Association of Treatment With Hydroxychloroquine or Azithromycin With In-Hospital Mortality in Patients With COVID-19 in New York State.
Identifieur interne : 001864 ( Main/Exploration ); précédent : 001863; suivant : 001865Association of Treatment With Hydroxychloroquine or Azithromycin With In-Hospital Mortality in Patients With COVID-19 in New York State.
Auteurs : Eli S. Rosenberg ; Elizabeth M. Dufort ; Tomoko Udo ; Larissa A. Wilberschied ; Jessica Kumar ; James Tesoriero ; Patti Weinberg [États-Unis] ; James Kirkwood ; Alison Muse ; Jack Dehovitz [États-Unis] ; Debra S. Blog ; Brad Hutton ; David R. Holtgrave ; Howard A. ZuckerSource :
- JAMA [ 1538-3598 ] ; 2020.
Descripteurs français
- KwdFr :
- Adolescent (MeSH), Adulte (MeSH), Adulte d'âge moyen (MeSH), Anti-infectieux (effets indésirables), Anti-infectieux (usage thérapeutique), Arrêt cardiaque (étiologie), Association de médicaments (MeSH), Azithromycine (effets indésirables), Azithromycine (usage thérapeutique), Betacoronavirus (MeSH), Femelle (MeSH), Hospitalisation (MeSH), Humains (MeSH), Hydroxychloroquine (effets indésirables), Hydroxychloroquine (usage thérapeutique), Infections à coronavirus (mortalité), Infections à coronavirus (traitement médicamenteux), Jeune adulte (MeSH), Modèles des risques proportionnels (MeSH), Modèles logistiques (MeSH), Mortalité hospitalière (MeSH), Mâle (MeSH), Pandémies (MeSH), Pneumopathie virale (mortalité), Pneumopathie virale (traitement médicamenteux), Sujet âgé (MeSH), Troubles du rythme cardiaque (induit chimiquement), État de New York (MeSH), Études rétrospectives (MeSH).
- MESH :
- effets indésirables : Anti-infectieux, Azithromycine, Hydroxychloroquine.
- induit chimiquement : Troubles du rythme cardiaque.
- mortalité : Infections à coronavirus, Pneumopathie virale.
- traitement médicamenteux : Infections à coronavirus, Pneumopathie virale.
- usage thérapeutique : Anti-infectieux, Azithromycine, Hydroxychloroquine.
- étiologie : Arrêt cardiaque.
- Adolescent, Adulte, Adulte d'âge moyen, Association de médicaments, Betacoronavirus, Femelle, Hospitalisation, Humains, Jeune adulte, Modèles des risques proportionnels, Modèles logistiques, Mortalité hospitalière, Mâle, Pandémies, Sujet âgé, État de New York, Études rétrospectives.
English descriptors
- KwdEn :
- Adolescent (MeSH), Adult (MeSH), Aged (MeSH), Anti-Infective Agents (adverse effects), Anti-Infective Agents (therapeutic use), Arrhythmias, Cardiac (chemically induced), Azithromycin (adverse effects), Azithromycin (therapeutic use), Betacoronavirus (MeSH), COVID-19 (MeSH), Coronavirus Infections (drug therapy), Coronavirus Infections (mortality), Drug Therapy, Combination (MeSH), Female (MeSH), Heart Arrest (etiology), Hospital Mortality (MeSH), Hospitalization (MeSH), Humans (MeSH), Hydroxychloroquine (adverse effects), Hydroxychloroquine (therapeutic use), Logistic Models (MeSH), Male (MeSH), Middle Aged (MeSH), New York (MeSH), Pandemics (MeSH), Pneumonia, Viral (drug therapy), Pneumonia, Viral (mortality), Proportional Hazards Models (MeSH), Retrospective Studies (MeSH), SARS-CoV-2 (MeSH), Young Adult (MeSH).
- MESH :
- chemical , adverse effects : Anti-Infective Agents, Azithromycin, Hydroxychloroquine.
- chemical , therapeutic use : Anti-Infective Agents, Azithromycin, Hydroxychloroquine.
- geographic : New York.
- chemically induced : Arrhythmias, Cardiac.
- drug therapy : Coronavirus Infections, Pneumonia, Viral.
- etiology : Heart Arrest.
