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Use of repurposed and adjuvant drugs in hospital patients with covid-19: multinational network cohort study

Prats-Uribe, Albert ; Sena, Anthony G ; Lai, Lana Yin Hui ; Ahmed, Waheed-Ul-Rahman ; Alghoul, Heba ; Alser, Osaid ; Alshammari, Thamir M ; Areia, Carlos ; Carter, William ; Casajust, Paula ; Dawoud, Dalia ; Golozar, Asieh ; Jonnagaddala, Jitendra ; Mehta, Paras P ; Gong, Mengchun ; Morales, Daniel R ; Nyberg, Fredrik ; Posada, Jose D ; Recalde, Martina ; Roel, Elena ; Shah, Karishma ; Shah, Nigam H ; Schilling, Lisa M ; Subbian, Vignesh ; Vizcaya, David ; Zhang, Lin ; Zhang, Ying ; Zhu, Hong ; Liu, Li ; Cho, Jaehyeong ; Lynch, Kristine E ; Matheny, Michael E ; You, Seng Chan ; Rijnbeek, Peter R ; Hripcsak, George ; Lane, Jennifer CE ; Burn, Edward ; Reich, Christian ; Suchard, Marc A ; Duarte-Salles, Talita ; Kostka, Kristin ; Ryan, Patrick B ; Prieto-Alhambra, Daniel

BMJ (Online), 2021-05, Vol.373, p.n1038-n1038 [Periódico revisado por pares]

England: BMJ Publishing Group LTD

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Título:
Use of repurposed and adjuvant drugs in hospital patients with covid-19: multinational network cohort study
Autor: Prats-Uribe, Albert ; Sena, Anthony G ; Lai, Lana Yin Hui ; Ahmed, Waheed-Ul-Rahman ; Alghoul, Heba ; Alser, Osaid ; Alshammari, Thamir M ; Areia, Carlos ; Carter, William ; Casajust, Paula ; Dawoud, Dalia ; Golozar, Asieh ; Jonnagaddala, Jitendra ; Mehta, Paras P ; Gong, Mengchun ; Morales, Daniel R ; Nyberg, Fredrik ; Posada, Jose D ; Recalde, Martina ; Roel, Elena ; Shah, Karishma ; Shah, Nigam H ; Schilling, Lisa M ; Subbian, Vignesh ; Vizcaya, David ; Zhang, Lin ; Zhang, Ying ; Zhu, Hong ; Liu, Li ; Cho, Jaehyeong ; Lynch, Kristine E ; Matheny, Michael E ; You, Seng Chan ; Rijnbeek, Peter R ; Hripcsak, George ; Lane, Jennifer CE ; Burn, Edward ; Reich, Christian ; Suchard, Marc A ; Duarte-Salles, Talita ; Kostka, Kristin ; Ryan, Patrick B ; Prieto-Alhambra, Daniel
Assuntos: 80 and over ; Adjuvant ; adjuvant chemotherapy ; Administrative Claims ; administrative claims (health care) ; Administrative Claims, Healthcare - statistics & numerical data ; Adolescent ; Adrenal Cortex Hormones ; Adrenal Cortex Hormones - therapeutic use ; Adult ; Aged ; Aged, 80 and over ; Antibiotics ; Azithromycin ; Azithromycin - therapeutic use ; Ceftriaxone ; Ceftriaxone - therapeutic use ; Chemotherapy ; Chemotherapy, Adjuvant - methods ; Child ; Child, Preschool ; China ; China - epidemiology ; cohort analysis ; Cohort Studies ; corticosteroid ; Corticosteroids ; COVID-19 ; COVID-19 - diagnosis ; COVID-19 - drug therapy ; COVID-19 - epidemiology ; COVID-19 - virology ; Dexamethasone ; diagnosis ; drug combination ; Drug Combinations ; Drug development ; drug effect ; drug repositioning ; Drug Repositioning - methods ; drug therapy ; electronic health record ; Electronic Health Records ; Electronic Health Records - statistics & numerical data ; Electronic medical records ; enoxaparin ; Enoxaparin - therapeutic use ; epidemiology ; Female ; Fluoroquinolones ; Fluoroquinolones - therapeutic use ; Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi ; genetics ; Healthcare ; hospital patient ; human ; Humans ; Hydroxychloroquine ; Hydroxychloroquine - therapeutic use ; Infant ; Infant, Newborn ; Inpatients ; Lopinavir ; Lopinavir - therapeutic use ; lopinavir-ritonavir drug combination ; Male ; Microbiology in the medical area ; Middle Aged ; Mikrobiologi inom det medicinska området ; Mortality ; newborn ; Pandemics ; Preschool ; preschool child ; procedures ; Public Health, Global Health, Social Medicine and Epidemiology ; quinolone derivative ; Republic of Korea ; Republic of Korea - epidemiology ; Ritonavir ; Ritonavir - therapeutic use ; Safety ; SARS-CoV-2 ; SARS-CoV-2 - drug effects ; SARS-CoV-2 - genetics ; South Korea ; Spain ; Spain - epidemiology ; Temporal variations ; Treatment Outcome ; United States ; United States - epidemiology ; very elderly ; virology ; Vitamin D ; Vitamin D - therapeutic use ; Young Adult
É parte de: BMJ (Online), 2021-05, Vol.373, p.n1038-n1038
Notas: ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
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Descrição: AbstractObjectiveTo investigate the use of repurposed and adjuvant drugs in patients admitted to hospital with covid-19 across three continents.DesignMultinational network cohort study.SettingHospital electronic health records from the United States, Spain, and China, and nationwide claims data from South Korea.Participants303 264 patients admitted to hospital with covid-19 from January 2020 to December 2020.Main outcome measuresPrescriptions or dispensations of any drug on or 30 days after the date of hospital admission for covid-19.ResultsOf the 303 264 patients included, 290 131 were from the US, 7599 from South Korea, 5230 from Spain, and 304 from China. 3455 drugs were identified. Common repurposed drugs were hydroxychloroquine (used in from <5 (<2%) patients in China to 2165 (85.1%) in Spain), azithromycin (from 15 (4.9%) in China to 1473 (57.9%) in Spain), combined lopinavir and ritonavir (from 156 (<2%) in the VA-OMOP US to 2,652 (34.9%) in South Korea and 1285 (50.5%) in Spain), and umifenovir (0% in the US, South Korea, and Spain and 238 (78.3%) in China). Use of adjunctive drugs varied greatly, with the five most used treatments being enoxaparin, fluoroquinolones, ceftriaxone, vitamin D, and corticosteroids. Hydroxychloroquine use increased rapidly from March to April 2020 but declined steeply in May to June and remained low for the rest of the year. The use of dexamethasone and corticosteroids increased steadily during 2020.ConclusionsMultiple drugs were used in the first few months of the covid-19 pandemic, with substantial geographical and temporal variation. Hydroxychloroquine, azithromycin, lopinavir-ritonavir, and umifenovir (in China only) were the most prescribed repurposed drugs. Antithrombotics, antibiotics, H2 receptor antagonists, and corticosteroids were often used as adjunctive treatments. Research is needed on the comparative risk and benefit of these treatments in the management of covid-19.
Editor: England: BMJ Publishing Group LTD
Idioma: Inglês

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Use of repurposed and adjuvant drugs in hospital patients with covid-19: multinational network cohort study

England: BMJ Publishing Group LTD

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