All-cause mortality among patients treated with repurposed antivirals and antibiotics for COVID-19 in Mexico City: A real-world observational study.

• DOI: 10.17179/excli2021-3413
• Publication Date: 2021-01-01
• Authors: Javier Mancilla-G...; Jorge García-Méndez; Jessica Márquez-S...; Rodrigo Estefano ...; Eduardo Aguirre-A...; Héctor Isaac Roch...; Ashuin Kammar‐García
• Keywords: Oseltamivir; Lopinavir; Zanamivir; Colistin

The aim of our study was to evaluate all-cause mortality risk in patients with laboratory-confirmed COVID-19 Mexico City treated repurposed antivirals and antibiotics. This real-world retrospective cohort contemplated 395,343 evaluated for suspected between February 24 September 14, 2020 688 primary-to-tertiary medical units City. Patients were included a positive RT-PCR SARS-CoV-2; those receiving unspecified antivirals, excluded; groups prescribed < 30 patients, eliminated. Survival risks determined antibiotics, both, or none. We assessed the effect early (<2 days) versus late (>2 use on sub-cohort patients. Multivariable adjustment, propensity score matching, generalized estimating equations, calculation E-values performed limit confounding. 136,855 analyzed; mean age 44.2 (SD:16.8) years; 51.3 % men. 16.6 received (3 %), antibiotics (10 both (3.6 %). Antivirals studied Oseltamivir (n=8414), Amantadine (n=319), Lopinavir-Ritonavir (n=100), Rimantadine (n=61), Zanamivir (n=39), Acyclovir (n=36). (73.7 %, p<0.0001) (85.8 lower than no antiviral/antibiotic (93.6 After multivariable increased death occurred (HR=1.72, 95 CI: 1.61-1.84) ambulatory (HR=4.7, 3.94-5.62) non-critical (HR=2.03, 1.86-2.21) general population 1.61-1.84), (HR=4.79, 4.01-5.75), (HR=2.05, 1.88-2.23), pregnancy (HR=8.35, 1.77-39.30); as well hospitalized (HR=1.13, 1.01-1.26) critical (HR=1.22, 1.05-1.43) after score-matching. Early oseltamivir did not modify risk. Antibiotics factor 1.08-1.19) pediatrics (HR=4.22, 2.01-8.86), but protective (HR=0.81, 0.77-0.86) (HR=0.67, 0.63-0.72). No significant benefit observed; associated mortality. may increase survival