The effect of oseltamivir use in critically ill patients with COVID-19: A multicenter propensity score-matched study |
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Affiliation: | 1. Department of Pharmacy Practice, Faculty of Pharmacy, King Abdulaziz University, Jeddah, Saudi Arabia;2. Department of Pharmacy Practice, College of Pharmacy, Princess Nourah Bint Abdulrahman University, P.O.Box 84428, Riyadh 11671, Saudi Arabia;3. Pharmaceutical Care Services, King Salman Specialist Hospital, Hail Health Cluster, Ministry of Health, Hail, Saudi Arabia;4. Department of Clinical Pharmacy, College of Pharmacy, University of Hail, Hail, Saudi Arabia;5. Statistics Department, European Organization for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium;6. Pharmaceutical Care Department, King Abdulaziz Medical City, Riyadh, Saudi Arabia;7. College of Pharmacy, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia;8. King Abdullah International Medical Research Center-King Saud Bin Abdulaziz University for Health Sciences, Ministry of National Guard – Health Affairs., Riyadh, Saudi Arabia;9. Basic Sciences Department, College of Science and Health Professions, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia;10. King Abdullah International Medical Research Center, Jeddah, Saudi Arabia;11. Pharmaceutical Services Administration, King Saud Medical City, Riyadh. Saudi Arabia;12. Pharmaceutical Care Services, Abha Maternity and Children Hospital, Asir Heath Affairs, Abha, Saudi Arabia;13. Pharmaceutical Care Department, Prince Sultan Military Medical City, Riyadh, Saudi Arabia;14. Department of Pharmaceutical Sciences, Fakeeh College of Medical Sciences, Jeddah, Saudi Arabia;15. College Of Pharmacy, Shaqra University, Shaqra, Saudi Arabia |
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Abstract: | BackgroundOseltamivir has been used as adjunctive therapy in the management of patients with COVID-19. However, the evidence about using oseltamivir in critically ill patients with severe COVID-19 remains scarce. This study aims to evaluate the effectiveness and safety of oseltamivir in critically ill patients with COVID-19.MethodsThis multicenter, retrospective cohort study includes critically ill adult patients with COVID-19 admitted to the intensive care unit (ICU). Patients were categorized into two groups based on oseltamivir use within 48 hours of ICU admission (Oseltamivir vs. Control). The primary endpoint was viral load clearance.ResultsA total of 226 patients were matched into two groups based on their propensity score. The time to COVID-19 viral load clearance was shorter in patients who received oseltamivir (11 vs. 16 days, p = 0.042; beta coefficient: −0.84, 95%CI: (−1.33, 0.34), p = 0.0009). Mechanical ventilation (MV) duration was also shorter in patients who received oseltamivir (6.5 vs. 8.5 days, p = 0.02; beta coefficient: −0.27, 95% CI: [−0.55,0.02], P = 0.06). In addition, patients who received oseltamivir had lower odds of hospital/ventilator-acquired pneumonia (OR:0.49, 95% CI:(0.283,0.861), p = 0.01). On the other hand, there were no significant differences between the groups in the 30-day and in-hospital mortality.ConclusionOseltamivir was associated with faster viral clearance and shorter MV duration without safety concerns in critically ill COVID-19 patients. |
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Keywords: | COVID-19 Viral clearance Oseltamivir Critically ill Intensive care unit Mechanical ventilation duration Mortality |
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