Evidence on the efficacy of adding macrolides (azithromycin or clarithromycin) to the treatment regimen for COVID-19 is limited. We testify whether adding azithromycin or clarithromycin to a standard of care regimen was superior to standard of supportive care alone in patients with mild COVID-19.This randomized trial included three groups of patients with COVID-19. The azithromycin group included, 107 patients who received azithromycin 500 mg/24 h for 7 days, the clarithromycin group included 99 patients who received clarithromycin 500 /12 h for 7 days, and the control group included 99 patients who received standard care only. All three groups received only symptomatic treatment for control of fever and cough .Clinical and biochemical evaluations of the study participants including assessment of the symptoms duration, real-time reverse transcription-polymerase chain reaction (rRT-PCR), C-reactive protein (CRP), serum ferritin, D-dimer, complete blood count (CBC), in addition to non-contrast chest computed tomography (CT), were performed. The overall results revealed significant early improvement of symptoms (fever, dyspnea and cough) in patients treated with either azithromycin or clarithromycin compared to control group, also there was significant early conversion of SARS-CoV-2 PCR to negative in patients treated with either azithromycin or clarithromycin compared to control group ( p < 0.05 for all).There was no significant difference in time to improvement of fever, cough, dyspnea, anosmia, gastrointestinal tract "GIT" symptoms and time to PCR negative conversion between patients treated with azithromycin compared to patients treated with clarithromycin ( p > 0.05 for all). Follow up chest CT done after 2 weeks of start of treatment showed significant improvement in patients treated with either azithromycin or clarithromycin compared to control group ( p < 0.05 for all).Adding Clarithromycin or azithromycin to the therapeutic protocols for COVID-19 could be beneficial for early control of fever and early PCR negative conversion in Mild COVID-19. Trial registration : (NCT04622891) www.ClinicalTrials.gov retrospectively registered (November 10, 2020).
【저자키워드】 Molecular biology, Molecular medicine, 【초록키워드】 COVID-19, Treatment, Efficacy, protocol, Azithromycin, randomized trial, C-reactive protein, CRP, D-dimer, Symptom, cough, Anosmia, CBC, Computed tomography, Chest computed tomography, polymerase chain reaction, rRT-PCR, PCR, Chest CT, complete blood count, Fever, Dyspnea, therapeutic, Patient, Symptomatic treatment, Mild, gastrointestinal tract, blood count, supportive care, SARS-CoV-2 PCR, regimen, Chain Reaction, clarithromycin, Standard of care, Serum ferritin, significant difference, control group, Trial registration, no significant difference, standard care, Negative conversion, Study participants, real-time reverse transcription-polymerase chain reaction, three groups, treatment regimen, Registered, performed, addition, study participant, three group, biochemical evaluation, patients treated, patients with COVID-19, 【제목키워드】 COVID-19, Efficacy, management, Patient, Mild,