Comparison of the Eight Different Treatment Regimens for the Hospitalized Patients with COVID-19: A Retrospective Cohort Study

Background: Coronavirus disease 2019 (COVID -19) characterized by a mild to severe respiratory illness, has been affecting the world since late 2019 and leading to an increase in hospitalizations and deaths. There is still no specific highly effective treatment for this disease. This study aimed to compare the efficacy of the eight different treatment regimens for the hospitalized patients with COVID-19.

Methods: This retrospective cohort study was conducted on the hospitalized patients who had laboratory-confirmed COVID-19 by a real-time Reverse Transcriptase Polymerase Chain Reaction (RT-PCR) of nasopharyngeal samples.

Results: Among all patients hospitalized with COVID-19 between March to September 2020, 861 patients were included in the study. This study indicated that treatment protocols included either remdesivir or favipiravir were superior to hydroxychloroquine in reducing the risk of in-hospital mortality of the patients with confirmed COVID-19, especially in critical patients defined as those who were ICU admitted or under mechanical ventilation (HR, 0.43; 95% CI, 0.23 to 0.82; P=0.011 and HR, 0.45; 95% CI, 0.22 to 0.90; P=0.024, respectively). Whereas receiving lopinavir/ritonavir in combination with either hydroxychloroquine plus interferon β and corticosteroids (HR, 1.85; 95% CI, 1.17 to 2.94; P=0.009), hydroxychloroquine plus interferon β (HR, 1.66; 95% CI, 1.01 to 2.74; P=0.046), or interferon β (HR, 1.80; 95% CI, 1.12 to 2.89; P=0.015) was associated with a significant increase in this risk.

Conclusion: Our findings indicate that using remdesivir and favipiravir in combination with interferon β and corticosteroids might be beneficial in hospitalized patients with COVID-19, especially in the critical ones.