- mortality : Coronavirus Infections, Pneumonia, Viral.
- Adolescent, Adult, Aged, Betacoronavirus, COVID-19, Drug Therapy, Combination, Female, Hospital Mortality, Hospitalization, Humans, Logistic Models, Male, Middle Aged, Pandemics, Proportional Hazards Models, Retrospective Studies, SARS-CoV-2, Young Adult.
Abstract
Importance
Hydroxychloroquine, with or without azithromycin, has been considered as a possible therapeutic agent for patients with coronavirus disease 2019 (COVID-19). However, there are limited data on efficacy and associated adverse events.
Objective
To describe the association between use of hydroxychloroquine, with or without azithromycin, and clinical outcomes among hospital inpatients diagnosed with COVID-19.
Design, Setting, and Participants
Retrospective multicenter cohort study of patients from a random sample of all admitted patients with laboratory-confirmed COVID-19 in 25 hospitals, representing 88.2% of patients with COVID-19 in the New York metropolitan region. Eligible patients were admitted for at least 24 hours between March 15 and 28, 2020. Medications, preexisting conditions, clinical measures on admission, outcomes, and adverse events were abstracted from medical records. The date of final follow-up was April 24, 2020.
Exposures
Receipt of both hydroxychloroquine and azithromycin, hydroxychloroquine alone, azithromycin alone, or neither.
Main Outcomes and Measures
Primary outcome was in-hospital mortality. Secondary outcomes were cardiac arrest and abnormal electrocardiogram findings (arrhythmia or QT prolongation).
Results
Among 1438 hospitalized patients with a diagnosis of COVID-19 (858 [59.7%] male, median age, 63 years), those receiving hydroxychloroquine, azithromycin, or both were more likely than those not receiving either drug to have diabetes, respiratory rate >22/min, abnormal chest imaging findings, O2 saturation lower than 90%, and aspartate aminotransferase greater than 40 U/L. Overall in-hospital mortality was 20.3% (95% CI, 18.2%-22.4%). The probability of death for patients receiving hydroxychloroquine + azithromycin was 189/735 (25.7% [95% CI, 22.3%-28.9%]), hydroxychloroquine alone, 54/271 (19.9% [95% CI, 15.2%-24.7%]), azithromycin alone, 21/211 (10.0% [95% CI, 5.9%-14.0%]), and neither drug, 28/221 (12.7% [95% CI, 8.3%-17.1%]). In adjusted Cox proportional hazards models, compared with patients receiving neither drug, there were no significant differences in mortality for patients receiving hydroxychloroquine + azithromycin (HR, 1.35 [95% CI, 0.76-2.40]), hydroxychloroquine alone (HR, 1.08 [95% CI, 0.63-1.85]), or azithromycin alone (HR, 0.56 [95% CI, 0.26-1.21]). In logistic models, compared with patients receiving neither drug cardiac arrest was significantly more likely in patients receiving hydroxychloroquine + azithromycin (adjusted OR, 2.13 [95% CI, 1.12-4.05]), but not hydroxychloroquine alone (adjusted OR, 1.91 [95% CI, 0.96-3.81]) or azithromycin alone (adjusted OR, 0.64 [95% CI, 0.27-1.56]), . In adjusted logistic regression models, there were no significant differences in the relative likelihood of abnormal electrocardiogram findings.
Conclusions and Relevance
Among patients hospitalized in metropolitan New York with COVID-19, treatment with hydroxychloroquine, azithromycin, or both, compared with neither treatment, was not significantly associated with differences in in-hospital mortality. However, the interpretation of these findings may be limited by the observational design.
DOI: 10.1001/jama.2020.8630
PubMed: 32392282
PubMed Central: PMC7215635
Affiliations:
Links toward previous steps (curation, corpus...)
