Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Nov;24(11):1020-1027.
doi: 10.5005/jp-journals-10071-23599.

A Retrospective Observational Study of Hypoxic COVID-19 Patients Treated with Immunomodulatory Drugs in a Tertiary Care Hospital

Nilesh Mahale  1 , Prasad Rajhans  1 , Purushotham Godavarthy  1 , Vikram L Narasimhan  1 , Gauri Oak  2 , Srinath Marreddy  1 , Amruta Bedekar  3 , Ujwal Dhundi  1 , Harshwardhan S Pawar  1 , Prasad Akole  1 , Balasaheb Pawar  1 , Bhagyashri Bhurke  1 , Shailaja Chavan  4 , Parikshit Prayag  4 , Bharat Purandare  1 , Pradip Dalvi  1 , Vishnu Telbhare  1 , Prasanna Marudwar  1 , Dnyaneshwar Diwane  1 , Manasi Shahane  1 , Amrita Prayag  1 , Shradha Gugale  1 , Shreyas Bhor  1 , Sameer Jog  1
Affiliations

A Retrospective Observational Study of Hypoxic COVID-19 Patients Treated with Immunomodulatory Drugs in a Tertiary Care Hospital

Nilesh Mahale et al. Indian J Crit Care Med. 2020 Nov.

Abstract

Objectives: To describe the demographics and evaluate the clinical outcomes of hypoxic coronavirus disease-2019 (COVID-19) patients treated with different immunomodulatory (IM) drugs in a resource-limited setting.

Materials and methods: We conducted a retrospective cohort study of these patients admitted to our hospital between March 22 and May 31, 2020. Data were abstracted from multiple electronic data sources or patient charts to provide information on patient characteristics, clinical, laboratory variables, and outcomes.

Results: A total of 134 patients met the inclusion criteria and were followed up till June 7, 2020. The median age of the patients was 55.6 years (range 20-89 years) and 68% were men. At least one comorbidity was seen in 72% of the patients with diabetes (44%) and hypertension (46%) being the most common. At triage, fever (82%), shortness of breath (77%), and cough (61%) were the most common presenting symptoms. A PaO2/FiO2 ratio less than 300 was seen in 60%, and 4.5% required invasive mechanical ventilation within 72 hours of hospital admission. Five immunomodulatory agents (hydroxychloroquine, methylprednisolone, colchicine, etoricoxib, and tocilizumab) were administered in different combinations. Overall, in-hospital mortality was 26.9%, and 32% required mechanical ventilation. Around 69% of patients were discharged home. Five variables (SpO2, PaO2/FiO2 ratio, leucocytosis, lymphopenia, and creatinine) on admission were found to be significant in the patients who died.

Conclusion: Our study provides the characteristics and outcomes of hypoxic COVID-19 patients treated with IM drugs in varied combination. Five independent variables were strong predictors of mortality.

How to cite this article: Mahale N, Rajhans P, Godavarthy P, Narasimhan VL, Oak G, Marreddy S, et al. A Retrospective Observational Study of Hypoxic COVID-19 Patients Treated with Immunomodulatory Drugs in a Tertiary Care Hospital. Indian J Crit Care Med 2020;24(11):1020-1027.

Keywords: Acute respiratory distress syndrome; Coronavirus disease-2019; Immunomodulatory drugs; Resource-limited settings.

PubMed Disclaimer

Conflict of interest statement

Source of support: Nil Conflict of interest: None

Figures

Flowchart 1
Flowchart 1
Patient inclusion and disposition on admission
See this image and copyright information in PMC

References

    1. Andrews M, Areekal B, Rajesh K, Krishnan J, Suryakala R, Krishnan B, et al. First confirmed case of COVID-19 infection in India: a case report. Indian J Med Res. 2020;151(5):490–492. doi: 10.4103/ijmr.IJMR_2131_20. DOI: - DOI - PMC - PubMed
    1. Ruan Q, Yang K, Wang W, Jiang L, Song J. Clinical predictors of mortality due to COVID-19 based on an analysis of data of 150 patients from Wuhan, China. Intensive Care Med. 2020;46(5):846–848. doi: 10.1007/s00134-020-05991-x. DOI: - DOI - PMC - PubMed
    1. Wu C, Chen X, Cai Y, Xia J, Zhou X, Xu S, et al. Risk factors associated with acute respiratory distress syndrome and death in patients with coronavirus disease 2019 pneumonia in Wuhan, China. JAMA Int Med. 2020;180(7):934. doi: 10.1001/jamainternmed.2020.0994. DOI: - DOI - PMC - PubMed
    1. Yang X, Yu Y, Xu J, Shu H, Xia J, Liu H, et al. Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: a single-centered, retrospective, observational study. Lancet Respirat Med. 2020;8(5):475–481. doi: 10.1016/S2213-2600(20)30079-5. DOI: - DOI - PMC - PubMed
    1. Tufan A, Avanoğlu Güler A, Matucci-Cerinic M. COVID-19, immune system response, hyperinflammation and repurposing antirheumatic drugs. Turk J Med Sci. 2020;50(SI-1:):620–632. doi: 10.3906/sag-2004-168. DOI: - DOI - PMC - PubMed

LinkOut - more resources