Abstract

The corona virus disease (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS CoV-2) virus has affected the whole world. Researches are on-going in search of effective and safe drugs. The first wave of the pandemic was managed with some repurposed drugs and some newer antiviral drugs. There is limited data on the effectiveness and safety of these drugs. Our study was done to determine the effectiveness and safety of drugs used as combination in COVID 19 infection. Methods: This was a descriptive record-based study done in a tertiary care COVID hospital in Manjeri of Malappuram district in Kerala from 1st March 2020 to 30th November 2020. Demographic details, comorbidities, lab investigations, treatment measures and medications on admission till discharge, adverse effects & outcomes were taken from medical records. The severity assessment was obtained from World Health Organisation (WHO) Ordinal Scale and outcome assessment was based on the number of days taken for a 2-point step down from the WHO ordinal scale. Data were entered into Excel sheet and analysed using SPSS. The effectiveness of combination was determined using independent t test. Results: Of the 200 patients, majority received Hydroxychloroquine (n=125) and Azithromycin(n=192). The other drugs prescribed were anticoagulants, monoclonal antibodies, steroids and convalescent plasma. All the patients in Category B had WHO ordinal scale of 3 while majority 97(59.9%) in Category C had an ordinal Scale of 4. The oxygen mask days and mean WHO 2 step down days were lower in the 45 patients who received Remdesivir with anticoagulation. The common adverse effects observed were were hematuria 17(8.5%), new onset diabetes mellitus 14(7%), diarrhoea 5(2.5%) and hypoglycemia 2(1%). Conclusion: The majority of patients received Hydroxychloroquine and Azithromycin with or without Anticoagulants, Corticosteroids, Antiviral drugs, Monoclonal antibodies and Convalescent plasma according to severity of disease. The combination of Remdesivir with Anticoagulation was found to reduce the severity grade of COVID 19 infection faster compared to Anticoagulation alone and those without Remdesivir in Category C patients.

Description