4CPS-004 Trends in treatments during COVID-19 pandemic in a university tertiary hospital. Issue 1 (23rd March 2023)

• Record Type: Journal Article
• Authors: Albanell, M; Tuset, M; Meira, F; Escolà, A; Soy, D; Soriano, A; García-Vidal, C; Murgadella, A; Oriol, I
• Is Part Of: European journal of hospital pharmacy. Volume 30:Issue 1(2023)supplement 1
• Page Start: A24
• Page End: A24
• Publication Date: 2023-03-23
• Subjects: Pharmacy -- Periodicals; Hospital pharmacies -- Periodicals; 615.1
• DOI: 10.1136/ejhpharm-2023-eahp.53
• Languages: English
• ISSNs: 2047-9956

Abstract

Abstract : Background and Importance: Pharmacotherapeutic management of SARS-CoV-2 infection from the beginning of COVID-19 pandemic to now has evolved in accordance with research and clinical experience, improving treatments and thus clinical outcomes. Aim and Objectives: Our aim is to analyse the changes in the epidemiology and prevalence of use of the different treatments used against COVID-19 and its clinical outcomes throughout the pandemic (from March 2020 to May 2021) in a retrospective unicentre study. We present the data of a university tertiary hospital. Material and Methods: We identified all COVID-19 patients admitted to our hospital >48h through the electronic medical records (SAP Medication ® ). We evaluated demographic data (age and sex), clinical features (number of admissions/month in ICU or regular wards, mean length of stay and deaths including those <48h) as well as monthly drug consumption of remdesivir, hydroxychloroquine, lopinavir/ritonavir, beta-interferon, tocilizumab, baricitinib, anakinra, corticoids (dexamethasone 6 mg/day and >20 mg/day, methylprednisolone >40 mg/day, prednisone >30 mg/day, hydrocortisone>100 mg/day) and antibiotics. Results: A total of 4406 patients with SARS-CoV-2 infection were admitted of which 3723 met the inclusion criteria. The median age was 66 years, with higher percentage of men (59%). The number of patients admitted to ICU, semi critical care or a regular ward was, respectively 20%, 5, 3% and 74, 7%. The percentage of deaths after the large peak of mortality (15, 2%) in March progressively decreased to 7, 7% in the first trimester 2021. The median length of stay for ICU/semi critical care or regular care was 26, 2 and 8, 7 days. Trends in monthly use of the most frequent drugs are shown in the figure below. More than 80% of inpatients took lopinavir/ritonavir and hydroxychloroquine at the beginning, but consumption was drastically reduced after. The use of beta interferon was anecdotical after first months. The most used antimicrobials were ceftriaxone (45, 5%) and azithromycin (34, 9%), followed by levofloxacin (8, 9%), amoxicillin/clavulanate (7, 1%) and ceftaroline (6, 0%). Conclusion and Relevance: The use of drugs during the pandemic of COVID-19 has shown a clear evolution over months towards more standardised treatments, with remdesivir as antiviral and dexamethasone, tocilizumab and baricitinib standing out as anti-inflammatory drugs in our centre. Homogenisation and standardisation of COVID-19 treatments have been managed as a reflection of the scientific evidence accumulated throughout the pandemic. References and/or Acknowledgements: Conflict of Interest: No conflict of interest