Effect of Combination Therapy of Hydroxychloroquine and Azithromycin on Mortality in Patients With COVID-19.
Identifieur interne : 000C23 ( Main/Corpus ); précédent : 000C22; suivant : 000C24Effect of Combination Therapy of Hydroxychloroquine and Azithromycin on Mortality in Patients With COVID-19.
Auteurs : Marinella Lauriola ; Arianna Pani ; Giovanbattista Ippoliti ; Andrea Mortara ; Stefano Milighetti ; Marjieh Mazen ; Gianluca Perseghin ; Daniele Pastori ; Paolo Grosso ; Francesco ScaglioneSource :
- Clinical and translational science [ 1752-8062 ] ; 2020.
English descriptors
- KwdEn :
- Aged (MeSH), Aged, 80 and over (MeSH), Azithromycin (administration & dosage), COVID-19 (drug therapy), COVID-19 (mortality), Drug Therapy, Combination (MeSH), Female (MeSH), Hospital Mortality (MeSH), Humans (MeSH), Hydroxychloroquine (administration & dosage), Male (MeSH), Middle Aged (MeSH), Retrospective Studies (MeSH), SARS-CoV-2 (MeSH).
- MESH :
- chemical , administration & dosage : Azithromycin, Hydroxychloroquine.
- drug therapy : COVID-19.
- mortality : COVID-19.
- Aged, Aged, 80 and over, Drug Therapy, Combination, Female, Hospital Mortality, Humans, Male, Middle Aged, Retrospective Studies, SARS-CoV-2.
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.
DOI: 10.1111/cts.12860
PubMed: 32926573
PubMed Central: PMC7719367
Links to Exploration step
pubmed:32926573Le document en format XML
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Lauriola</name><affiliation><nlm:affiliation>Infectious Disease Department, Policlinico di Monza, Monza, Italy.</nlm:affiliation></affiliation></author><author><name sortKey="Pani, Arianna" sort="Pani, Arianna" uniqKey="Pani A" first="Arianna" last="Pani">Arianna Pani</name><affiliation><nlm:affiliation>Department of Oncology and Hemato-Oncology, Università degli Studi di Milano, Milan, Italy.</nlm:affiliation></affiliation></author><author><name sortKey="Ippoliti, Giovanbattista" sort="Ippoliti, Giovanbattista" uniqKey="Ippoliti G" first="Giovanbattista" last="Ippoliti">Giovanbattista Ippoliti</name><affiliation><nlm:affiliation>Internal Medicine Department, Policlinico di Monza, Monza, Italy.</nlm:affiliation></affiliation></author><author><name sortKey="Mortara, Andrea" sort="Mortara, Andrea" uniqKey="Mortara A" first="Andrea" last="Mortara">Andrea Mortara</name><affiliation><nlm:affiliation>Cardiology Department, Policlinico di Monza, Monza, Italy.</nlm:affiliation></affiliation></author><author><name sortKey="Milighetti, Stefano" sort="Milighetti, Stefano" uniqKey="Milighetti S" first="Stefano" last="Milighetti">Stefano Milighetti</name><affiliation><nlm:affiliation>Internal Medicine Department, Policlinico di Monza, Monza, Italy.</nlm:affiliation></affiliation></author><author><name sortKey="Mazen, Marjieh" sort="Mazen, Marjieh" uniqKey="Mazen M" first="Marjieh" last="Mazen">Marjieh Mazen</name><affiliation><nlm:affiliation>Internal Medicine Department, Policlinico di Monza, Monza, Italy.</nlm:affiliation></affiliation></author><author><name sortKey="Perseghin, Gianluca" sort="Perseghin, Gianluca" uniqKey="Perseghin G" first="Gianluca" last="Perseghin">Gianluca Perseghin</name><affiliation><nlm:affiliation>Internal Medicine Department, Policlinico di Monza, Monza, Italy.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Department of Medicine and Surgery, Università degli Studi di Milano Bicocca, Milan, Italy.</nlm:affiliation></affiliation></author><author><name sortKey="Pastori, Daniele" sort="Pastori, Daniele" uniqKey="Pastori D" first="Daniele" last="Pastori">Daniele Pastori</name><affiliation><nlm:affiliation>Department of Clinical, Internal, Anesthesiologic, and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy.</nlm:affiliation></affiliation></author><author><name sortKey="Grosso, Paolo" sort="Grosso, Paolo" uniqKey="Grosso P" first="Paolo" last="Grosso">Paolo Grosso</name><affiliation><nlm:affiliation>Intensive Care Unit, Policlinico di Monza, Monza, Italy.</nlm:affiliation></affiliation></author><author><name sortKey="Scaglione, Francesco" sort="Scaglione, Francesco" uniqKey="Scaglione F" first="Francesco" last="Scaglione">Francesco Scaglione</name><affiliation><nlm:affiliation>Department of Oncology and Hemato-Oncology, Università degli Studi di Milano, Milan, Italy.</nlm:affiliation></affiliation></author></analytic><series><title level="j">Clinical and translational science</title><idno type="eISSN">1752-8062</idno><imprint><date when="2020" type="published">2020</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Aged (MeSH)</term><term>Aged, 80 and over (MeSH)</term><term>Azithromycin (administration & dosage)</term><term>COVID-19 (drug therapy)</term><term>COVID-19 (mortality)</term><term>Drug Therapy, Combination (MeSH)</term><term>Female (MeSH)</term><term>Hospital Mortality (MeSH)</term><term>Humans (MeSH)</term><term>Hydroxychloroquine (administration & dosage)</term><term>Male (MeSH)</term><term>Middle Aged (MeSH)</term><term>Retrospective Studies (MeSH)</term><term>SARS-CoV-2 (MeSH)</term></keywords><keywords scheme="MESH" type="chemical" qualifier="administration & dosage" xml:lang="en"><term>Azithromycin</term><term>Hydroxychloroquine</term></keywords><keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>COVID-19</term></keywords><keywords scheme="MESH" qualifier="mortality" xml:lang="en"><term>COVID-19</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Aged</term><term>Aged, 80 and over</term><term>Drug Therapy, Combination</term><term>Female</term><term>Hospital Mortality</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Retrospective Studies</term><term>SARS-CoV-2</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">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.