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.
【초록키워드】 COVID-19, Treatment, coronavirus disease, SARS-CoV-2, coronavirus, Pneumonia, randomized trial, Infection, Comorbidities, drug, cohort study, death, combination treatment, age, HCQ, women, in-hospital mortality, Evidence, retrospective, Combination, contraindications, positive airway pressure, In-hospital death, regression analysis, C reactive protein, acute respiratory syndrome, 95% CI, 95% confidence interval, hazard ratio, azithromycin treatment, single-center, treatment group, primary end point, Kaplan-Meier curve, multivariable, log rank test, performed, reduced, recorded, receive, consecutive patient, patients treated, the median, use of hydroxychloroquine, 【제목키워드】 COVID-19, Azithromycin, Effect,