Source: Clinical & Translational Science

Marinella Lauriola Arianna Pani Giovanbattista IppolitiAndrea MortaraStefano MilighettiMarjieh MazenGianluca PerseghinDaniele PastoriPaolo GrossoFrancesco Scaglione

doi:10.1111/cts.12860

Full study here.

Abstract

Conflicting evidence regarding the use of hydroxychloroquine and azithromycin for the treatment of severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) infection do exist.

We performed a retrospective single‐center cohort study including 377 consecutive patients admitted for pneumonia related to coronavirus disease (COVID‐19). Of these 297 were in combination treatment, 17 were on hydroxychloroquine alone and 63 did not receive any of these two drugs because of contraindications. The primary endpoint was in‐hospital death.

Mean age was 71.8±13.4 years and 34.2% were women. We recorded 146 deaths: 35 in no treatment, 7 in hydroxychloroquine and 102 in hydroxychloroquine + azithromycin group (log‐rank test for Kaplan‐Meier curve p<0.001).

At multivariable Cox proportional hazard regression analysis, age (hazard ratio [HR] 1.057, 95% confidence interval [CI] 1.035‐1.079, p<0.001), mechanical ventilation/CPAP (HR 2.726, 95%CI 1.823‐4.074, p<0.001), C Reactive Protein above the median (HR 2.191, 95%CI 1.479‐3.246, p<0.001) were directly associated with death, whilst use of hydroxychloroquine + azithromycin (vs. no treatment) (HR 0.265, 95%CI 0.171‐0.412, p<0.001) was inversely associated.

In this study, we found reduced in‐hospital mortality in patients treated with a combination of hydroxychloroquine and azithromycin after adjustment for comorbidities. A large randomized trial is necessary to confirm these findings.








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The Effect of Early Hydroxychloroquine-based Therapy in COVID-19 Patients in Ambulatory Care Settings: A Nationwide Prospective Cohort Study

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Hydroxychloroquine is Effective and Safe for the Treatment of COVID-19, and May be Universally Effective When Used Early Before Hospitalization: A Systematic Review

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