About: Treatment with Hydroxychloroquine, Azithromycin, and Combination in Patients Hospitalized with COVID-19

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type	Academic Article research paper schema:ScholarlyArticle
isDefinedBy	Covid-on-the-Web dataset
has title	Treatment with Hydroxychloroquine, Azithromycin, and Combination in Patients Hospitalized with COVID-19
Creator	Alangaden, George Reyes, Katherine Parraga, Tommy Ford, Henry Kilgore, Paul Do, Wang, Dee Ackerman, Adam Arshad, Samia Bhargava, Pallavi Brar, Indira Chaudhry, Zohra Chen, Anne Fadel, Raef Gardner-Gray, Jayna Godfrey, Amanda Gudipati, Smitha Hamed, Asif Herc, Erica Huitsing, Kylie Jacobsen, Gordon Jennings, Jeffrey Lanfranco, Odaliz Lezotte, Jonathan Maki, Gina Nadeem, Owais Nauriyal, Varidhi Ramesh, Mayur Ruhala, Joseph Shallal, Anita Suleyman, Geehan Swiderek, Jennifer Tariq, Zain Vahia, Amit Williams, Johnathan Zervos, Marcus Yared, Nicholas Mckinnon, John Hamed, Abdul Lanfranco, Abreu O'neill, William
Source	Elsevier; Medline; PMC
abstract	SIGNIFICANCE: The United States is in an acceleration phase of the COVID-19 pandemic. Currently there is no known effective therapy or vaccine for treatment of SARS-CoV-2, highlighting urgency around identifying effective therapies. OBJECTIVE: The purpose of this study was to evaluate the role of hydroxychloroquine therapy alone and in combination with azithromycin in hospitalized patients positive for COVID-19. DESIGN: Multi-center retrospective observational study SETTING: The Henry Ford Health System (HFHS) in Southeast Michigan: large six hospital integrated health system; the largest of hospitals is an 802-bed quaternary academic teaching hospital in urban Detroit, Michigan. PARTICIPANTS: Consecutive patients hospitalized with a COVID-related admission in the health system from March 10,2020 to May 2,2020 were included. Only the first admission was included for patients with multiple admissions. All patients evaluated were 18 years of age and older and were treated as inpatients for at least 48 hours unless expired within 24 hours. EXPOSURE: Receipt of hydroxychloroquine alone, hydroxychloroquine in combination with azithromycin, azithromycin alone, or neither. MAIN OUTCOME: The primary outcome was in-hospital mortality. RESULTS: Of 2,541 patients, with a median total hospitalization time of 6 days (IQR: 4-10 days), median age was 64 years (IQR:53-76 years), 51% male, 56% African American, with median time to follow-up of 28.5 days (IQR:3-53). Overall in-hospital mortality was 18.1% (95% CI:16.6%-19.7%); by treatment: hydroxychloroquine + azithromycin, 157/783 (20.1% [95% CI: 17.3%-23.0%]), hydroxychloroquine alone, 162/1202 (13.5% [95% CI: 11.6%-15.5%]), azithromycin alone, 33/147 (22.4% [95% CI: 16.0%-30.1%]), and neither drug, 108/409 (26.4% [95% CI: 22.2%-31.0%]). Primary cause of mortality was respiratory failure (88%); no patient had documented torsades de pointes. From Cox regression modeling, predictors of mortality were age>65 years (HR:2.6 [95% CI:1.9-3.3]), white race (HR:1.7 [95% CI:1.4-2.1]), CKD (HR:1.7 [95%CI:1.4-2.1]), reduced O2 saturation level on admission (HR:1.5 [95%CI:1.1-2.1]), and ventilator use during admission (HR: 2.2 [95%CI:1.4-3.3]). Hydroxychloroquine provided a 66% hazard ratio reduction, and hydroxychloroquine + azithromycin 71% compared to neither treatment (p < 0.001). CONCLUSIONS AND RELEVANCE: In this multi-hospital assessment, when controlling for COVID-19 risk factors, treatment with hydroxychloroquine alone and in combination with azithromycin was associated with reduction in COVID-19 associated mortality. Prospective trials are needed to examine this impact.
has issue date	2020-07-02(xsd:dateTime)
bibo:doi	10.1016/j.ijid.2020.06.099
bibo:pmid	32623082
has license	no-cc
sha1sum (hex)	b739badc993dc7ea4519d3520fa3998c5a825c7f
schema:url	https://doi.org/10.1016/j.ijid.2020.06.099
resource representing a document's title	Treatment with Hydroxychloroquine, Azithromycin, and Combination in Patients Hospitalized with COVID-19
has PubMed Central identifier	PMC7330574
has PubMed identifier	32623082
schema:publication	Int J Infect Dis
resource representing a document's body	covid:b739badc993dc7ea4519d3520fa3998c5a825c7f#body_text
is schema:about of	named entity 'Count' named entity 'Hydroxychloroquine' named entity 'Journal' named entity 'Azithromycin' named entity 'Combination' named entity '352' named entity 'Patients' named entity 'Hydroxychloroquine' named entity 'COVID' named entity 'Azithromycin' named entity 'intensive care unit' named entity 'adverse events' named entity 'New York' named entity 'hydroxychloroquine' named entity 'Southeast Michigan' named entity 'ritonavir' named entity 'COVID' named entity 'randomized trial' named entity 'hydroxychloroquine' named entity 'QTc interval' named entity 'medical conditions' named entity 'emergency use authorization' named entity 'COVID-19' named entity 'azithromycin' named entity 'body mass index' named entity 'propensity score matching' named entity 'chloroquine' named entity 'COVID' named entity 'respiratory failure' named entity 'RT-PCR' named entity 'asthma' named entity 'COVID' named entity 'anti-thrombotic' named entity 'SARS-CoV-2' named entity 'hydroxychloroquine' named entity 'myocarditis' named entity 'COVID' named entity 'SARS-CoV-2' named entity 'clinical trial' named entity 'hydroxychloroquine' named entity 'Cox regression'

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