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. 2021 Jan 6;15(1):e0009051.
doi: 10.1371/journal.pntd.0009051. eCollection 2021 Jan.

Effect of early oxygen therapy and antiviral treatment on disease progression in patients with COVID-19: A retrospective study of medical charts in China

Lu Long  1   2 , Liang Wu  3 , Lang Chen  4 , Daixing Zhou  5 , Hongyu Wu  4 , Donghao Lu  2   6   7 , Honglin Li  8 , Xiaoxia Duan  1 , Yutong Han  1 , Xianzhi Li  1 , Qiuxia Wang  4 , Jing Zhang  4
Affiliations

Effect of early oxygen therapy and antiviral treatment on disease progression in patients with COVID-19: A retrospective study of medical charts in China

Lu Long et al. PLoS Negl Trop Dis. .

Abstract

Background: Until now, no antiviral treatment has been proven to be effective for the coronavirus disease 2019 (COVID-19). The timing of oxygen therapy was considered to have a great influence on the symptomatic relief of hypoxemia and seeking medical intervention, especially in situations with insufficient medical resources, but the evidence on the timing of oxygen therapy is limited.

Methods and findings: Medical charts review was carried out to collect the data of hospitalized patients with COVID-19 infection confirmed in Tongji hospital, Wuhan from 30th December 2019 to 8th March 2020. In this study, the appropriate timing of oxygen therapy and risk factors associated with severe and fatal illness were identified and the effectiveness of antivirus on disease progression was assessed. Among 1362 patients, the prevalence of hypoxia symptoms was significantly higher in those patients with severe and fatal illness than in those with less severe disease. The onset of hypoxia symptoms was most common in the second to third week after symptom onset, and patients with critical and fatal illness experienced these symptoms earlier than those with mild and severe illness. In multivariable analyses, the risk of death increased significantly when oxygen therapy was started more than 2 days after hypoxia symptoms onset among critical patients (OR, 1.92; 95%CI, 1.20 to 3.10). Compared to the critically ill patients without IFN-a, the patients who were treated with IFN-a had a lower mortality (OR, 0.60; 95%CI, 0.39 to 0.91).

Conclusions: Early initiation of oxygen therapy was associated with lower mortality among critical patients. This study highlighted the importance of early oxygen therapy after the onset of hypoxia symptoms. Our results also lend support to potentially beneficial effects of IFNα on critical illness.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Flow chart of enrolment of 1362 confirmed COVID-2019 patients during the study period (from 30th December 2019 to 8th March 2020).
Fig 2
Fig 2. Percentages of patients under different chronic medical conditions and disease severity in different age groups.
A. mild and severe cases with or without comorbidities. B. critical and fatal cases with or without comorbidities.
Fig 3
Fig 3. Frequency of hypoxia symptoms onset for patients with different severity of disease by days after onset of symptom (n = 480).
See this image and copyright information in PMC

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