COVID-19 outpatients: early risk-stratified treatment with zinc plus low-dose hydroxychloroquine and azithromycin: a retrospective case series study.
Identifieur interne : 000927 ( Main/Corpus ); précédent : 000926; suivant : 000928COVID-19 outpatients: early risk-stratified treatment with zinc plus low-dose hydroxychloroquine and azithromycin: a retrospective case series study.
Auteurs : Roland Derwand ; Martin Scholz ; Vladimir ZelenkoSource :
- International journal of antimicrobial agents [ 1872-7913 ] ; 2020.
English descriptors
- KwdEn :
- Adolescent (MeSH), Adult (MeSH), Aged (MeSH), Aged, 80 and over (MeSH), Azithromycin (administration & dosage), Azithromycin (adverse effects), COVID-19 (drug therapy), Drug Therapy, Combination (MeSH), Female (MeSH), Humans (MeSH), Hydroxychloroquine (administration & dosage), Hydroxychloroquine (adverse effects), Male (MeSH), Middle Aged (MeSH), Outpatients (MeSH), Retrospective Studies (MeSH), SARS-CoV-2 (MeSH), Young Adult (MeSH), Zinc (administration & dosage), Zinc (adverse effects).
- MESH :
- chemical , administration & dosage : Azithromycin, Hydroxychloroquine, Zinc.
- chemical , adverse effects : Azithromycin, Hydroxychloroquine, Zinc.
- drug therapy : COVID-19.
- Adolescent, Adult, Aged, Aged, 80 and over, Drug Therapy, Combination, Female, Humans, Male, Middle Aged, Outpatients, Retrospective Studies, SARS-CoV-2, Young Adult.
Abstract
The aim of this study was to describe the outcomes of patients with coronavirus disease 2019 (COVID-19) in the outpatient setting after early treatment with zinc, low-dose hydroxychloroquine and azithromycin (triple therapy) dependent on risk stratification. This was a retrospective case series study in the general practice setting. A total of 141 COVID-19 patients with laboratory-confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in the year 2020 were included. The main outcome measures were risk-stratified treatment decision and rates of hospitalisation and all-cause death. A median of 4 days [interquartile range (IQR) 3-6 days; available for n = 66/141 patients] after the onset of symptoms, 141 patients (median age 58 years, IQR 40-67 years; 73.0% male) received a prescription for triple therapy for 5 days. Independent public reference data from 377 confirmed COVID-19 patients in the same community were used as untreated controls. Of 141 treated patients, 4 (2.8%) were hospitalised, which was significantly fewer (P < 0.001) compared with 58 (15.4%) of 377 untreated patients [odds ratio (OR) = 0.16, 95% confidence interval (CI) 0.06-0.5]. One patient (0.7%) in the treatment group died versus 13 patients (3.4%) in the untreated group (OR = 0.2, 95% CI 0.03-1.5; P = 0.12). No cardiac side effects were observed. Risk stratification-based treatment of COVID-19 outpatients as early as possible after symptom onset using triple therapy, including the combination of zinc with low-dose hydroxychloroquine, was associated with significantly fewer hospitalisations.
DOI: 10.1016/j.ijantimicag.2020.106214
PubMed: 33122096
PubMed Central: PMC7587171
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">COVID-19 outpatients: early risk-stratified treatment with zinc plus low-dose hydroxychloroquine and azithromycin: a retrospective case series study.</title><author><name sortKey="Derwand, Roland" sort="Derwand, Roland" uniqKey="Derwand R" first="Roland" last="Derwand">Roland Derwand</name><affiliation><nlm:affiliation>Alexion Pharma Germany GmbH, 80687, Munich, Germany.</nlm:affiliation></affiliation></author><author><name sortKey="Scholz, Martin" sort="Scholz, Martin" uniqKey="Scholz M" first="Martin" last="Scholz">Martin Scholz</name><affiliation><nlm:affiliation>Heinrich-Heine-University, Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany. Electronic address: scholzmartin19@gmail.com.</nlm:affiliation></affiliation></author><author><name sortKey="Zelenko, Vladimir" sort="Zelenko, Vladimir" uniqKey="Zelenko V" first="Vladimir" last="Zelenko">Vladimir Zelenko</name><affiliation><nlm:affiliation>Medical Group Practice, Monroe, NY, 10950, USA.</nlm:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2020">2020</date><idno type="RBID">pubmed:33122096</idno><idno type="pmid">33122096</idno><idno type="doi">10.1016/j.ijantimicag.2020.106214</idno><idno type="pmc">PMC7587171</idno><idno type="wicri:Area/Main/Corpus">000927</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Corpus" wicri:corpus="PubMed">000927</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">COVID-19 outpatients: early risk-stratified treatment with zinc plus low-dose hydroxychloroquine and azithromycin: a retrospective case series study.</title><author><name sortKey="Derwand, Roland" sort="Derwand, Roland" uniqKey="Derwand R" first="Roland" last="Derwand">Roland Derwand</name><affiliation><nlm:affiliation>Alexion Pharma Germany GmbH, 80687, Munich, Germany.