# Impact of Using Antiviral Therapy on COVID-19 Progression in ICU Patients: A Saudi Arabian Retrospective Analysis

## TL;DR

This study shows that early antiviral therapy in ICU patients with severe COVID-19 can reduce ICU admissions and mortality rates.

## Contribution

The study provides new evidence on the effectiveness of early antiviral therapy in ICU settings and identifies demographic associations with specific antiviral use.

## Key findings

- Early antiviral therapy reduced ICU admissions by 30% and mortality by 20%.
- Demographic factors influenced the choice of antiviral medications like Kaletra, favipiravir, remdesivir, and oseltamivir.
- Microbiological cure rates were low at 15.4%, with most patients not achieving cure.

## Abstract

Background

The COVID-19 pandemic has posed an unprecedented challenge to the global healthcare system, necessitating effective therapeutic strategies to mitigate its impact. This study investigates the significance of early antiviral therapy in the context of intensive care units (ICUs) and its potential to influence the progression and outcomes of severe COVID-19 cases.

Methodology

This retrospective cohort study leveraged a diverse patient population with confirmed severe COVID-19 admitted to ICUs. A total of 1,250 patients were included in the analysis, and their medical records were comprehensively reviewed. The study aimed to assess the impact of early antiviral therapy on patient outcomes, focusing on the administration of remdesivir within the first 48 hours of ICU admission.

Results

In a study of 1,250 COVID-19 patients, early antiviral therapy with remdesivir significantly reduced ICU admissions by 30% (N = 225) compared to standard care (N = 525). The early therapy group also exhibited a 20% lower mortality rate (N = 120) than the control group (N = 150). Demographic associations with antiviral usage were observed. Kaletra was favored by females, non-Saudi individuals, and healthcare workers, while favipiravir was associated with gender. Remdesivir and ribavirin use were linked to gender and Saudi nationality, while oseltamivir was related to gender, Saudi nationality, and body mass index. Microbiological cure rates were 15.4%, with 84.6% not achieving it. ICU outcomes included 37.7% deaths, 55.7% home discharges, and 6.6% transfers, while hospital outcomes featured 38.5% deaths, 54.4% home discharges, and 7.1% transfers.

Conclusions

This study presents a comprehensive analysis of COVID-19 patient demographics, antiviral medication associations, and clinical outcomes. The findings highlight the significance of tailoring treatment strategies based on patient characteristics and viral history. These insights contribute to a deeper understanding of COVID-19 management and can inform clinical decision-making and further research in this field.