Analysis of Antiviral Drug Usage in COVID-19 Fatalities: A Retrospective Study

Abstract

Background: Although several repurposed antiviral drugs have been used for the treatment of coronavirus disease 2019 (COVID-19), only a few, such as remdesivir (RDV) and molnupiravir, have shown promising effects. Objectives: The objectives of this study were to investigate the association of repurposed antiviral drugs with COVID-19 mortality. Methods: This cross-sectional study analyzed data from 1,477 patients who died from COVID-19 at Razi Hospital in Rasht between 2019 and 2022. Demographic and clinical data, including age, sex, insurance status, oxygen saturation, ICU admission, comorbidities, number of comorbidities, antiviral drug type, and the number of drugs used, were recorded. Results: The study analyzed 1,477 deceased COVID-19 patients, of whom 475 (32.2%) did not receive any antiviral drugs, 609 (41.2%) received one, 381 (25.8%) received two, and 12 (0.8%) received three antiviral drugs. Remdesivir was more frequently administered to females (47.7%) compared to males (42.8%), while oseltamivir (OST) and lopinavir/ritonavir (LPV/r) were used more commonly in males (15.4% and 13.9%, respectively). A statistically significant difference was observed in the use of OST (P = 0.001) and LPV/r (P = 0.002) between genders. Additionally, patients with insurance were significantly more likely to receive RDV (P = 0.006) and interferon beta-1a (INF-β-1a) (P = 0.009) compared to those without insurance. Conclusions: The findings of this study reveal that approximately one-third of COVID-19-related deaths occurred in patients who had not received any antiviral treatment. Among those who did receive treatment, the majority were administered only one antiviral drug, most commonly RDV.