</nlm:affiliation></affiliation></author><author><name sortKey="Scholz, Martin" sort="Scholz, Martin" uniqKey="Scholz M" first="Martin" last="Scholz">Martin Scholz</name><affiliation><nlm:affiliation>Heinrich-Heine-University, Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany. Electronic address: scholzmartin19@gmail.com.</nlm:affiliation></affiliation></author><author><name sortKey="Zelenko, Vladimir" sort="Zelenko, Vladimir" uniqKey="Zelenko V" first="Vladimir" last="Zelenko">Vladimir Zelenko</name><affiliation><nlm:affiliation>Medical Group Practice, Monroe, NY, 10950, USA.</nlm:affiliation></affiliation></author></analytic><series><title level="j">International journal of antimicrobial agents</title><idno type="eISSN">1872-7913</idno><imprint><date when="2020" type="published">2020</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adolescent (MeSH)</term><term>Adult (MeSH)</term><term>Aged (MeSH)</term><term>Aged, 80 and over (MeSH)</term><term>Azithromycin (administration & dosage)</term><term>Azithromycin (adverse effects)</term><term>COVID-19 (drug therapy)</term><term>Drug Therapy, Combination (MeSH)</term><term>Female (MeSH)</term><term>Humans (MeSH)</term><term>Hydroxychloroquine (administration & dosage)</term><term>Hydroxychloroquine (adverse effects)</term><term>Male (MeSH)</term><term>Middle Aged (MeSH)</term><term>Outpatients (MeSH)</term><term>Retrospective Studies (MeSH)</term><term>SARS-CoV-2 (MeSH)</term><term>Young Adult (MeSH)</term><term>Zinc (administration & dosage)</term><term>Zinc (adverse effects)</term></keywords><keywords scheme="MESH" type="chemical" qualifier="administration & dosage" xml:lang="en"><term>Azithromycin</term><term>Hydroxychloroquine</term><term>Zinc</term></keywords><keywords scheme="MESH" type="chemical" qualifier="adverse effects" xml:lang="en"><term>Azithromycin</term><term>Hydroxychloroquine</term><term>Zinc</term></keywords><keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>COVID-19</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adolescent</term><term>Adult</term><term>Aged</term><term>Aged, 80 and over</term><term>Drug Therapy, Combination</term><term>Female</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Outpatients</term><term>Retrospective Studies</term><term>SARS-CoV-2</term><term>Young Adult</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">The aim of this study was to describe the outcomes of patients with coronavirus disease 2019 (COVID-19) in the outpatient setting after early treatment with zinc, low-dose hydroxychloroquine and azithromycin (triple therapy) dependent on risk stratification. This was a retrospective case series study in the general practice setting. A total of 141 COVID-19 patients with laboratory-confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in the year 2020 were included. The main outcome measures were risk-stratified treatment decision and rates of hospitalisation and all-cause death. A median of 4 days [interquartile range (IQR) 3-6 days; available for n = 66/141 patients] after the onset of symptoms, 141 patients (median age 58 years, IQR 40-67 years; 73.0% male) received a prescription for triple therapy for 5 days. Independent public reference data from 377 confirmed COVID-19 patients in the same community were used as untreated controls. Of 141 treated patients, 4 (2.8%) were hospitalised, which was significantly fewer (P < 0.001) compared with 58 (15.4%) of 377 untreated patients [odds ratio (OR) = 0.16, 95% confidence interval (CI) 0.06-0.5]. One patient (0.7%) in the treatment group died versus 13 patients (3.4%) in the untreated group (OR = 0.2, 95% CI 0.03-1.5; P = 0.12). No cardiac side effects were observed. Risk stratification-based treatment of COVID-19 outpatients as early as possible after symptom onset using triple therapy, including the combination of zinc with low-dose hydroxychloroquine, was associated with significantly fewer hospitalisations.</div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">33122096</PMID><DateCompleted><Year>2020</Year><Month>12</Month><Day>08</Day></DateCompleted><DateRevised><Year>2021</Year><Month>02</Month><Day>01</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1872-7913</ISSN><JournalIssue CitedMedium="Internet"><Volume>56</Volume><Issue>6</Issue><PubDate><Year>2020</Year><Month>Dec</Month></PubDate></JournalIssue><Title>International journal of antimicrobial agents</Title><ISOAbbreviation>Int J Antimicrob Agents</ISOAbbreviation></Journal><ArticleTitle>COVID-19 outpatients: early risk-stratified treatment with zinc plus low-dose hydroxychloroquine and azithromycin: a retrospective case series study.