Le document en format XML
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Rosenberg</name><affiliation><nlm:affiliation>University at Albany School of Public Health, State University of New York, Rensselaer.</nlm:affiliation><wicri:noCountry code="subField">Rensselaer</wicri:noCountry></affiliation></author><author><name sortKey="Dufort, Elizabeth M" sort="Dufort, Elizabeth M" uniqKey="Dufort E" first="Elizabeth M" last="Dufort">Elizabeth M. Dufort</name><affiliation><nlm:affiliation>New York State Department of Health, Albany.</nlm:affiliation><wicri:noCountry code="subField">Albany</wicri:noCountry></affiliation></author><author><name sortKey="Udo, Tomoko" sort="Udo, Tomoko" uniqKey="Udo T" first="Tomoko" last="Udo">Tomoko Udo</name><affiliation><nlm:affiliation>University at Albany School of Public Health, State University of New York, Rensselaer.</nlm:affiliation><wicri:noCountry code="subField">Rensselaer</wicri:noCountry></affiliation></author><author><name sortKey="Wilberschied, Larissa A" sort="Wilberschied, Larissa A" uniqKey="Wilberschied L" first="Larissa A" last="Wilberschied">Larissa A. Wilberschied</name><affiliation><nlm:affiliation>New York State Department of Health, Albany.</nlm:affiliation><wicri:noCountry code="subField">Albany</wicri:noCountry></affiliation></author><author><name sortKey="Kumar, Jessica" sort="Kumar, Jessica" uniqKey="Kumar J" first="Jessica" last="Kumar">Jessica Kumar</name><affiliation><nlm:affiliation>New York State Department of Health, Albany.</nlm:affiliation><wicri:noCountry code="subField">Albany</wicri:noCountry></affiliation></author><author><name sortKey="Tesoriero, James" sort="Tesoriero, James" uniqKey="Tesoriero J" first="James" last="Tesoriero">James Tesoriero</name><affiliation><nlm:affiliation>New York State Department of Health, Albany.</nlm:affiliation><wicri:noCountry code="subField">Albany</wicri:noCountry></affiliation></author><author><name sortKey="Weinberg, Patti" sort="Weinberg, Patti" uniqKey="Weinberg P" first="Patti" last="Weinberg">Patti Weinberg</name><affiliation wicri:level="2"><nlm:affiliation>IPRO, Lake Success, New York.</nlm:affiliation><country xml:lang="fr">États-Unis</country><placeName><region type="state">État de New York</region></placeName><wicri:cityArea>IPRO, Lake Success</wicri:cityArea></affiliation></author><author><name sortKey="Kirkwood, James" sort="Kirkwood, James" uniqKey="Kirkwood J" first="James" last="Kirkwood">James Kirkwood</name><affiliation><nlm:affiliation>New York State Department of Health, Albany.</nlm:affiliation><wicri:noCountry code="subField">Albany</wicri:noCountry></affiliation></author><author><name sortKey="Muse, Alison" sort="Muse, Alison" uniqKey="Muse A" first="Alison" last="Muse">Alison Muse</name><affiliation><nlm:affiliation>New York State Department of Health, Albany.</nlm:affiliation><wicri:noCountry code="subField">Albany</wicri:noCountry></affiliation></author><author><name sortKey="Dehovitz, Jack" sort="Dehovitz, Jack" uniqKey="Dehovitz J" first="Jack" last="Dehovitz">Jack Dehovitz</name><affiliation wicri:level="2"><nlm:affiliation>IPRO, Lake Success, New York.</nlm:affiliation><country xml:lang="fr">États-Unis</country><placeName><region type="state">État de New York</region></placeName><wicri:cityArea>IPRO, Lake Success</wicri:cityArea></affiliation><affiliation><nlm:affiliation>Downstate Health Sciences University, State University of New York, Brooklyn.</nlm:affiliation><wicri:noCountry code="subField">Brooklyn</wicri:noCountry></affiliation></author><author><name sortKey="Blog, Debra S" sort="Blog, Debra S" uniqKey="Blog D" first="Debra S" last="Blog">Debra S. Blog</name><affiliation><nlm:affiliation>New York State Department of Health, Albany.</nlm:affiliation><wicri:noCountry code="subField">Albany</wicri:noCountry></affiliation></author><author><name sortKey="Hutton, Brad" sort="Hutton, Brad" uniqKey="Hutton B" first="Brad" last="Hutton">Brad Hutton</name><affiliation><nlm:affiliation>New York State Department of Health, Albany.</nlm:affiliation><wicri:noCountry code="subField">Albany</wicri:noCountry></affiliation></author><author><name sortKey="Holtgrave, David R" sort="Holtgrave, David R" uniqKey="Holtgrave D" first="David R" last="Holtgrave">David R. Holtgrave</name><affiliation><nlm:affiliation>University at Albany School of Public Health, State University of New York, Rensselaer.