Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2024, 168(1):35-43 | DOI: 10.5507/bp.2023.045

Mortality of hospitalized patients with COVID-19: Effects of treatment options (vitamin D, anticoagulation, isoprinosine, ivermectin) assessed by propensity score matching, retrospective analysis

Jiri Plasek1, 2, Jozef Dodulik1, Petr Gai3, Barbora Hrstkova4, Jan Skrha5, Lukas Zlatohlavek5, Renata Vlasakova5, Peter Danko6, Petr Ondracek7, Eva Cubova8, Bronislav Capek9, Marie Kollarova10, Tomas Furst11, Jan Vaclavik1, 2
1 Department of Internal Medicine and Cardiology, University Hospital Ostrava, Ostrava, Czech Republic
2 Center for Research on Internal Medicine and Cardiovascular diseases, Faculty of Medicine, University of Ostrava, Czech Republic
3 Department of Pulmonary Medicine and Tuberculosis, University Hospital Ostrava, Ostrava, Czech Republic
4 Clinic for Infectious diseases, University Hospital Ostrava, Ostrava, Czech Republic
5 3rd Department of Internal Medicine, General University Hospital, Prague
6 Department of Internal Medicine, Havirov Regional Hospital, Havirov, Czech Republic
7 Department of Internal Medicine, Bilovec Regional Hospital, Bilovec, Czech Republic
8 Department of Internal Medicine, Fifejdy Ostrava City Hospital, Ostrava, Czech Republic
9 Department of Internal Medicine, Associated Medical Facilities, Krnov, Czech Republic
10 Department of Internal Medicine, Trinec Regional Hospital, Trinec, Czech Republic
11 Department of Mathematical Analysis and Application of Mathematics, Faculty of Science, Palacky University Olomouc, Czech Republic

Introduction: SARS-CoV-2 respiratory infection is associated with significant morbidity and mortality, especially in hospitalized high-risk patients. We aimed to evaluate the effects of treatment options (vitamin D, anticoagulation, isoprinosine, ivermectin) on hospital mortality in non-vaccinated patients during the 2021 spring wave in the Czech Republic.

Methods: Initially, 991 patients hospitalized in the period January 1, 2021, to March 31, 2021, with PCR-confirmed SARS-CoV-2 acute respiratory infection in two university and five rural hospitals were included in the study. After exclusion of patients with an unknown outcome, a total of 790 patients entered the final analysis. The effects of different treatments were assessed in this cohort by means of propensity score matching.

Results: Of the 790 patients, 282 patients died in the hospital; 37.7% were male and 33.3% were female. Age, sex, state of the disease, pneumonia, therapy, and several comorbidities were matched to simulate a case-control study. For anticoagulation treatment, 233 cases (full-dose) vs. 233 controls (prophylactic dose) were matched. The difference in mortality was significant in 16 of the 50 runs. For the treatment with isoprinosine, ivermectin, and vitamin D, none of the 50 runs led to a significant difference in hospital mortality.

Conclusion: Prophylactic-dose anticoagulation treatment in our study was found to be beneficial in comparison with the full dose. Supplementation with vitamin D did not show any meaningful benefit in terms of lowering the hospital mortality. Neither ivermectin nor, isoprinosine was found to significantly decrease hospital mortality.

Keywords: SARS-CoV-2, COVID-19, vitamin D3, ivermectin, Isoprinosine, mortality, anticoagulation, propensity score matching

Received: July 4, 2023; Revised: November 2, 2023; Accepted: November 7, 2023; Prepublished online: December 4, 2023; Published: March 12, 2024  Show citation

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Plasek, J., Dodulik, J., Gai, P., Hrstkova, B., Skrha, J., Zlatohlavek, L., ... Vaclavik, J. (2024). Mortality of hospitalized patients with COVID-19: Effects of treatment options (vitamin D, anticoagulation, isoprinosine, ivermectin) assessed by propensity score matching, retrospective analysis. Biomedical papers, 168(1), 35-43. doi: 10.5507/bp.2023.045
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