Effects of Anticoagulants and Corticosteroids Therapy in Patients Affected by Severe COVID-19 Pneumonia

  1. Khalid Ghalilah
  2. Abdul Momin Sabir
  3. Irshad Ali Alvi
  4. Malak Alharbi
  5. Abdulrahman Basabrain
  6. Mahmooud Aljundi
  7. Ghazi Almohammadi
  8. Zainab Almuairfi
  9. Raed Alharbi
  10. A. A. E. Ahmed

Reviewed by

Read the full article See related articles

Listed in

Log in to save this article

Abstract

Background: In the absence of a standard of treatment for COVID-19, the combined use of anti-inflammatory (corticosteroids and Enoxaparin) and antiviral drugs may be more effective than using either modality alone in the treatment of COVID-19. Methods: Patients hospitalized between April 10th, 2020, through May 10th, 2020, who had confirmed COVID-19 infection with clinical or radiographic evidence of pneumonia, in which 65 patients have moderate COVID-19 pneumonia, and 63 patients have severe COVID-19 pneumonia. All patients received early combination therapy of anti-inflammatory (corticosteroids and Enoxaparin) and antiviral drugs. They assessed for type and duration of treatment, and days need to wean from oxygen therapy, length of stay, virus clearance time, and complication or adverse events. All patients had more than 28 days follow up after discharge from the hospital. Results: Moderate COVID-19 pneumonia group were 65 patients who received Enoxaparin, antiviral drugs, empirical antibiotics for pneumonia, and standard treatment for comorbidity. Male patients were 50 (76.9%) and female patients were 15 (23.1%). 34 (52.3%) patients have comorbidity, 25 (38.5%) patients have Diabetes Mellitus and 2 (3.1%) pregnant ladies. 19 (29.2%) patients were on low flow oxygen therapy, 3L oxygen or less to maintain oxygen saturation more than 92%. All patients discharged home with no major or minor bleeding complications or significant complications. Severe COVID-19 pneumonia group were 63 patients who received methylprednisolone, enoxaparin, antiviral drugs, empirical antibiotics for pneumonia, and standard treatment for comorbidity. Male patients were 55 (87.3%) and female patients were 8 (12.7%). 37 (58.7%) patients have comorbidity, and 24 (38.1%) patients have Diabetes Mellitus. 32 (50.8%) patients were on low flow oxygen therapy, 4-9L oxygen, and 31 (49.2%) patients were on low flow oxygen therapy, 10L oxygen or more, including 12 patients on a non-rebreathing mask. Patients received methylprednisolone were 37 (58.7%) for 3 days, 16 (25.4%) for 5 days and 10 (15.9%) for more than 5 days. Sixty-two patients discharged home with one patient had a long stay, and the other two transferred to ICU. One long-stay patient transferred to ICU on low flow oxygen therapy. Conclusion: Early use of a combined anti-inflammatory (corticosteroids and Enoxaparin) and antiviral drugs treatment in patients with moderate to severe COVID-19 pneumonia prevent complications of the disease and improve clinical outcomes.

Article activity feed

  1. Version published to 10.9734/jpri/2021/v33i43a32513
  2. Version published to 10.1101/2020.06.22.20134957v2 on medRxiv
  3. ScreenIT

    SciScore for 10.1101/2020.06.22.20134957: (What is this?)

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

    Table 1: Rigor

    Institutional Review Board StatementConsent: All patients signed informed consent for receiving medical acts and care.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    Outcome definitions: Statistical analysis: Data were analyzed using IBM SPSS for Windows.
    SPSS
    suggested: (SPSS, RRID:SCR_002865)

    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: An explicit section about the limitations of the techniques employed in this study was not found. We encourage authors to address study limitations.

    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

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  4. Version published to 10.1101/2020.06.22.20134957v1 on medRxiv