</nlm:affiliation><wicri:noCountry code="subField">Rensselaer</wicri:noCountry></affiliation></author><author><name sortKey="Zucker, Howard A" sort="Zucker, Howard A" uniqKey="Zucker H" first="Howard A" last="Zucker">Howard A. Zucker</name><affiliation><nlm:affiliation>New York State Department of Health, Albany.</nlm:affiliation><wicri:noCountry code="subField">Albany</wicri:noCountry></affiliation></author></analytic><series><title level="j">JAMA</title><idno type="eISSN">1538-3598</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>Anti-Infective Agents (adverse effects)</term><term>Anti-Infective Agents (therapeutic use)</term><term>Arrhythmias, Cardiac (chemically induced)</term><term>Azithromycin (adverse effects)</term><term>Azithromycin (therapeutic use)</term><term>Betacoronavirus (MeSH)</term><term>COVID-19 (MeSH)</term><term>Coronavirus Infections (drug therapy)</term><term>Coronavirus Infections (mortality)</term><term>Drug Therapy, Combination (MeSH)</term><term>Female (MeSH)</term><term>Heart Arrest (etiology)</term><term>Hospital Mortality (MeSH)</term><term>Hospitalization (MeSH)</term><term>Humans (MeSH)</term><term>Hydroxychloroquine (adverse effects)</term><term>Hydroxychloroquine (therapeutic use)</term><term>Logistic Models (MeSH)</term><term>Male (MeSH)</term><term>Middle Aged (MeSH)</term><term>New York (MeSH)</term><term>Pandemics (MeSH)</term><term>Pneumonia, Viral (drug therapy)</term><term>Pneumonia, Viral (mortality)</term><term>Proportional Hazards Models (MeSH)</term><term>Retrospective Studies (MeSH)</term><term>SARS-CoV-2 (MeSH)</term><term>Young Adult (MeSH)</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Adolescent (MeSH)</term><term>Adulte (MeSH)</term><term>Adulte d'âge moyen (MeSH)</term><term>Anti-infectieux (effets indésirables)</term><term>Anti-infectieux (usage thérapeutique)</term><term>Arrêt cardiaque (étiologie)</term><term>Association de médicaments (MeSH)</term><term>Azithromycine (effets indésirables)</term><term>Azithromycine (usage thérapeutique)</term><term>Betacoronavirus (MeSH)</term><term>Femelle (MeSH)</term><term>Hospitalisation (MeSH)</term><term>Humains (MeSH)</term><term>Hydroxychloroquine (effets indésirables)</term><term>Hydroxychloroquine (usage thérapeutique)</term><term>Infections à coronavirus (mortalité)</term><term>Infections à coronavirus (traitement médicamenteux)</term><term>Jeune adulte (MeSH)</term><term>Modèles des risques proportionnels (MeSH)</term><term>Modèles logistiques (MeSH)</term><term>Mortalité hospitalière (MeSH)</term><term>Mâle (MeSH)</term><term>Pandémies (MeSH)</term><term>Pneumopathie virale (mortalité)</term><term>Pneumopathie virale (traitement médicamenteux)</term><term>Sujet âgé (MeSH)</term><term>Troubles du rythme cardiaque (induit chimiquement)</term><term>État de New York (MeSH)</term><term>Études rétrospectives (MeSH)</term></keywords><keywords scheme="MESH" type="chemical" qualifier="adverse effects" xml:lang="en"><term>Anti-Infective Agents</term><term>Azithromycin</term><term>Hydroxychloroquine</term></keywords><keywords scheme="MESH" type="chemical" qualifier="therapeutic use" xml:lang="en"><term>Anti-Infective Agents</term><term>Azithromycin</term><term>Hydroxychloroquine</term></keywords><keywords scheme="MESH" type="geographic" xml:lang="en"><term>New York</term></keywords><keywords scheme="MESH" qualifier="chemically induced" xml:lang="en"><term>Arrhythmias, Cardiac</term></keywords><keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>Coronavirus Infections</term><term>Pneumonia, Viral</term></keywords><keywords scheme="MESH" qualifier="effets indésirables" xml:lang="fr"><term>Anti-infectieux</term><term>Azithromycine</term><term>Hydroxychloroquine</term></keywords><keywords scheme="MESH" qualifier="etiology" xml:lang="en"><term>Heart Arrest</term></keywords><keywords scheme="MESH" qualifier="induit chimiquement" xml:lang="fr"><term>Troubles du rythme cardiaque</term></keywords><keywords scheme="MESH" qualifier="mortality" xml:lang="en"><term>Coronavirus Infections</term><term>Pneumonia, Viral</term></keywords><keywords