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Open AccessArticle

The Use of Antiviral Agents against SARS-CoV-2: Ineffective or Time and Age Dependent Result? A Retrospective, Observational Study among COVID-19 Older Adults

1
Emergency Department, Humanitas Clinical and Research Center, IRCCS, 20089 Milan, Italy
2
Department of Biomedical Sciences, Humanitas University, 20090 Pieve Emanuele, Italy
3
Internal Medicine Department, Geriatrics, Santa Margherita Rehabilitation and Cure Institute, ASP, 27100 Pavia, Italy
4
Department of Infectious Diseases, Humanitas Clinical and Research Center, IRCCS, 20089 Milan, Italy
5
Health Directorate, Humanitas Clinical and Research Center, IRCCS, 20089 Milan, Italy
6
Artificial Intelligence Center, Humanitas Clinical and Research Center, IRCCS, 20089 Milan, Italy
7
Dino Ferrari Centre, Neuroscience Section, Department of Pathophysiology and Transplantation (DEPT), University of Milan, 20122 Milan, Italy
8
Neurology Unit and MS Centre, Fondazione IRCCS Ca’ Granda Ospedale Maggiore, Policlinico, 20122 Milan, Italy
*
Author to whom correspondence should be addressed.
All authors are part of the Humanitas COVID-19 Task Force.
F. Martinelli-Boneschi and A. Voza contributed equally to this article as last authors.
Academic Editor: Fekade Sime
J. Clin. Med. 2021, 10(4), 686; https://doi.org/10.3390/jcm10040686
Received: 11 December 2020 / Revised: 6 February 2021 / Accepted: 8 February 2021 / Published: 10 February 2021
(This article belongs to the Section Infectious Diseases)
Background: Our aim was to investigate the impact of therapeutics with antiviral activity against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on mortality of older adults affected by coronavirus disease 2019 (COVID-19), taking into consideration the time interval from symptoms onset to drugs administration. Methods: Data from 143 COVID-19 patients over 65 years of age admitted to the Humanitas Clinical and Research Center Emergency Department (Milan, Italy) and treated with Lopinavir/ritonavir (LPV/r) or Darunavir/cobicistat (DVR/c) associated to Hydroxychloroquine (HCQ) were retrospectively analyzed. Statistical analysis was performed by using a logistic regression model and survival analysis to assess the role of different predictors of in-hospital mortality, including an early (<6 days from symptoms onset) vs. late treatment onset, signs and symptoms at COVID-19 presentation, type of antiviral treatment (LPV/r or DVR/c) and patients’ age (65–80 vs. >80 years old). Results: Multivariate analysis showed that an older age (OR: 2.54) and dyspnea as presenting symptom (OR: 2.01) were associated with higher mortality rate, whereas cough as presenting symptom (OR: 0.53) and a timely drug administration (OR: 0.44) were associated with lower mortality. Survival analysis demonstrated that the timing of drug administration had an impact on mortality in 65–80 years-old patients (p = 0.02), whereas no difference was seen in those >80 years-old. This impact was more evident in patients with dyspnea as primary symptom of COVID-19, in whom mortality decreased from 57.1% to 38.3% due to timely drug administration (OR: 0.5; p = 0.04). Conclusions: There was a significant association between the use of a combined antiviral regimen and HCQ and lower mortality, when timely-administered, in COVID-19 patients aged 65–80 years. Our findings support timely treatment onset as a key component in the treatment of COVID-19. View Full-Text
Keywords: age; antivirals; COVID-19; darunavir/cobicistat; geriatric; gerontology; hydroxychloroquine; lopinavir/ritonavir; SARS-CoV-2; timing age; antivirals; COVID-19; darunavir/cobicistat; geriatric; gerontology; hydroxychloroquine; lopinavir/ritonavir; SARS-CoV-2; timing
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MDPI and ACS Style

Desai, A.; Caltagirone, G.; Sari, S.; Pocaterra, D.; Kogan, M.; Azzolini, E.; Savevski, V.; Martinelli-Boneschi, F.; Voza, A. The Use of Antiviral Agents against SARS-CoV-2: Ineffective or Time and Age Dependent Result? A Retrospective, Observational Study among COVID-19 Older Adults . J. Clin. Med. 2021, 10, 686. https://doi.org/10.3390/jcm10040686

AMA Style

Desai A, Caltagirone G, Sari S, Pocaterra D, Kogan M, Azzolini E, Savevski V, Martinelli-Boneschi F, Voza A. The Use of Antiviral Agents against SARS-CoV-2: Ineffective or Time and Age Dependent Result? A Retrospective, Observational Study among COVID-19 Older Adults . Journal of Clinical Medicine. 2021; 10(4):686. https://doi.org/10.3390/jcm10040686

Chicago/Turabian Style

Desai, Antonio; Caltagirone, Giuseppe; Sari, Sharon; Pocaterra, Daria; Kogan, Maria; Azzolini, Elena; Savevski, Victor; Martinelli-Boneschi, Filippo; Voza, Antonio. 2021. "The Use of Antiviral Agents against SARS-CoV-2: Ineffective or Time and Age Dependent Result? A Retrospective, Observational Study among COVID-19 Older Adults " J. Clin. Med. 10, no. 4: 686. https://doi.org/10.3390/jcm10040686

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