Arbidol treatment with reduced mortality of adult patients with COVID-19 in Wuhan, China: a retrospective cohort study

  1. Qibin Liu
  2. Xuemin Fang
  3. Lu Tian
  4. Naveen Vankadari
  5. Xianxiang Chen
  6. Ke Wang
  7. Dan Li
  8. Xiyong Dai
  9. Feng Xu
  10. Lei Shen
  11. Bing Wang
  12. Li Yao
  13. Peng Peng

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Abstract

The worldwide COVID-19 pandemic is increasing exponentially and demands an effective and promising therapy at most emergency.

METHODS

We have assembled a cohort consisting 504 hospitalized COVID-19 patients. Detailed information on patients’ characteristics and antiviral medication use during their stay at designated hospitals along with their pre and post treatment results were collected. The study objective is to evaluate the treatment efficacy of Arbidol, together with the concurrent drugs Oseltamivir and Lopinavir/Ritonavir on mortality and lesion absorption based on chest CT scan.

FINDINGS

The overall mortality rate was 15.67% in the cohort. The older age, lower SpO2 level, larger lesion, early admission date, and the presence of pre-existing conditions were associated with higher mortality. After adjusting for the patients age, sex, pre-existing condition, SpO2, lesion size, admission date, hospital, and concurrent antiviral drug use, Arbidol was found promising and associated with reduced mortality. The OR for Arbidol is 0·183 (95% CI, 0·075 to 0·446; P<0·001). Furthermore, Arbidol is also associated with faster lesion absorption after adjusting for patient’s characteristics and concurrent antiviral drug use (P=0·0203).

INTERPRETATION

The broad-spectrum antiviral drug Arbidol was found to be associated with faster

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  1. Version published to 10.1101/2020.04.11.20056523v2 on medRxiv
  2. ScreenIT

    SciScore for 10.1101/2020.04.11.20056523: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board StatementIRB: The study protocol was reviewed and approved by the Ethics committee of WPH (WPE 2020-12).
    RandomizationFor Tongji Hospital, a randomly selected ward of 100 patients admitted between February 1, 2020 and February 5, 2002, was included.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    The lesion in the selected plane was circled and quantified (eFigure 1) by ImageJ by NIH23. STATISTICAL ANALYSIS: Patient characteristics at baseline were summarized according to treatment and hospital.
    ImageJ
    suggested: (ImageJ, RRID:SCR_003070)

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    There are several important limitations in the current study. The study is not a randomized clinical trial, and therefore the estimated treatment benefit of Arbidol and Oseltamivir may be due to confounding effect. We have collected the information on known confounders including age, comorbidities, admission data, and disease severity measured through SpO2 and CT scan. However, there is always a risk of unmeasured confounders, which can explain the observed treatment effect. On the other hand, given the size of the observed benefit, the unmeasured confounding effect needs to be very strong to completely account for the estimated benefit. Secondly, we didn’t account for the effect of important supporting treatment such as oxygen and ventilator use. Their availability and deployment may affect the estimated treatment effect. Thirdly, although the cohort size is not small, the patients from Tongji and Union hospitals are not necessarily the most representative samples of patients admitted into these hospitals. For example, ICU patients in these two hospitals are not included. We have also excluded surviving patients not discharged from WPH, and consequently, the observed mortality rate among patients from WPH in this cohort is substantially higher than that among all patients admitted into WPH. These sampling biases may affect the generalizability of our findings. Furthermore, there are only 33 patients taking both Arbidol and Oseltamivir in the entire cohort, which limits the r...

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    About SciScore

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  3. Version published to 10.1101/2020.04.11.20056523v1 on medRxiv