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Effect of Combination Therapy of Hydroxychloroquine and Azithromycin on Mortality in Patients With COVID-19.
Clin Transl Sci. 2020 Sep 14 [Online ahead of print]CT

Abstract

Conflicting evidence regarding the use of hydroxychloroquine (HCQ) 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 2019 (COVID-19). Of these, 297 were in combination treatment, 17 were on HCQ alone, and 63 did not receive either of these 2 drugs because of contraindications. The primary end point 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 HCQ treatment group, and 102 in HCQ + azithromycin treatment 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/continuous positive airway pressure (HR 2.726, 95% CI 1.823-4.074, P < 0.001), and C reactive protein above the median (HR 2.191, 95% CI 1.479-3.246, P < 0.001) were directly associated with death, whereas use of HCQ + azithromycin (vs. no treatment; HR 0.265, 95% CI 0.171-0.412, P < 0.001) was inversely associated. In this study, we found a reduced in-hospital mortality in patients treated with a combination of HCQ and azithromycin after adjustment for comorbidities. A large randomized trial is necessary to confirm these findings.

Authors+Show Affiliations

Infectious Disease Department, Policlinico di Monza, Monza, Italy.Department of Oncology and Hemato-Oncology, Università degli Studi di Milano, Milan, Italy.Internal Medicine Department, Policlinico di Monza, Monza, Italy.Cardiology Department, Policlinico di Monza, Monza, Italy.Internal Medicine Department, Policlinico di Monza, Monza, Italy.Internal Medicine Department, Policlinico di Monza, Monza, Italy.Internal Medicine Department, Policlinico di Monza, Monza, Italy. Department of Medicine and Surgery, Università degli Studi di Milano Bicocca, Milan, Italy.Department of Clinical, Internal, Anesthesiologic, and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy.Intensive Care Unit, Policlinico di Monza, Monza, Italy.Department of Oncology and Hemato-Oncology, Università degli Studi di Milano, Milan, Italy.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32926573

Citation

Lauriola, Marinella, et al. "Effect of Combination Therapy of Hydroxychloroquine and Azithromycin On Mortality in Patients With COVID-19." Clinical and Translational Science, 2020.
Lauriola M, Pani A, Ippoliti G, et al. Effect of Combination Therapy of Hydroxychloroquine and Azithromycin on Mortality in Patients With COVID-19. Clin Transl Sci. 2020.
Lauriola, M., Pani, A., Ippoliti, G., Mortara, A., Milighetti, S., Mazen, M., Perseghin, G., Pastori, D., Grosso, P., & Scaglione, F. (2020). Effect of Combination Therapy of Hydroxychloroquine and Azithromycin on Mortality in Patients With COVID-19. Clinical and Translational Science. https://doi.org/10.1111/cts.12860
Lauriola M, et al. Effect of Combination Therapy of Hydroxychloroquine and Azithromycin On Mortality in Patients With COVID-19. Clin Transl Sci. 2020 Sep 14; PubMed PMID: 32926573.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effect of Combination Therapy of Hydroxychloroquine and Azithromycin on Mortality in Patients With COVID-19. AU - Lauriola,Marinella, AU - Pani,Arianna, AU - Ippoliti,Giovanbattista, AU - Mortara,Andrea, AU - Milighetti,Stefano, AU - Mazen,Marjieh, AU - Perseghin,Gianluca, AU - Pastori,Daniele, AU - Grosso,Paolo, AU - Scaglione,Francesco, Y1 - 2020/09/14/ PY - 2020/06/23/received PY - 2020/07/13/accepted PY - 2020/9/15/pubmed PY - 2020/9/15/medline PY - 2020/9/14/entrez JF - Clinical and translational science JO - Clin Transl Sci N2 - Conflicting evidence regarding the use of hydroxychloroquine (HCQ) 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 2019 (COVID-19). Of these, 297 were in combination treatment, 17 were on HCQ alone, and 63 did not receive either of these 2 drugs because of contraindications. The primary end point 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 HCQ treatment group, and 102 in HCQ + azithromycin treatment 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/continuous positive airway pressure (HR 2.726, 95% CI 1.823-4.074, P < 0.001), and C reactive protein above the median (HR 2.191, 95% CI 1.479-3.246, P < 0.001) were directly associated with death, whereas use of HCQ + azithromycin (vs. no treatment; HR 0.265, 95% CI 0.171-0.412, P < 0.001) was inversely associated. In this study, we found a reduced in-hospital mortality in patients treated with a combination of HCQ and azithromycin after adjustment for comorbidities. A large randomized trial is necessary to confirm these findings. SN - 1752-8062 UR - https://www.unboundmedicine.com/medline/citation/32926573/Effect_of_Combination_Therapy_of_Hydroxychloroquine_and_Azithromycin_on_Mortality_in_Patients_With_COVID_19_ L2 - https://doi.org/10.1111/cts.12860 DB - PRIME DP - Unbound Medicine ER -
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