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Impact of Azithromycin and/or Hydroxychloroquine on Hospital Mortality in COVID-19.
J Clin Med. 2020 Aug 30; 9(9)JC

Abstract

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has led to widespread use of hydroxychloroquine and azithromycin despite the lack of conclusive evidence for their safety and efficacy. We evaluated the association between treatment with hydroxychloroquine and/or azithromycin and hospital mortality as the primary outcome. We compared the hospital mortality of patients treated with hydroxychloroquine alone, azithromycin alone, or their combination to the mortality of patients who received neither drug. A logistic multivariate model with overlap weight propensity score was used for estimation of odds ratios (ORs) with 95% confidence intervals (95% CIs). One thousand four hundred and three patients with SARS-CoV-2 infection were admitted to the hospital. At the time of the analysis, the outcome was available for 1376 (98%) of them. Five hundred and eighty-seven patients (42%) received azithromycin and 377 patients (27%) received hydroxychloroquine, alone or in combination. In-hospital mortality was 26%. After the adjusted analysis, azithromycin alone was associated with lower mortality (OR 0.60, 95% CI 0.42-0.85) compared to no treatment. Hydroxychloroquine alone (OR 0.76, 95% CI 0.53-1.08) and the combination of azithromycin and hydroxychloroquine (OR 1.13, 95% CI 0.77-1.69) were not associated with hospital mortality. In this cohort of patients, azithromycin alone was associated with lower hospital mortality but hydroxychloroquine was not associated with increased or reduced mortality. While we await randomized clinical trials, these data support the use of azithromycin in novel coronavirus disease 2019 (COVID-19) and can contribute to better understanding of its role in further meta-analyses.

Authors+Show Affiliations

Department of Anesthesia, Intensive Care and Pain Medicine, Fondazione Poliambulanza Istituto Ospedaliero, 25124 Brescia, Italy.Department of Anesthesia, Intensive Care and Pain Medicine, Fondazione Poliambulanza Istituto Ospedaliero, 25124 Brescia, Italy.Department of Anesthesia, Intensive Care and Pain Medicine, Fondazione Poliambulanza Istituto Ospedaliero, 25124 Brescia, Italy.Department of Anesthesia, Intensive Care and Pain Medicine, Fondazione Poliambulanza Istituto Ospedaliero, 25124 Brescia, Italy.Department of Anesthesia, Intensive Care and Pain Medicine, Fondazione Poliambulanza Istituto Ospedaliero, 25124 Brescia, Italy.Department of Anesthesia, Intensive Care and Pain Medicine, Fondazione Poliambulanza Istituto Ospedaliero, 25124 Brescia, Italy. Department of Intensive Care Medicine and Anaesthesiology, Fondazione Policlinico Universitario A. Gemelli, Università Cattolica del Sacro Cuore, 00168 Rome, Italy.Department of Anesthesia, Intensive Care and Pain Medicine, Fondazione Poliambulanza Istituto Ospedaliero, 25124 Brescia, Italy.Department of Anesthesia, Intensive Care and Pain Medicine, Fondazione Poliambulanza Istituto Ospedaliero, 25124 Brescia, Italy.Department of Information and Communications Technology, Fondazione Poliambulanza Istituto Ospedaliero, 25124 Brescia, Italy.Department of Anesthesia, Intensive Care and Pain Medicine, Fondazione Poliambulanza Istituto Ospedaliero, 25124 Brescia, Italy.Department of Anesthesia, Intensive Care and Pain Medicine, Fondazione Poliambulanza Istituto Ospedaliero, 25124 Brescia, Italy.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32872629

Citation

Albani, Filippo, et al. "Impact of Azithromycin And/or Hydroxychloroquine On Hospital Mortality in COVID-19." Journal of Clinical Medicine, vol. 9, no. 9, 2020.
Albani F, Fusina F, Giovannini A, et al. Impact of Azithromycin and/or Hydroxychloroquine on Hospital Mortality in COVID-19. J Clin Med. 2020;9(9).
Albani, F., Fusina, F., Giovannini, A., Ferretti, P., Granato, A., Prezioso, C., Divizia, D., Sabaini, A., Marri, M., Malpetti, E., & Natalini, G. (2020). Impact of Azithromycin and/or Hydroxychloroquine on Hospital Mortality in COVID-19. Journal of Clinical Medicine, 9(9). https://doi.org/10.3390/jcm9092800
Albani F, et al. Impact of Azithromycin And/or Hydroxychloroquine On Hospital Mortality in COVID-19. J Clin Med. 2020 Aug 30;9(9) PubMed PMID: 32872629.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Impact of Azithromycin and/or Hydroxychloroquine on Hospital Mortality in COVID-19. AU - Albani,Filippo, AU - Fusina,Federica, AU - Giovannini,Alessia, AU - Ferretti,Pierluigi, AU - Granato,Anna, AU - Prezioso,Chiara, AU - Divizia,Danilo, AU - Sabaini,Alessandra, AU - Marri,Marco, AU - Malpetti,Elena, AU - Natalini,Giuseppe, Y1 - 2020/08/30/ PY - 2020/07/26/received PY - 2020/08/20/revised PY - 2020/08/27/accepted PY - 2020/9/3/entrez PY - 2020/9/3/pubmed PY - 2020/9/3/medline KW - SARS-CoV-2 KW - azithromycin KW - hydroxychloroquine JF - Journal of clinical medicine JO - J Clin Med VL - 9 IS - 9 N2 - The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has led to widespread use of hydroxychloroquine and azithromycin despite the lack of conclusive evidence for their safety and efficacy. We evaluated the association between treatment with hydroxychloroquine and/or azithromycin and hospital mortality as the primary outcome. We compared the hospital mortality of patients treated with hydroxychloroquine alone, azithromycin alone, or their combination to the mortality of patients who received neither drug. A logistic multivariate model with overlap weight propensity score was used for estimation of odds ratios (ORs) with 95% confidence intervals (95% CIs). One thousand four hundred and three patients with SARS-CoV-2 infection were admitted to the hospital. At the time of the analysis, the outcome was available for 1376 (98%) of them. Five hundred and eighty-seven patients (42%) received azithromycin and 377 patients (27%) received hydroxychloroquine, alone or in combination. In-hospital mortality was 26%. After the adjusted analysis, azithromycin alone was associated with lower mortality (OR 0.60, 95% CI 0.42-0.85) compared to no treatment. Hydroxychloroquine alone (OR 0.76, 95% CI 0.53-1.08) and the combination of azithromycin and hydroxychloroquine (OR 1.13, 95% CI 0.77-1.69) were not associated with hospital mortality. In this cohort of patients, azithromycin alone was associated with lower hospital mortality but hydroxychloroquine was not associated with increased or reduced mortality. While we await randomized clinical trials, these data support the use of azithromycin in novel coronavirus disease 2019 (COVID-19) and can contribute to better understanding of its role in further meta-analyses. SN - 2077-0383 UR - https://www.unboundmedicine.com/medline/citation/32872629/Impact_of_Azithromycin_and/or_Hydroxychloroquine_on_Hospital_Mortality_in_COVID_19_ L2 - https://www.mdpi.com/resolver?pii=jcm9092800 DB - PRIME DP - Unbound Medicine ER -
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