The clinical outcomes and effectiveness of antiviral agents among underweight patients with COVID-19

ABSTRACT

Objectives

This study investigated the outcomes of underweight patients with COVID-19 and the effectiveness of antiviral agents in this population.

Methods

A retrospective cohort study using theTriNetX research network was conducted. Propensity score matching (PSM) was employed to balance the first cohort involving COVID-19 patients with underweight and normal-weight. In the second cohort, underweight patients receiving antiviral agents and untreated individuals were matched using PSM. The primary outcome was a composite of all-cause hospitalization and death during the 7–30-day follow-up period.

Results

After PSM, the first cohort including each group of 13,502 patients with balanced baseline characteristics were identified for comparing the outcome of patients with underweight and normal weight. The underweight group had a higher risk of the composite primary outcome than those with normal weight (hazard ratio [HR], 1.251; 95% confidence interval [CI], 1.132–1.382). The second cohort included each 884 underweight patients with and without receiving antivirals.Compared with untreated patients, those receiving antiviral treatment had a lower risk of composite primary outcomes (HR, 0.426; 95% CI, 0.278–0.653).

Conclusion

Underweight status may be associated with a higher risk of all-cause hospitalization and death in patients with COVID-19.Among underweight patients, antiviral agents demonstrated clinically beneficial effects.

KEYWORDS:

• SARS-CoV-2
• COVID-19
• underweight
• body mass index
• antiviral agent
• mortality

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Ethics statement

This study was approved by the Institutional Review Board of the Chi Mei Medical Center (No. 11202–002).

Data availability statement

Raw data were generated at TriNetX network. Derived data supporting the findings of this study are available from the corresponding author Chih-Cheng Lai on requestable.

Supplemental data

Supplemental data for this article can be accessed online at https://doi.org/10.1080/14787210.2024.2303017.

Additional information

Funding

This paper was not funded.