About: The Use of Adjuvant Therapy in Preventing Progression to Severe Pneumonia in Patients with Coronavirus Disease 2019: A Multicenter Data Analysis

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type	Academic Article research paper schema:ScholarlyArticle
isDefinedBy	Covid-on-the-Web dataset
has title	The Use of Adjuvant Therapy in Preventing Progression to Severe Pneumonia in Patients with Coronavirus Disease 2019: A Multicenter Data Analysis
Creator	Wang, Wei Mei, Ji Li, H Yu, Qizhi Feng, Z Feng, Zhichao Li, Huiling Ma, X Rong, Pengfei Wang, W Yao, Shanhu Ma, ; Ouyang, Xin Zhou, Wenming Kang, W Kang, Wendi Li, Jennifer Liu, Jincai Mao, ; Rong, P Westmead, ) Yao, S Zeng, Qiuhua
Source	MedRxiv
abstract	ABSTRACT IMPORTANCE Coronavirus disease 2019 (COVID-19) is a global pandemic associated with high mortality and effective treatment to prevent clinical deterioration to severe pneumonia has not yet been well clarified. OBJECTIVE To investigate the role of several adjuvant treatments in preventing severe pneumonia in patients with COVID-19. DESIGN, SETTING, AND PARTICIPANTS Multicenter, retrospective cohort study of 564 consecutively hospitalized patients with confirmed COVID-19 at Third Xiangya Hospital of Central South University, Changsha Public Health Treatment Center, First Hospital of Yueyang, Junshan People's Hospital of Yueyang, Central Hospital of Shaoyang, Central Hospital of Xiangtan, Second Hospital of Changde, Central Hospital of Loudi, and First Affiliated Hospital of University of South China in Hunan province from January 17, 2020 to February 28, 2020; The final date of follow-up was March 15, 2020. EXPOSURES Nonspecific antivirals (arbidol, lopinavir/ritonavir, and interferon α), antihypertensives, and chloroquine. MAIN OUTCOMES AND MEASURES The development of severe COVID-19 pneumonia; Demographic, epidemiological, clinical, laboratory, radiological, and treatment data were collected and analyzed. RESULTS Of 564 patients, the median age was 47 years (interquartile range, 36-58 years), and 284 (50.4%) patients were men. Sixty-nine patients (12.2%) developed severe pneumonia. Patients who developed severe pneumonia were older (median age of 59 and 45 years, respectively), and more patients had comorbidities including hypertension (30.4% and 12.3%, respectively), diabetes (17.4% and 6.7%, respectively), and cardiovascular disease (8.7% and 3.2%, respectively) and presented with fever (84.1% and 60.4%, respectively) and shortness of breath (10.1% and 3.8%, respectively) compared with those who did not. Nonspecific antiviral therapy did not prevent clinical progression to severe pneumonia, although fewer hypertensive patients on angiotensin-converting enzyme inhibitors or angiotensin-receptor blockers (ACEI/ARB) therapy developed severe pneumonia in contrast with those on non-ACEI/ARB antihypertensive therapy (1 of 16 [6.3%] patients and 16 of 49 [32.7%] patients, respectively [difference, 26.4%; 95% CI, 1.5% to 41.3%]). Multivariate logistic regression analysis showed that hypertension without receiving ACEI/ARB therapy was an independent risk factor (odds ratio [OR], 2.07; 95% CI, 1.07 to 4.00) for developing severe pneumonia irrespective of age. Besides, none of patients treated with chloroquine developed severe pneumonia, though without significance (difference, 12.0%; 95% CI, -3.5% to 30.0%) by propensity score matching. CONCLUSIONS AND RELEVANCE Hypertensive patients on ACEI or ARB may be protective from severe pneumonia in COVID-19 and hence these therapies should not be ceased unless there is a strong indication or further epidemiological evidence. Though none of the current antiviral and immunoregulation therapy showed benefit in preventing COVID-19 progression, chloroquine deserved further investigation.
has issue date	2020-04-10(xsd:dateTime)
bibo:doi	10.1101/2020.04.08.20057539
has license	medrxiv
sha1sum (hex)	1d54a30cff3933545aed099cf0b608a97c920a45
schema:url	https://doi.org/10.1101/2020.04.08.20057539
resource representing a document's title	The Use of Adjuvant Therapy in Preventing Progression to Severe Pneumonia in Patients with Coronavirus Disease 2019: A Multicenter Data Analysis
resource representing a document's body	covid:1d54a30cff3933545aed099cf0b608a97c920a45#body_text
is schema:about of	named entity 'Pneumonia' named entity 'Data Analysis' named entity 'Multicenter' named entity 'Severe Pneumonia' named entity 'viral entry' named entity 'radiologists' named entity 'ACEI' named entity 'adverse events' named entity 'fever' named entity 'orphan drugs' named entity 'chronic renal disease' named entity 'medRxiv' named entity 'CC-BY-NC-ND 4.0' named entity 'COPD' named entity 'normal distribution' named entity 'CC-BY-NC-ND 4.0' named entity 'cellular receptors' named entity 'missing data' named entity 'endosomal' named entity 'pneumonia' named entity 'antihypertensive therapy' named entity 'ACEI' named entity 'cardiovascular disease' named entity 'hypertension' named entity 'interferon-alpha' named entity '95% CI' named entity 'lactose' named entity 'statistically significant' named entity 'procalcitonin' named entity 'RAAS' named entity 'clinical progression' named entity 'antiviral therapies' named entity 'peer-reviewed' named entity 'COPD' named entity 'COVID-19' named entity 'enzyme' named entity 'diabetes' named entity 'immunoregulation' named entity 'membrane fusion' named entity 'AECI' named entity 'medRxiv' named entity 'mechanical ventilation' named entity 'azithromycin' named entity 'respiratory tract' named entity 'ACE2' named entity 'algorithm' named entity 'hypertension' named entity 'study design' named entity '95% CI' named entity 'medRxiv' named entity 'ACE2' named entity 'radiologists' named entity 'angiotensin' named entity 'lopinavir/ritonavir' named entity 'regression analysis' named entity 'aminopeptidase' named entity 'diuretic' named entity 'severe pneumonia' named entity 'pulmonary injury' named entity 'fever' named entity 'global pandemic' named entity 'proteolytic cleavage' named entity 'antihypertensive therapy'

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