</ArticleTitle><Pagination><MedlinePgn>106214</MedlinePgn></Pagination><ELocationID EIdType="pii" ValidYN="Y">S0924-8579(20)30425-8</ELocationID><ELocationID EIdType="doi" ValidYN="Y">10.1016/j.ijantimicag.2020.106214</ELocationID><Abstract><AbstractText>The aim of this study was to describe the outcomes of patients with coronavirus disease 2019 (COVID-19) in the outpatient setting after early treatment with zinc, low-dose hydroxychloroquine and azithromycin (triple therapy) dependent on risk stratification. This was a retrospective case series study in the general practice setting. A total of 141 COVID-19 patients with laboratory-confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in the year 2020 were included. The main outcome measures were risk-stratified treatment decision and rates of hospitalisation and all-cause death. A median of 4 days [interquartile range (IQR) 3-6 days; available for n = 66/141 patients] after the onset of symptoms, 141 patients (median age 58 years, IQR 40-67 years; 73.0% male) received a prescription for triple therapy for 5 days. Independent public reference data from 377 confirmed COVID-19 patients in the same community were used as untreated controls. Of 141 treated patients, 4 (2.8%) were hospitalised, which was significantly fewer (P < 0.001) compared with 58 (15.4%) of 377 untreated patients [odds ratio (OR) = 0.16, 95% confidence interval (CI) 0.06-0.5]. One patient (0.7%) in the treatment group died versus 13 patients (3.4%) in the untreated group (OR = 0.2, 95% CI 0.03-1.5; P = 0.12). No cardiac side effects were observed. Risk stratification-based treatment of COVID-19 outpatients as early as possible after symptom onset using triple therapy, including the combination of zinc with low-dose hydroxychloroquine, was associated with significantly fewer hospitalisations.</AbstractText><CopyrightInformation>Copyright © 2020 The Author(s). Published by Elsevier Ltd.. All rights reserved.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Derwand</LastName><ForeName>Roland</ForeName><Initials>R</Initials><AffiliationInfo><Affiliation>Alexion Pharma Germany GmbH, 80687, Munich, Germany.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Scholz</LastName><ForeName>Martin</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Heinrich-Heine-University, Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany. Electronic address: scholzmartin19@gmail.com.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Zelenko</LastName><ForeName>Vladimir</ForeName><Initials>V</Initials><AffiliationInfo><Affiliation>Medical Group Practice, Monroe, NY, 10950, USA.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2020</Year><Month>10</Month><Day>26</Day></ArticleDate></Article><MedlineJournalInfo><Country>Netherlands</Country><MedlineTA>Int J Antimicrob Agents</MedlineTA><NlmUniqueID>9111860</NlmUniqueID><ISSNLinking>0924-8579</ISSNLinking></MedlineJournalInfo><ChemicalList><Chemical><RegistryNumber>4QWG6N8QKH</RegistryNumber><NameOfSubstance UI="D006886">Hydroxychloroquine</NameOfSubstance></Chemical><Chemical><RegistryNumber>83905-01-5</RegistryNumber><NameOfSubstance 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effects</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D000086382" MajorTopicYN="N">COVID-19</DescriptorName><QualifierName UI="Q000188" MajorTopicYN="Y">drug therapy</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D004359" MajorTopicYN="N">Drug Therapy, Combination</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006886" MajorTopicYN="N">Hydroxychloroquine</DescriptorName><QualifierName UI="Q000008" MajorTopicYN="Y">administration & dosage</QualifierName><QualifierName UI="Q000009" MajorTopicYN="N">adverse effects</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008875" MajorTopicYN="N">Middle Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D010045" MajorTopicYN="N">Outpatients</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D012189" MajorTopicYN="N">Retrospective Studies</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000086402" MajorTopicYN="Y">SARS-CoV-2</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D055815" MajorTopicYN="N">Young Adult</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D015032" MajorTopicYN="N">Zinc</DescriptorName><QualifierName UI="Q000008" MajorTopicYN="Y">administration & dosage</QualifierName><QualifierName UI="Q000009" MajorTopicYN="N">adverse effects</QualifierName></MeshHeading></MeshHeadingList><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">Azithromycin</Keyword><Keyword MajorTopicYN="N">COVID-19</Keyword><Keyword MajorTopicYN="N">Hydroxychloroquine</Keyword><Keyword MajorTopicYN="N">Outpatients</Keyword><Keyword MajorTopicYN="N">SARS-CoV-2</Keyword><Keyword 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