scheme="MESH" qualifier="mortalité" xml:lang="fr"><term>Infections à coronavirus</term><term>Pneumopathie virale</term></keywords><keywords scheme="MESH" qualifier="traitement médicamenteux" xml:lang="fr"><term>Infections à coronavirus</term><term>Pneumopathie virale</term></keywords><keywords scheme="MESH" qualifier="usage thérapeutique" xml:lang="fr"><term>Anti-infectieux</term><term>Azithromycine</term><term>Hydroxychloroquine</term></keywords><keywords scheme="MESH" qualifier="étiologie" xml:lang="fr"><term>Arrêt cardiaque</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adolescent</term><term>Adult</term><term>Aged</term><term>Betacoronavirus</term><term>COVID-19</term><term>Drug Therapy, Combination</term><term>Female</term><term>Hospital Mortality</term><term>Hospitalization</term><term>Humans</term><term>Logistic Models</term><term>Male</term><term>Middle Aged</term><term>Pandemics</term><term>Proportional Hazards Models</term><term>Retrospective Studies</term><term>SARS-CoV-2</term><term>Young Adult</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Adolescent</term><term>Adulte</term><term>Adulte d'âge moyen</term><term>Association de médicaments</term><term>Betacoronavirus</term><term>Femelle</term><term>Hospitalisation</term><term>Humains</term><term>Jeune adulte</term><term>Modèles des risques proportionnels</term><term>Modèles logistiques</term><term>Mortalité hospitalière</term><term>Mâle</term><term>Pandémies</term><term>Sujet âgé</term><term>État de New York</term><term>Études rétrospectives</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>Importance</b></p><p>Hydroxychloroquine, with or without azithromycin, has been considered as a possible therapeutic agent for patients with coronavirus disease 2019 (COVID-19). However, there are limited data on efficacy and associated adverse events.</p></div><div type="abstract" xml:lang="en"><p><b>Objective</b></p><p>To describe the association between use of hydroxychloroquine, with or without azithromycin, and clinical outcomes among hospital inpatients diagnosed with COVID-19.</p></div><div type="abstract" xml:lang="en"><p><b>Design, Setting, and Participants</b></p><p>Retrospective multicenter cohort study of patients from a random sample of all admitted patients with laboratory-confirmed COVID-19 in 25 hospitals, representing 88.2% of patients with COVID-19 in the New York metropolitan region. Eligible patients were admitted for at least 24 hours between March 15 and 28, 2020. Medications, preexisting conditions, clinical measures on admission, outcomes, and adverse events were abstracted from medical records. The date of final follow-up was April 24, 2020.</p></div><div type="abstract" xml:lang="en"><p><b>Exposures</b></p><p>Receipt of both hydroxychloroquine and azithromycin, hydroxychloroquine alone, azithromycin alone, or neither.</p></div><div type="abstract" xml:lang="en"><p><b>Main Outcomes and Measures</b></p><p>Primary outcome was in-hospital mortality. Secondary outcomes were cardiac arrest and abnormal electrocardiogram findings (arrhythmia or QT prolongation).</p></div><div type="abstract" xml:lang="en"><p><b>Results</b></p><p>Among 1438 hospitalized patients with a diagnosis of COVID-19 (858 [59.7%] male, median age, 63 years), those receiving hydroxychloroquine, azithromycin, or both were more likely than those not receiving either drug to have diabetes, respiratory rate >22/min, abnormal chest imaging findings, O2 saturation lower than 90%, and aspartate aminotransferase greater than 40 U/L. Overall in-hospital mortality was 20.3% (95% CI, 18.2%-22.4%). The probability of death for patients receiving hydroxychloroquine + azithromycin was 189/735 (25.7% [95% CI, 22.3%-28.9%]), hydroxychloroquine alone, 54/271 (19.9% [95% CI, 15.2%-24.7%]), azithromycin alone, 21/211 (10.0% [95% CI, 5.9%-14.0%]), and neither drug, 28/221 (12.7% [95% CI, 8.3%-17.1%]). In adjusted Cox proportional hazards models, compared with patients receiving neither drug, there were no significant differences in mortality for patients receiving hydroxychloroquine + azithromycin (HR, 1.35 [95% CI, 0.76-2.40]), hydroxychloroquine alone (HR, 1.08 [95% CI, 0.63-1.85]), or azithromycin alone (HR, 0.56 [95% CI, 0.26-1.21]). In logistic models, compared with patients receiving neither drug cardiac arrest was significantly more likely in patients receiving hydroxychloroquine + azithromycin (adjusted OR, 2.13 [95% CI, 1.12-4.05]), but not hydroxychloroquine alone (adjusted OR, 1.91 [95% CI, 0.96-3.81]) or azithromycin alone (adjusted OR, 0.64 [95% CI, 0.27-1.56]), . In adjusted logistic regression models, there were no significant differences in the relative likelihood of abnormal electrocardiogram findings.