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Observational study of azithromycin in hospitalized patients with COVID-19

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10.1371/journal.pone.0238681
 
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hdl:2117/333850

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Rodríguez Molinero, AlejandroMés informació
Pérez López, CarlosMés informació
Gálvez Barrón, César Pavel
Miñarro Alonso, AntonioMés informació
Macho Pérez, Oscar
López, Gabriela F.
Robles, María Teresa
Dapena, María Dolores
Martínez, Sergi
Rodríguez, Ezequiel
Collado, Isabel
Document typeArticle
Defense date2020-09-03
PublisherPublic Library of Science (PLOS)
Rights accessOpen Access
Attribution 4.0 International
This work is protected by the corresponding intellectual and industrial property rights. Except where otherwise noted, its contents are licensed under a Creative Commons license : Attribution 4.0 International
Abstract
BACKGROUND: The rapid spread of the disease caused by the novel SARS-CoV-2 virus has led to the use of multiple therapeutic agents whose efficacy has not been previously demonstrated. The objective of this study was to analyze whether there is an association between the use of azithromycin and the evolution of the pulmonary disease or the time to discharge, in patients hospitalized with COVID-19. METHODS: This was an observational study on a cohort of 418 patients admitted to three regional hospitals in Catalonia, Spain. As primary outcomes, we studied the evolution of SAFI ratio (oxygen saturation/fraction of inspired oxygen) in the first 48 hours of treatment and the time to discharge. The results were compared between patients treated and untreated with the study drug through subcohort analyses matched for multiple clinical and prognostic factors, as well as through analysis of non-matched subcohorts, using Cox multivariate models adjusted for prognostic factors. RESULTS: There were 239 patients treated with azithromycin. Of these, 29 patients treated with azithromycin could be matched with an equivalent number of control patients. In the analysis of these matched subcohorts, SAFI at 48h had no significant changes associated to the use of azithromycin, though azithromycin treatment was associated with a longer time to discharge (10.0 days vs 6.7 days; log rank: p = 0.039). However, in the unmatched cohorts, the increased hospital stay associated to azithromycin use, was no significant after adjustment using Multivariate Cox regression models: hazard ratio 1.45 (IC95%: 0.88–2.41; p = 0.150). This study is limited by its small sample size and its observational nature; despite the strong pairing of the matched subcohorts and the adjustment of the Cox regression for multiple factors, the results may be affected by residual confusion. CONCLUSIONS: We did not find a clinical benefit associated with the use of azithromycin, in terms of lung function 48 hours after treatment or length of hospital stay.
CitationRodríguez, A. [et al.]. Observational study of azithromycin in hospitalized patients with COVID-19. "PloS one", 3 Setembre 2020, vol. 15, núm. 9, p. e0238681:1-e0238681:13. 
URIhttp://hdl.handle.net/2117/333850
DOI10.1371/journal.pone.0238681
ISSN1932-6203
Publisher versionhttps://journals.plos.org/plosone/article?id=10.1371/journal.pone.0238681
Other identifiershttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7470304/
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  • Departament d'Enginyeria de Sistemes, Automàtica i Informàtica Industrial - Articles de revista [1.528]
  • COVID-19 - Col·lecció especial COVID-19 [674]
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