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[Preprint]. 2020 Jun 5:2020.06.03.20121558. [Version 1] doi: 10.1101/2020.06.03.20121558

Multicenter point-prevalence evaluation of the utilization and safety of drug therapies for COVID-19

Nathaniel James Rhodes, Atheer Dairem, William Moore, Anooj Shah, Michael J Postelnick, Melissa E Badowski, Sarah M Michienzi, Jaime L Borkowski, Radhika S Polisetty, Karen Fong, Emily S Spivek, James R Beardsley, Cory M Hale, Andrea M Pallotta, Pavithra Srinivas, Lucas T Schulz
PMCID: PMC7302293  PMID: 32577687

Abstract

Background: There are currently no FDA-approved medications for the treatment of COVID-19. At the onset of the pandemic, off-label medication use was supported by limited or no clinical data. We sought to characterize experimental COVID-19 therapies and identify safety signals during this period. Methods: We conducted a non-interventional, multicenter, point prevalence study of patients hospitalized with suspected/confirmed COVID-19. Clinical and treatment characteristics within a 24-hour window were evaluated in a random sample of up to 30 patients per site. The primary objective was to describe COVID-19 targeted therapies. The secondary objective was to describe adverse drug reactions (ADRs). Results: A total of 352 patients from 15 US hospitals were included. Most patients were treated at academic medical centers (53.4%) or community hospitals (42.6%). Sixty-seven patients (19%) were receiving drug therapy in addition to supportive care. Drug therapies included hydroxychloroquine (69%), remdesivir (10%), and interleukin-6 inhibitors (9%). Five patients (7.5%) were receiving combination therapy. Patients with a history of asthma (14.9% vs. 7%, p=0.037) and those enrolled in clinical trials (26.9% vs. 3.2%, p<0.001) were more likely to receive therapy. Among those receiving COVID-19 therapy, eight patients (12%) experienced an ADR, and ADRs were more commonly recognized in patients enrolled in clinical trials (62.5% vs 22%, OR=5.9, p=0.028). Conclusions: While we observed high rates of supportive care for patients with COVID-19, we also found that ADRs were common among patients receiving drug therapy including in clinical trials. Comprehensive systems are needed to identify and mitigate ADRs associated with experimental COVID-19 therapies.

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