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The impact of early therapies for COVID-19 on death, hospitalization and persisting symptoms: a retrospective study

PURPOSE: Oral antivirals (nirmatrelvir/ritonavir and molnupiravir), intravenous short treatment of remdesivir and anti-SARS-CoV-2 monoclonal antibodies (mAbs) have been used for early COVID-19 treatments in high risk of disease progression patients. The term long COVID has been used to refer to a ra...

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Autores principales: Bertuccio, Paola, Degli Antoni, Melania, Minisci, Davide, Amadasi, Silvia, Castelli, Francesco, Odone, Anna, Quiros-Roldan, Eugenia
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10079146/
https://www.ncbi.nlm.nih.gov/pubmed/37024626
http://dx.doi.org/10.1007/s15010-023-02028-5
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author Bertuccio, Paola
Degli Antoni, Melania
Minisci, Davide
Amadasi, Silvia
Castelli, Francesco
Odone, Anna
Quiros-Roldan, Eugenia
author_facet Bertuccio, Paola
Degli Antoni, Melania
Minisci, Davide
Amadasi, Silvia
Castelli, Francesco
Odone, Anna
Quiros-Roldan, Eugenia
author_sort Bertuccio, Paola
collection PubMed
description PURPOSE: Oral antivirals (nirmatrelvir/ritonavir and molnupiravir), intravenous short treatment of remdesivir and anti-SARS-CoV-2 monoclonal antibodies (mAbs) have been used for early COVID-19 treatments in high risk of disease progression patients. The term long COVID has been used to refer to a range of new, returning, or ongoing symptoms after SARS-CoV-2 infection. Little is known about the impact of such therapies on long COVID. METHODS: This is a retrospective observational study, including all outpatients evaluated from April 2021 to March 2022 in Brescia, Lombardy, northern Italy. Patients were stratified in three groups: (a) treated with mAbs, (b) treated with antivirals drugs and (c) controls (patients eligible for a or b who refused treatment). Data were collected at baseline and at month 1 and 3 (data on self-reported symptoms were collected using a telephone-administered questionnaire). We assessed early COVID-19 therapies effectiveness in preventing hospitalization, death at 1 or 3 months and persisting symptoms at 3 months after the onset of SARS-CoV-2 infection. RESULTS: A total of 649 patients were included in the study, of which 242 (37.3%) were treated with mAbs, 197 (30.3%) with antiviral drugs and 210 (32.4%) were not treated. Patients most frequently reported cerebro-cardiovascular diseases (36.7%) followed by obesity (22%). Overall, 29 patients (4.5%) died or were hospitalized at 1 or 3-month follow-up. Death or hospitalization was positively associated with older ages, with a significant linear trend (OR 3.05; 95% CI 1.16–8.06, for patients aged 80 or more years compared to those aged less than 65). Data on long COVID at 3 months were available for 323 (49.8%) patients. A positive association emerged for females compared to men, with an OR of 2.14 (95% CI 1.30–3.53) for any symptoms. Conversely, inverse associations were found for treatment groups as compared to the control one, with significant estimates among patients treated with antiviral drugs for any symptoms (OR 0.43, 95% CI 0.21–0.87) and patients treated with mAbs for any neuro-behavioral symptoms (OR 0.48, 95% CI 0.25–0.92). CONCLUSIONS: We report beneficial effect of early use of anti-SARS-CoV-2 antivirals and mAbs on long COVID.
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spelling pubmed-100791462023-04-06 The impact of early therapies for COVID-19 on death, hospitalization and persisting symptoms: a retrospective study Bertuccio, Paola Degli Antoni, Melania Minisci, Davide Amadasi, Silvia Castelli, Francesco Odone, Anna Quiros-Roldan, Eugenia Infection Research PURPOSE: Oral antivirals (nirmatrelvir/ritonavir and molnupiravir), intravenous short treatment of remdesivir and anti-SARS-CoV-2 monoclonal antibodies (mAbs) have been used for early COVID-19 treatments in high risk of disease progression patients. The term long COVID has been used to refer to a range of new, returning, or ongoing symptoms after SARS-CoV-2 infection. Little is known about the impact of such therapies on long COVID. METHODS: This is a retrospective observational study, including all outpatients evaluated from April 2021 to March 2022 in Brescia, Lombardy, northern Italy. Patients were stratified in three groups: (a) treated with mAbs, (b) treated with antivirals drugs and (c) controls (patients eligible for a or b who refused treatment). Data were collected at baseline and at month 1 and 3 (data on self-reported symptoms were collected using a telephone-administered questionnaire). We assessed early COVID-19 therapies effectiveness in preventing hospitalization, death at 1 or 3 months and persisting symptoms at 3 months after the onset of SARS-CoV-2 infection. RESULTS: A total of 649 patients were included in the study, of which 242 (37.3%) were treated with mAbs, 197 (30.3%) with antiviral drugs and 210 (32.4%) were not treated. Patients most frequently reported cerebro-cardiovascular diseases (36.7%) followed by obesity (22%). Overall, 29 patients (4.5%) died or were hospitalized at 1 or 3-month follow-up. Death or hospitalization was positively associated with older ages, with a significant linear trend (OR 3.05; 95% CI 1.16–8.06, for patients aged 80 or more years compared to those aged less than 65). Data on long COVID at 3 months were available for 323 (49.8%) patients. A positive association emerged for females compared to men, with an OR of 2.14 (95% CI 1.30–3.53) for any symptoms. Conversely, inverse associations were found for treatment groups as compared to the control one, with significant estimates among patients treated with antiviral drugs for any symptoms (OR 0.43, 95% CI 0.21–0.87) and patients treated with mAbs for any neuro-behavioral symptoms (OR 0.48, 95% CI 0.25–0.92). CONCLUSIONS: We report beneficial effect of early use of anti-SARS-CoV-2 antivirals and mAbs on long COVID. Springer Berlin Heidelberg 2023-04-06 2023 /pmc/articles/PMC10079146/ /pubmed/37024626 http://dx.doi.org/10.1007/s15010-023-02028-5 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Research
Bertuccio, Paola
Degli Antoni, Melania
Minisci, Davide
Amadasi, Silvia
Castelli, Francesco
Odone, Anna
Quiros-Roldan, Eugenia
The impact of early therapies for COVID-19 on death, hospitalization and persisting symptoms: a retrospective study
title The impact of early therapies for COVID-19 on death, hospitalization and persisting symptoms: a retrospective study
title_full The impact of early therapies for COVID-19 on death, hospitalization and persisting symptoms: a retrospective study
title_fullStr The impact of early therapies for COVID-19 on death, hospitalization and persisting symptoms: a retrospective study
title_full_unstemmed The impact of early therapies for COVID-19 on death, hospitalization and persisting symptoms: a retrospective study
title_short The impact of early therapies for COVID-19 on death, hospitalization and persisting symptoms: a retrospective study
title_sort impact of early therapies for covid-19 on death, hospitalization and persisting symptoms: a retrospective study
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10079146/
https://www.ncbi.nlm.nih.gov/pubmed/37024626
http://dx.doi.org/10.1007/s15010-023-02028-5
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