Azvudine Reduce the In-Hospital Mortality of Patients with COVID-19 Pneumonia

Background: In our study, we aimed to estimate the in-hospital mortality of patients with COVID-19 pneumonia and its potential risk factors, more importantly, to estimate whether Azvudine reduce the patients’ in-hospital mortality.Methods: Our retrospective study was conducted on the medical records of 969 patients, consecutively admitted for COVID-19 pneumonia to two hospitals in Chongqing, China. We divided all cases into two groups based on Survived or Non-Survived, then performed the statistical analysis.Findings: In Non-Survived group, the mean age (mean in years 79.57 vs.68.95, p=0.000), percentage of male (72% vs.57%, p=0.000), Comorbidities (85% vs.72%, p=0.000), Diabetes (41% vs.24%, p=0.000), Cardiovascular diseases (54% vs.40%, p=0.001), Chronic kidney disease (22% vs.11%, p=0.000), frequency of systemic corticosteroids (57% vs.32%, p=0.000), supplemental oxygen (86% vs.56%, p=0.000), NIV (53% vs.13%, p=0.000), IMV (29% vs.3%, p=0.000) were higher than that in the Survived Group, but a significantly lower frequency of Azvudine using (13% vs.22%, p=0.008). There were significant differences in Neutrophil count (7.19 vs.4.19, p=0.000), Lymphocyte count (0.76 vs.1.03, p=0.000), CRP (65.8 vs.13.36, p=0.000), PCT (0.62 vs.0.1, p=0.000), D-dimer (2.54 vs.0.77, p=0.000), Oxygenation index (162 vs. 289, p=0.000) between Non-Survived group and Survived group. With multivariable adjusted logistic regression models, the risk factors associated with higher in-hospital mortality may be older age, with diabetes, Neutrophil count and CRP elevation, and treated by systemic corticosteroids, supplemental oxygen, NIV, IMV, but only Azvudine can be a protective factor. In group treating with Azvudine, it showed a significantly lower in-hospital mortality (11% vs.19%, p=0.008) in all patients and much lower in Severe sub-group (9% vs.26%, p=0.001),but no significantly differences in Moderate (11% vs.12%, p=0.861) and Critical sub-group (12% vs.33%, p=0.134).Interpretation: Azvudine can be a protective factor in patients with COVID-19 pneumonia. And Azvudine significantly reduce the risk of in-hospital mortality at Severe sub-group and female patients.Funding: This work was supported by the General Program of Chongqing Natural Science Foundation (CSTB2022NSCQ-MSX0901) and Kuanren Talents Program of the Second Affiliated Hospital of Chongqing Medical University (kryc-yq-2204).Declaration of Interest: The authors have declared no conflict of interest.Ethical Approval: The study was approved by the Research Ethics Commission of the Second Affiliated Hospital of Chongqing Medical University and the Chongqing Seventh People's Hospital.