Background: Since the outbreak of COVID-19, the application of appropriate treatment strategy for COVID-19 patients, notably for the severe patients, was a huge challenge in case management. Therefore, we aimed to evaluate the effectiveness of antiviral treatment in severe COVID-19 patients.Methods A retrospective cohort study was conducted from January 8, 2020 to March 9, 2020 in four designated hospitals of COVID-19 in Wuhan, China. 138 severe COVID-19patients with above 18 years were included in this study. 109 patients receiving the antiviral treatment were selected in antiviral group. The remaining 29 patients were in control group. The primary outcome of the study was in-hospital death and length of hospitalization. Secondary outcomes included ICU admission, length of stays in ICU, use of mechanical ventilation, length of mechanical ventilation, and the development of complications. Univariate analysis and Kaplan-Meier curves were used to examined the association between antiviral treatment and the clinical outcomes of the COVID-19 patients.Results 48 (44.0%) and 15 (51.7%) deaths were occurred in antiviral and control groups, respectively. Antiviral treatment was not associated with the rate of fatal outcome in COVID-19 patients ( P > 0.05). Among the survival patients, the median length of hospitalization was 11.0 days (IQR: 6.5–18.0) and 16.0 days (IQR: 8.5–26.0) in antiviral and control groups, respectively. No significant association was identified between the antiviral treatment and the length of hospitalization in survival patients ( P > 0.05). Moreover, the antiviral treatment was not statistically associated with ICU admission, mechanical ventilation and length of mechanical ventilation ( P > 0.05, respectively). However, the length of ICU stays in deaths was different both groups ( P < 0.05). The median length of ICU stays in deaths was 7.0 days (IQR: 3.0-14.3) and 15.5 days (IQR: 8.3–21.8) in antiviral and control groups, respectively. The occurrence of majority of complications were similar both groups. Sepsis was the single complication in which the occurrence rates were statistical different between the antiviral group and control group (40.4% vs 13.8%, P < 0.01).Conclusion No benefit of antiviral treatment in severe COVID-19 patients was observed in our study. Clinical physicians should cautiously prescribe the antiviral drugs in severe COVID-19 patients.
The effectiveness of antiviral treatment in severe COVID-19 patients in Wuhan: a retrospective cohort study