Эпидемиологическая и клиническая эффективность приема азоксимера бромида для профилактики острой респираторной инфекции и COVID-19 среди медицинских работников

Abstract

Background. Acute respiratory infections (ARIs) account for over 90% of all infectious diseases in the Russian Federation. During the COVID-19 pandemic, with no causal therapy developed so far, it is important to pay attention to preventive drugs. Objective. To assess the epidemiological and clinical efficacy of azoximer bromide (Polyoxidonium®) for the prevention of ARIs and COVID-19 in the vulnerable groups (healthcare professionals). Patients and methods. We performed an observational, prospective, selective study to assess the impact of azoximer bromide (AzB) on the incidence and tolerability of ARIs and SARS-CoV-2 infection among healthcare professionals in the Russian Federation. This study was conducted between April and August 2020 and included 476 participants. Of them, 311 individuals were in the experimental group (AzB+), whereas 165 individuals served as controls (AzB-). Patients in the experimental group received 1 tablet of azoximer bromide twice a day for 10 days. We evaluated the incidence of ARIs and COVID-19 (epidemiological efficacy) and disease severity (clinical efficacy). We surveyed the participants using a special questionnaire 3 months following treatment initiation or inclusion in the control group. Statistical analysis was performed using the R v. 3.6.3 software. Differences were considered significant at p < 0.05. Continuous variables were described by the number of observations (n), means, 95% confidence intervals (CIs) for means, medians (Me), and interquartile ranges (IQR). Categorical variables were presented as the absolute number of observations, percentages, and two-sided CIs. Results. We found that participants in the AzB+ group demonstrated a 43.3% lower ARI risk than controls (p < 0.001). The risk of COVID-19 was decreased by 71.4% (p < 0.001). We also demonstrated that AzB was effective in reducing ARI severity. Participant from the AzB+ group who developed some respiratory infections presented with a milder disease and 33.2% less common lower respiratory tract symptoms (such as cough, shortness of breath, and chest pain) (p < 0.001). The incidence of pneumonia in the experimental group was 14.1% lower than that in the control group (5.3%–22.9%) (p = 0.029). Conclusion. Thus, azoximer bromide used as a preventive measure or as a part of comprehensive therapy decreased the incidence of ARIs and COVID-19 among healthcare professionals and alleviated the disease, which suggests its high epidemiological and clinical efficacy. Key words: acute respiratory infections, COVID-19, Azoximer bromide, prevention, comprehensive therapy, healthcare professionals