</p></div><div type="abstract" xml:lang="en"><p><b>Conclusions and Relevance</b></p><p>Among patients hospitalized in metropolitan New York with COVID-19, treatment with hydroxychloroquine, azithromycin, or both, compared with neither treatment, was not significantly associated with differences in in-hospital mortality. However, the interpretation of these findings may be limited by the observational design.</p></div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">32392282</PMID><DateCompleted><Year>2020</Year><Month>10</Month><Day>01</Day></DateCompleted><DateRevised><Year>2021</Year><Month>01</Month><Day>10</Day></DateRevised><Article PubModel="Print"><Journal><ISSN IssnType="Electronic">1538-3598</ISSN><JournalIssue CitedMedium="Internet"><Volume>323</Volume><Issue>24</Issue><PubDate><Year>2020</Year><Month>06</Month><Day>23</Day></PubDate></JournalIssue><Title>JAMA</Title><ISOAbbreviation>JAMA</ISOAbbreviation></Journal><ArticleTitle>Association of Treatment With Hydroxychloroquine or Azithromycin With In-Hospital Mortality in Patients With COVID-19 in New York State.</ArticleTitle><Pagination><MedlinePgn>2493-2502</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1001/jama.2020.8630</ELocationID><Abstract><AbstractText Label="Importance">Hydroxychloroquine, with or without azithromycin, has been considered as a possible therapeutic agent for patients with coronavirus disease 2019 (COVID-19). However, there are limited data on efficacy and associated adverse events.</AbstractText><AbstractText Label="Objective">To describe the association between use of hydroxychloroquine, with or without azithromycin, and clinical outcomes among hospital inpatients diagnosed with COVID-19.</AbstractText><AbstractText Label="Design, Setting, and Participants">Retrospective multicenter cohort study of patients from a random sample of all admitted patients with laboratory-confirmed COVID-19 in 25 hospitals, representing 88.2% of patients with COVID-19 in the New York metropolitan region. Eligible patients were admitted for at least 24 hours between March 15 and 28, 2020. Medications, preexisting conditions, clinical measures on admission, outcomes, and adverse events were abstracted from medical records. The date of final follow-up was April 24, 2020.</AbstractText><AbstractText Label="Exposures">Receipt of both hydroxychloroquine and azithromycin, hydroxychloroquine alone, azithromycin alone, or neither.</AbstractText><AbstractText Label="Main Outcomes and Measures">Primary outcome was in-hospital mortality. Secondary outcomes were cardiac arrest and abnormal electrocardiogram findings (arrhythmia or QT prolongation).</AbstractText><AbstractText Label="Results">Among 1438 hospitalized patients with a diagnosis of COVID-19 (858 [59.7%] male, median age, 63 years), those receiving hydroxychloroquine, azithromycin, or both were more likely than those not receiving either drug to have diabetes, respiratory rate >22/min, abnormal chest imaging findings, O2 saturation lower than 90%, and aspartate aminotransferase greater than 40 U/L. Overall in-hospital mortality was 20.3% (95% CI, 18.2%-22.4%). The probability of death for patients receiving hydroxychloroquine + azithromycin was 189/735 (25.7% [95% CI, 22.3%-28.9%]), hydroxychloroquine alone, 54/271 (19.9% [95% CI, 15.2%-24.7%]), azithromycin alone, 21/211 (10.0% [95% CI, 5.9%-14.0%]), and neither drug, 28/221 (12.7% [95% CI, 8.3%-17.1%]). In adjusted Cox proportional hazards models, compared with patients receiving neither drug, there were no significant differences in mortality for patients receiving hydroxychloroquine + azithromycin (HR, 1.35 [95% CI, 0.76-2.40]), hydroxychloroquine alone (HR, 1.08 [95% CI, 0.63-1.85]), or azithromycin alone (HR, 0.56 [95% CI, 0.26-1.21]). In logistic models, compared with patients receiving neither drug cardiac arrest was significantly more likely in patients receiving hydroxychloroquine + azithromycin (adjusted OR, 2.13 [95% CI, 1.12-4.05]), but not hydroxychloroquine alone (adjusted OR, 1.91 [95% CI, 0.96-3.81]) or azithromycin alone (adjusted OR, 0.64 [95% CI, 0.27-1.56]), . In adjusted logistic regression models, there were no significant differences in the relative likelihood of abnormal electrocardiogram findings.