings support timely treatment onset as a key component in the treatment of COVID-19.

Original languageEnglish
Article number686
Number of pages11
JournalJournal of Clinical Medicine
Volume10
Issue number4
DOIs
Publication statusPublished - Feb 2 2021

Keywords

  • Age
  • Antivirals
  • COVID-19
  • Darunavir/cobicistat
  • Geriatric
  • Gerontology
  • Hydroxychloroquine
  • Lopinavir/ritonavir
  • SARS-CoV-2
  • Timing

ASJC Scopus subject areas

  • Medicine(all)

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