Hydroxychloroquine plus azithromycin and early hospital admission are beneficial in COVID-19 patients: Turkish experience with real-life data

Hydroxychloroquine plus azithromycin and early hospital admission are beneficial in COVID-19 patients: Turkish experience with real-life data

Background/aim: New treatment regimens for COVID-19, which has threatened the world recently, continue to be investigated. Although some of the treatments are promising, it is thought to be early to state that there is definitive treatment. Experiences and treatment protocol studies from treatment centers are still important. The aim of this study is to evaluate factors affecting the treatment process of the first cases followed in our clinic. Materials and methods: The consecutive hospitalized patients with COVID-19 pneumonia were analyzed in this retrospective and cross-sectional study. Data were recorded from the electronic and written files of patients. Results: Eighty-three patients were evaluated. The median age was 50 ± 15 years. Forty-eight (57.8%) patients had one or more comorbidities. The most common comorbidity was hypertension. The most common symptom was cough in 58 patients (70%). The overall mortality was 15%, and 85% of the patients were discharged. The time between the onset of symptoms and hospitalization was statistically significantly longer in deceased patients (P = 0.039). Age, D-Dimer, troponin, CK, CK-MB, ferritin, procalcitonin, and neutrophil to lymphocyte ratio were statistically significantly higher in deceased patients than survivor patients. In subgroup analysis, in the patients receiving azithromycin plus hydroxychloroquine and other antibiotics plus hydroxychloroquine, the duration of hospitalization was shorter in the azithromycin group (P = 0.027). Conclusion: Early treatment and early admission to the hospital can be crucial for the better treatment process. Combination therapy with azithromycin may be preferred in the first treatment choice because it can shorten the length of hospital stay.Key words: COVID-19, pneumonia, azithromycin, hydroxychloroquine, treatment, mortality, biomarkers

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  • 1. Dai H, Zhang X, Xia J, Zhang T, Shang Y et al. High-resolution chest CT features and clinical characteristics of patients infected with COVID-19 in Jiangsu, China. International Journal of Infectious Disease 2020; 95: 106-112. doi: 10.1016/j. ijid.2020.04.003
  • 2. Şimşek Yavuz S, Ünal S. Antiviral treatment of COVID-19. Turkish Journal of Medical Sciences 2020; 50: 611-619. doi: 10.3906/sag-2004-145
  • 3. T.C. Ministry of Health, General Directorate of Public Health. COVID-19 (SARS-CoV2 Infection) Guide (Science Board Study) March 25, 2020. www.hsgm.saglik.gov.tr
  • 4. Vincent JL, Taccone FS. Understanding pathways to death in patients with COVID-19. The Lancet Respiratory Medicine 2020; 8(5): 430-432. doi: 10.1016/S2213- 2600(20)30165-X
  • 5. Kim ES, Chin BS, Kang CK, Kim NJ, Kang YM et al. Clinical course and outcomes of patients with severe acute respiratory syndrome coronavirus 2 infection: a preliminary report of the first 28 patients from the Korean cohort study on COVID-19. Journal of Korean Medical Science 2020; 35 (13): 1-12. doi: 10.3346/jkms.2020.35.e142
  • 6. Liu Y, Du X, Chen J, Jin Y, Peng L et al. Neutrophil-tolymphocyte ratio as an independent risk factor for mortality in hospitalized patients with COVID-19. The Journal of Infection 2020; 81(1): 6-12. doi: 10.1016/j.jinf.2020.04.002
  • 7. Yang X, Yang Q, Wang Y, Wu Y, Xu J et al. Thrombocytopenia and its association with mortality in patients with COVID-19. Journal of Thrombosis and Haemostasis 2020; 18(6): 1469- 1472. doi: 10.1111/jth.14848
  • 8. Du RH, Liang LR, Yang CQ, Wang W, Cao TZ et al. . Predictors of mortality for patients with COVID-19 pneumonia caused by SARS-CoV-2: a prospective cohort study. European Respiratory Journal 2020; 55(5): 1-8. doi: 10.1183/13993003.00524-2020
  • 9. Zheng F, Tang W, Li H, Huang YX, Xie YL et al. Clinical characteristics of 161 cases of corona virus disease 2019 (COVID-19) in Changsha. European Review for Medical and Pharmacological Sciences 2020; 24: 3404-3410. doi: 10.26355/ eurrev_202003_20711
  • 10. Li DL, Chen MX. Critical patients with coronavirus disease 2019: Risk factors and outcome nomogram. The Journal of Infection 2020; 80(6): 37-38. doi: 10.1016/j.jinf.2020.03.025
  • 11. Yi Y, Lagniton PNP, Ye S, Li E, Xu R. COVID-19: what has been learned and to be learned about the novel coronavirus disease. Int J Biol Sci 2020; 16(10): 1753-1766. doi: 10.7150/ijbs.45134
  • 12. Megarbane B, Scherrmann JM. Hydroxychloroquine and azithromycin to treat patients with COVID-19: both friends and foes? Journal of Clinical Pharmacology 2020; 60(7): 808- 814. doi: 10.1002/jcph.1646
  • 13. Gautret P, Lagier JC, Parola P, Hoang VT, Meddeb L et al. Clinical and microbiological effect of a combination of hydroxychloroquine and azithromycin in 80 COVID-19 patients with at least a six-day follow up: A pilot observational study. Travel Medicine and Infectious Disease 2020; 34: 1-7. doi: 10.1016/j.tmaid.2020.101663
  • 14. Molina JM, Delaugerre C, Le Goff J, Mela-Lima B, PonscarmeD et al. No evidence of rapid antiviral clearance or clinical benefit with the combination of hydroxychloroquine and azithromycin in patients with severe COVID-19 infection. Medecine et Maladies Infectieuses 2020; 50(4): 384. doi: 10.1016/j.medmal.2020.03.006
Turkish Journal of Medical Sciences-Cover
  • ISSN: 1300-0144
  • Yayın Aralığı: Yılda 6 Sayı
  • Yayıncı: TÜBİTAK
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