Effectiveness of drugs employed in the treatment of COVID-19: real-world evidence

BACKGROUND: Drugs used to treat patients with SARS-CoV-2 infection have been tested in different clinical trials but less in real-life studies. Our goal was to assess the effectiveness of several specific COVID-19 drugs. RESEARCH DESIGN AND METHODS: Retrospective study of all patients testing positive for SARS-CoV-2 infection between 1 March 2020 and 9 January 2022. We extracted sociodemographic, basal comorbidities, specific medication for their COVID-19, COVID-19 vaccination data, and outcomes such as death and admission to hospital and intensive care unit (ICU) during the different periods of the pandemic. RESULTS: The prescription of corticosteroids to out-of-hospital patients was related to a higher likelihood of hospital admission. Among the hospitalized patients, all of the drugs studied (dexamethasone, prednisone, methylprednisolone, remdesivir, ritonavir/lopinavir, and tocilizumab) were related to a higher likelihood of dying at 90 days or being admitted to an ICU. In patients admitted to an ICU, corticosteroids prevented intrahospital mortality (Odds ratio: 0.73; 95% confident intervals: 0.554-0.969). All drugs were related to longer length of hospital admission and ICU stays. CONCLUSIONS: Most drugs used for COVID-19 patients had no clear benefit except in the case of corticosteroids, associated with a reduced risk of intrahospital mortality among ICU patients. TRIAL REGISTRATION: The study is registered at ClinicalTrials.gov (CT.gov identifier: NCT04463706).