tetano
Editor, Senior Moderator
Int J Clin Pract
. 2021 Jun 25;e14574.
doi: 10.1111/ijcp.14574. Online ahead of print.
Variation in therapeutic strategies for the management of severe COVID-19 in India- A nationwide cross-sectional survey
Bharat Jagiasi[SUP] 1 [/SUP], Prashant Nasa[SUP] 2 [/SUP], Gunjan Chanchalani[SUP] 3 [/SUP], Ahsan Ahmed[SUP] 4 [/SUP], A K Ajith Kumar[SUP] 5 [/SUP], Kanwalpreet Sodhi[SUP] 6 [/SUP], Kishore Mangal[SUP] 7 [/SUP], Manoj K Singh[SUP] 8 [/SUP], Nitesh Gupta[SUP] 9 [/SUP], Prasanna U Bidkar[SUP] 10 [/SUP], Ranvir S Tyagi[SUP] 11 [/SUP], Reshu G Khanikar[SUP] 12 [/SUP], Swagata Tripathy[SUP] 13 [/SUP], Swapna Khanzode[SUP] 14 [/SUP], K Subba Reddy[SUP] 15 [/SUP], Saurabh Saigal[SUP] 16 [/SUP], S Vijay A Sivakumar[SUP] 17 [/SUP], Yash Javeri[SUP] 18 [/SUP], Seema S Tekwani[SUP] 19 [/SUP]
Affiliations
Abstract
Aim: During the pandemic of coronavirus disease 2019 (COVID-19), the physicians are using various off-label therapeutics to manage COVID-19. We undertook a cross-sectional survey to study the current variation in therapeutic strategies for managing severe COVID-19 in India.
Methods: From January 4 to January 18, 2021, an online cross-sectional survey was conducted among physicians involved in the management of severe COVID-19. The survey had three sections: 1. Antiviral agents, 2. Immunomodulators, and 3. Adjuvant therapies.
Results: 1055 respondents (from 24 states and five union territories), of which 64.2% were consultants, 54.3% working in private hospitals, and 39.1% were from critical care medicine completed the survey. Remdesivir (95.2%), antithrombotics (94.2%), corticosteroids (90.3%), vitamins (89.7%), and empirical antibiotics (85.6%) were the commonly used therapeutics. Ivermectin (33%), convalescent plasma (28.6%), and favipiravir (17.6%) were other antiviral agents used. Methylprednisolone (50.2%) and dexamethasone (44.1%) were preferred corticosteroids and at a dose equivalent of 8 mg of dexamethasone phosphate (70.2%). There was significant variation among physicians from different medical specialities in the use of favipiravir, corticosteroids, empirical antibiotics, and vitamins.
Conclusion: There is a considerable variation in the physicians' choice of therapeutic strategies for the management of severe COVID-19 in India, as compared to available evidence.
Keywords: COVID-19/drug therapy; India COVID-19 management; Off-label drugs for COVID-19; Physicians practices in India; SARS-CoV-2; Severe COVID-19; Surveys and Questionnaires.
. 2021 Jun 25;e14574.
doi: 10.1111/ijcp.14574. Online ahead of print.
Variation in therapeutic strategies for the management of severe COVID-19 in India- A nationwide cross-sectional survey
Bharat Jagiasi[SUP] 1 [/SUP], Prashant Nasa[SUP] 2 [/SUP], Gunjan Chanchalani[SUP] 3 [/SUP], Ahsan Ahmed[SUP] 4 [/SUP], A K Ajith Kumar[SUP] 5 [/SUP], Kanwalpreet Sodhi[SUP] 6 [/SUP], Kishore Mangal[SUP] 7 [/SUP], Manoj K Singh[SUP] 8 [/SUP], Nitesh Gupta[SUP] 9 [/SUP], Prasanna U Bidkar[SUP] 10 [/SUP], Ranvir S Tyagi[SUP] 11 [/SUP], Reshu G Khanikar[SUP] 12 [/SUP], Swagata Tripathy[SUP] 13 [/SUP], Swapna Khanzode[SUP] 14 [/SUP], K Subba Reddy[SUP] 15 [/SUP], Saurabh Saigal[SUP] 16 [/SUP], S Vijay A Sivakumar[SUP] 17 [/SUP], Yash Javeri[SUP] 18 [/SUP], Seema S Tekwani[SUP] 19 [/SUP]
Affiliations
- PMID: 34171154
- DOI: 10.1111/ijcp.14574
Abstract
Aim: During the pandemic of coronavirus disease 2019 (COVID-19), the physicians are using various off-label therapeutics to manage COVID-19. We undertook a cross-sectional survey to study the current variation in therapeutic strategies for managing severe COVID-19 in India.
Methods: From January 4 to January 18, 2021, an online cross-sectional survey was conducted among physicians involved in the management of severe COVID-19. The survey had three sections: 1. Antiviral agents, 2. Immunomodulators, and 3. Adjuvant therapies.
Results: 1055 respondents (from 24 states and five union territories), of which 64.2% were consultants, 54.3% working in private hospitals, and 39.1% were from critical care medicine completed the survey. Remdesivir (95.2%), antithrombotics (94.2%), corticosteroids (90.3%), vitamins (89.7%), and empirical antibiotics (85.6%) were the commonly used therapeutics. Ivermectin (33%), convalescent plasma (28.6%), and favipiravir (17.6%) were other antiviral agents used. Methylprednisolone (50.2%) and dexamethasone (44.1%) were preferred corticosteroids and at a dose equivalent of 8 mg of dexamethasone phosphate (70.2%). There was significant variation among physicians from different medical specialities in the use of favipiravir, corticosteroids, empirical antibiotics, and vitamins.
Conclusion: There is a considerable variation in the physicians' choice of therapeutic strategies for the management of severe COVID-19 in India, as compared to available evidence.
Keywords: COVID-19/drug therapy; India COVID-19 management; Off-label drugs for COVID-19; Physicians practices in India; SARS-CoV-2; Severe COVID-19; Surveys and Questionnaires.