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The Effect of Antiviral Agents in the Treatment of COVID-19 Patients: A Propensity Score-Matched and a Stabilized Inverted Probability of Treatment Weight Study (SIPTW)

Jamal Wadi Al Ramahi, Amal Matar, Nour Hasan, Ma’en Maher Al-Ali, Lara Abdulhadi, Dania Abu Kaf, Hanadi hamadalla, Ala’a bade, Mohammad Atou, Sae’ed Mar’i, Tamer Alhame, Obeidah Masoud, Hakan Erdem

Earlier purpose: To evaluate the antivirals casual effects in the treatment of COVID-19 patients, focusing on recovery, the need for home oxygen therapy on discharge and in-hospital mortality.

Methods: A retrospective study of the admitted COVID-19 patients, the outcomes assessed were effect-difference between antivirals and controls for recovery, mortality, and the need for home oxygen. A Propensity Score Matched-Patients (PSM), variables entered for patients were age, gender, documented fever, tobacco, body mass index, LDH level, ferritin level, antivirals, imaging severity categories, D-dimer level, oxygen saturation. Other variables were excluded for multicollinearity. Outcomes were inferred from the PSM-adjusted patients and Stabilized Inverse Probability of Treatment Weight (SIPTW) analysis.

Results: All cohort and PSM-adjusted patients were described. Mortality was for 143 (12.7%) patients in the ICU was 124 (55.8%). SIPTW analysis demonstrated no significant difference between the antiviral treatment arm and control patients in recovered (P=NS), the need for home oxygen therapy (P=NS), and the difference in all-cause mortality between the treatment and control groups (P=NS). On multivariate analysis, recovery, the need for home oxygen and mortality with both favipiravir and remdesivir was not significantly different.

Conclusion: There was no evidence of significant benefit from the antiviral therapy in the treatment of COVID-19 patients in recovery, home oxygen requirements, and death.