</AbstractText><AbstractText Label="Conclusions and Relevance">Among patients hospitalized in metropolitan New York with COVID-19, treatment with hydroxychloroquine, azithromycin, or both, compared with neither treatment, was not significantly associated with differences in in-hospital mortality. However, the interpretation of these findings may be limited by the observational design.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Rosenberg</LastName><ForeName>Eli S</ForeName><Initials>ES</Initials><AffiliationInfo><Affiliation>University at Albany School of Public Health, State University of New York, Rensselaer.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Dufort</LastName><ForeName>Elizabeth M</ForeName><Initials>EM</Initials><AffiliationInfo><Affiliation>New York State Department of Health, Albany.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Udo</LastName><ForeName>Tomoko</ForeName><Initials>T</Initials><AffiliationInfo><Affiliation>University at Albany School of Public Health, State University of New York, Rensselaer.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Wilberschied</LastName><ForeName>Larissa A</ForeName><Initials>LA</Initials><AffiliationInfo><Affiliation>New York State Department of Health, Albany.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Kumar</LastName><ForeName>Jessica</ForeName><Initials>J</Initials><AffiliationInfo><Affiliation>New York State Department of Health, Albany.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Tesoriero</LastName><ForeName>James</ForeName><Initials>J</Initials><AffiliationInfo><Affiliation>New York State Department of Health, Albany.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Weinberg</LastName><ForeName>Patti</ForeName><Initials>P</Initials><AffiliationInfo><Affiliation>IPRO, Lake Success, New York.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Kirkwood</LastName><ForeName>James</ForeName><Initials>J</Initials><AffiliationInfo><Affiliation>New York State Department of Health, Albany.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Muse</LastName><ForeName>Alison</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>New York State Department of Health, Albany.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>DeHovitz</LastName><ForeName>Jack</ForeName><Initials>J</Initials><AffiliationInfo><Affiliation>IPRO, Lake Success, New York.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Downstate Health Sciences University, State University of New York, Brooklyn.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Blog</LastName><ForeName>Debra S</ForeName><Initials>DS</Initials><AffiliationInfo><Affiliation>New York State Department of Health, Albany.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Hutton</LastName><ForeName>Brad</ForeName><Initials>B</Initials><AffiliationInfo><Affiliation>New York State Department of Health, Albany.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Holtgrave</LastName><ForeName>David R</ForeName><Initials>DR</Initials><AffiliationInfo><Affiliation>University at Albany School of Public Health, State University of New York, Rensselaer.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Zucker</LastName><ForeName>Howard A</ForeName><Initials>HA</Initials><AffiliationInfo><Affiliation>New York State Department of Health, Albany.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D016448">Multicenter Study</PublicationType><PublicationType UI="D064888">Observational Study</PublicationType></PublicationTypeList></Article><MedlineJournalInfo><Country>United States</Country><MedlineTA>JAMA</MedlineTA><NlmUniqueID>7501160</NlmUniqueID><ISSNLinking>0098-7484</ISSNLinking></MedlineJournalInfo><ChemicalList><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D000890">Anti-Infective Agents</NameOfSubstance></Chemical><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>AIM</CitationSubset><CitationSubset>IM</CitationSubset><CommentsCorrectionsList><CommentsCorrections RefType="CommentIn"><RefSource>Front Immunol. 