Jia Huang1#, Song Zhai2#, Fangfan Ye1, Song Wang1, Manfei Zeng1, George Way3, Vipul Madahar3, Tengfei Zhu1, Liping Qiu1, Zehui Xu1, Manhua Ye1, Lei Liu1*, Xinping Cui2* and Jiayu Liao3*
1National Clinical Research Center for Infectious Disease, The Second Affiliated Hospital of Southern University of Science and Technology, China 2Department of Statistics, University of California at Riverside, 900 University Avenue Riverside, USA 3Department of Bioengineering, University of California at Riverside, 900 University Avenue Riverside, USAFulltext PDF
Various medical treatments for COVID-19 are attempted. After patients are discharged, SARSCoV- 2 recurring cases are reported and the recurrence could profoundly impact patient healthcare and social economics. To date, no data on the effects of medical treatments on recurrence has been published. We analyzed the combinatorial treatment data of ten different drugs for the recurring cases in a single medical center, Shenzhen, China. A total of 417 patients were considered and 414 of them were included in this study (3 deaths) with mild-to-critical COVID-19. Patients were treated by eight different drug combinations and followed up for recurrence for 28 days quarantine after being discharged from the medical center between February and May, 2020. We applied the Synthetic Minority Oversampling Technique (SMOTE) to overcome the rare recurring events in certain patient subgroups. Virtual Twins Matching (VTM) analysis, facilitated by random forest regression, was performed for medical treatment-recurrence classification, while minimizing effects of confounding factors. We used the Multiple Comparisons with the Best (MCB) as the test of the best drug combination in each patient subgroup. Among those drug combinations, Methylprednisolone/ Interferon/Lopinavir/Ritonavir/Arbidol led to the lowest recurring rate (0.133) overall, as compared to the average recurring rate (0.203). For the younger group (age 20 to 27) or the older group (age 60 to 70), the optimal drug combinations are different, but the above combination is still the second best. For obese patients, the combination of Ribavirin/Interferon/Lopinavir/Ritonavir/Arbidol led to the lowest recurring rate for age group of 20 to 50, whereas the combination of Interferon/ Lopinavir/Ritonavir/Arbidol led to lowest recurring rate for age group of 50 to 70. The insights into combinatorial therapy we provided here shed lights on the use of a combination of (biological and chemical) anti-virus therapy and/or anti-cytokine storm as a potentially effective therapeutic treatment for COVID-19.
COVID-19; Obese patients; Combinatorial therapy; Drugs; Recurrence
Huang J, Zhai S, Ye F, Wang S, Zeng M, Way G, et al. Age- and Obese- Dependent COVID-19 Recurrence from Combinatorial Therapy. Ann Med Medical Res. 2021;4:1036..