The results analyze the evolution of 13,500 patients from 174 hospitals thanks to the work of more than 1,000 Hospital Pharmacists that reveal the benefit of corticosteroids and tocilizumab associated with a reduction in mortality of up to 50%.
On March 20, 2020, the RERFAR-COVID-19 SEFH Registry of the Spanish Society of Hospital Pharmacy (SEFH) began in Spain, which has included to date a total of 174 hospitals throughout the Spanish territory. So far, more than 13,500 patients have been included in a registry that will report on the results that have been associated with the characteristics of patients with Covid-19 hospitalized in Spain, including the different pharmacological treatments that have been used during the pandemic.
In the opinion of Dr. Jesús Sierra, Specialist Pharmacist and coordinator of RERFAR-COVID-19 SEFH, “the results found in the first analysis carried out are consistent with the information available for some of the drugs used in the treatment of Covid-19, as is the case with corticosteroids. While they provide information so far not available such as the association of tocilizumab to a reduction in mortality. These results also guide us on a possible contribution of hydroxychloroquine in lower doses than those studied in clinical trials with results reported so far. ”
“These first results – continues Dr. Sierra – have helped us to identify potential treatments and guidelines whose reducing effects on mortality should be confirmed in clinical trials specifically designed for this.”
On May 10, 5,386 patients had completed the follow-up, finding a global mortality at 28 days of 17.8% (95% CI, 16.8% -18.8%). The study has compared the results of the patients, considering their age, severity, associated diseases and other relevant factors. Some modifiable prognostic factors, which have been associated with a reduction in mortality at 28 days. After corticosteroids (Hazard Ratio = 0.46; 95% CI: 0.34-0.62) and tocilizumab (HR = 0.55) were identified as strong associated factors after one week of hospitalization (with a mortality reduction of close to 50%). 95% CI: 0.44-0.68). A weaker protective association was found with low molecular weight heparin (HR = 0.70, 95% CI: 0.60-0.81), hydroxychloroquine alone (HR = 0.71, 95% CI: 0.55-0.93) or in combination with lopinavir / ritonavir ( HR = 0.74, 95% CI 0.58-0.95) and azithromycin (HR = 0.83, 95% CI 0.72-0.96).
These results should be interpreted in the context of the observational evidence from which they come, and may be useful for interpreting the health results associated with Covid-19 during the pandemic in Spain, as well as for the design of new studies. All the data that is part of this investigation will be communicated shortly, this being a preliminary report of these results.
1,000 Hospital Pharmacists
More than 1,000 hospital pharmacists have participated in a study that has, in addition to Dr. Sierra, researchers Drs. Javier Sáez, Laila Abdelkader, Emilio García-Cabrera, Emilio Alegre, Mª Adoración Nieto, Sara S. Kim, Cristina Puivecino, Jordi Nicolás, Sandra Flores, Icíar Martínez and Leonor Periáñez.
In addition, Delos Clinical has been an indispensable piece in the development of RERFAR, carrying out all the work of inclusion of centers, in addition to its participation in the design, statistical analysis and evaluation of the results.