2020 Aug 04;11:1739</RefSource><PMID Version="1">32849619</PMID></CommentsCorrections><CommentsCorrections RefType="CommentIn"><RefSource>Travel Med Infect Dis. 2020 Nov - Dec;38:101881</RefSource><PMID Version="1">32956851</PMID></CommentsCorrections></CommentsCorrectionsList><MeshHeadingList><MeshHeading><DescriptorName UI="D000293" MajorTopicYN="N">Adolescent</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000328" MajorTopicYN="N">Adult</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000368" MajorTopicYN="N">Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000890" MajorTopicYN="N">Anti-Infective Agents</DescriptorName><QualifierName UI="Q000009" MajorTopicYN="N">adverse effects</QualifierName><QualifierName UI="Q000627" MajorTopicYN="Y">therapeutic use</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D001145" MajorTopicYN="N">Arrhythmias, Cardiac</DescriptorName><QualifierName UI="Q000139" MajorTopicYN="N">chemically induced</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D017963" MajorTopicYN="N">Azithromycin</DescriptorName><QualifierName UI="Q000009" MajorTopicYN="N">adverse effects</QualifierName><QualifierName UI="Q000627" MajorTopicYN="Y">therapeutic use</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D000073640" 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MajorTopicYN="N">Hospitalization</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006886" MajorTopicYN="N">Hydroxychloroquine</DescriptorName><QualifierName UI="Q000009" MajorTopicYN="N">adverse effects</QualifierName><QualifierName UI="Q000627" MajorTopicYN="Y">therapeutic use</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D016015" MajorTopicYN="N">Logistic Models</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008875" MajorTopicYN="N">Middle Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D009518" MajorTopicYN="N" Type="Geographic">New York</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D058873" MajorTopicYN="N">Pandemics</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D011024" 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Blog</name><name sortKey="Dufort, Elizabeth M" sort="Dufort, Elizabeth M" uniqKey="Dufort E" first="Elizabeth M" last="Dufort">Elizabeth M. Dufort</name><name sortKey="Holtgrave, David R" sort="Holtgrave, David R" uniqKey="Holtgrave D" first="David R" last="Holtgrave">David R. Holtgrave</name><name sortKey="Hutton, Brad" sort="Hutton, Brad" uniqKey="Hutton B" first="Brad" last="Hutton">Brad Hutton</name><name sortKey="Kirkwood, James" sort="Kirkwood, James" uniqKey="Kirkwood J" first="James" last="Kirkwood">James Kirkwood</name><name sortKey="Kumar, Jessica" sort="Kumar, Jessica" uniqKey="Kumar J" first="Jessica" last="Kumar">Jessica Kumar</name><name sortKey="Muse, Alison" sort="Muse, Alison" uniqKey="Muse A" first="Alison" last="Muse">Alison Muse</name><name sortKey="Rosenberg, Eli S" sort="Rosenberg, Eli S" uniqKey="Rosenberg E" first="Eli S" last="Rosenberg">Eli S. Rosenberg</name><name sortKey="Tesoriero, James" sort="Tesoriero, James" uniqKey="Tesoriero J" first="James" last="Tesoriero">James Tesoriero</name><name sortKey="Udo, Tomoko" sort="Udo, Tomoko" uniqKey="Udo T" first="Tomoko" last="Udo">Tomoko Udo</name><name sortKey="Wilberschied, Larissa A" sort="Wilberschied, Larissa A" uniqKey="Wilberschied L" first="Larissa A" last="Wilberschied">Larissa A. Wilberschied</name><name sortKey="Zucker, Howard A" sort="Zucker, Howard A" uniqKey="Zucker H" first="Howard A" last="Zucker">Howard A. Zucker</name></noCountry><country name="États-Unis"><region name="État de New York"><name sortKey="Weinberg, Patti" sort="Weinberg, Patti" uniqKey="Weinberg P" first="Patti" last="Weinberg">Patti Weinberg</name></region><name sortKey="Dehovitz, Jack" sort="Dehovitz, Jack" uniqKey="Dehovitz J" first="Jack" last="Dehovitz">Jack Dehovitz</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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