</div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">32926573</PMID><DateCompleted><Year>2020</Year><Month>12</Month><Day>22</Day></DateCompleted><DateRevised><Year>2020</Year><Month>12</Month><Day>22</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1752-8062</ISSN><JournalIssue CitedMedium="Internet"><Volume>13</Volume><Issue>6</Issue><PubDate><Year>2020</Year><Month>11</Month></PubDate></JournalIssue><Title>Clinical and translational science</Title><ISOAbbreviation>Clin Transl Sci</ISOAbbreviation></Journal><ArticleTitle>Effect of Combination Therapy of Hydroxychloroquine and Azithromycin on Mortality in Patients With COVID-19.</ArticleTitle><Pagination><MedlinePgn>1071-1076</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1111/cts.12860</ELocationID><Abstract><AbstractText>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.</AbstractText><CopyrightInformation>© 2020 The Authors. Clinical and Translational Science published by Wiley Periodicals LLC on behalf of the American Society for Clinical Pharmacology and Therapeutics.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Lauriola</LastName><ForeName>Marinella</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Infectious Disease Department, Policlinico di Monza, Monza, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Pani</LastName><ForeName>Arianna</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>Department of Oncology and Hemato-Oncology, Università degli Studi di Milano, Milan, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Ippoliti</LastName><ForeName>Giovanbattista</ForeName><Initials>G</Initials><AffiliationInfo><Affiliation>Internal Medicine Department, Policlinico di Monza, Monza, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Mortara</LastName><ForeName>Andrea</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>Cardiology Department, Policlinico di Monza, Monza, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Milighetti</LastName><ForeName>Stefano</ForeName><Initials>S</Initials><AffiliationInfo><Affiliation>Internal Medicine Department, Policlinico di Monza, Monza, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Mazen</LastName><ForeName>Marjieh</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Internal Medicine Department, Policlinico di Monza, Monza, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Perseghin</LastName><ForeName>Gianluca</ForeName><Initials>G</Initials><AffiliationInfo><Affiliation>Internal Medicine Department, Policlinico di Monza, Monza, Italy.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Department of Medicine and Surgery, Università degli Studi di Milano Bicocca, Milan, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Pastori</LastName><ForeName>Daniele</ForeName><Initials>D</Initials><AffiliationInfo><Affiliation>Department of Clinical, Internal, Anesthesiologic, and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Grosso</LastName><ForeName>Paolo</ForeName><Initials>P</Initials><AffiliationInfo><Affiliation>Intensive Care Unit, Policlinico di Monza, Monza, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Scaglione</LastName><ForeName>Francesco</ForeName><Initials>F</Initials><AffiliationInfo><Affiliation>Department of Oncology and Hemato-Oncology, Università degli Studi di Milano, Milan, Italy.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D064888">Observational Study</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2020</Year><Month>10</Month><Day>13</Day></ArticleDate></Article><MedlineJournalInfo><Country>United States</Country><MedlineTA>Clin Transl Sci</MedlineTA><NlmUniqueID>101474067</NlmUniqueID><ISSNLinking>1752-8054</ISSNLinking></MedlineJournalInfo><ChemicalList><Chemical><RegistryNumber>4QWG6N8QKH</RegistryNumber><NameOfSubstance UI="D006886">Hydroxychloroquine</NameOfSubstance></Chemical><Chemical><RegistryNumber>83905-01-5</RegistryNumber><NameOfSubstance UI="D017963">Azithromycin</NameOfSubstance></Chemical></ChemicalList><SupplMeshList><SupplMeshName Type="Protocol" UI="C000705127">COVID-19 drug treatment</SupplMeshName></SupplMeshList><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000368" MajorTopicYN="N">Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000369" MajorTopicYN="N">Aged, 80 and over</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D017963" MajorTopicYN="N">Azithromycin</DescriptorName><QualifierName UI="Q000008" MajorTopicYN="Y">administration & dosage</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D000086382" MajorTopicYN="N">COVID-19</DescriptorName><QualifierName UI="Q000188" MajorTopicYN="Y">drug therapy</QualifierName><QualifierName UI="Q000401" MajorTopicYN="N">mortality</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="D017052" MajorTopicYN="N">Hospital Mortality</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006886" MajorTopicYN="N">Hydroxychloroquine</DescriptorName><QualifierName 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