Observational study of azithromycin in hospitalized patients with COVID-19.
<h4>Background</h4>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 azi...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Public Library of Science (PLoS)
2020-01-01
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| Series: | PLoS ONE |
| Online Access: | https://doi.org/10.1371/journal.pone.0238681 |
| _version_ | 1818405513372631040 |
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| author | Alejandro Rodríguez-Molinero Carlos Pérez-López César Gálvez-Barrón Antonio Miñarro Oscar Macho Gabriela F López Maria Teresa Robles María Dolores Dapena Sergi Martínez Ezequiel Rodríguez Isabel Collado COVID-19 research group of CSAPG |
| author_facet | Alejandro Rodríguez-Molinero Carlos Pérez-López César Gálvez-Barrón Antonio Miñarro Oscar Macho Gabriela F López Maria Teresa Robles María Dolores Dapena Sergi Martínez Ezequiel Rodríguez Isabel Collado COVID-19 research group of CSAPG |
| author_sort | Alejandro Rodríguez-Molinero |
| collection | DOAJ |
| description | <h4>Background</h4>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.<h4>Methods</h4>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.<h4>Results</h4>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.<h4>Conclusions</h4>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. |
| first_indexed | 2024-12-14T08:57:14Z |
| format | Article |
| id | doaj.art-037ebed1895045c0877ce0a8fec1804d |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-12-14T08:57:14Z |
| publishDate | 2020-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-037ebed1895045c0877ce0a8fec1804d2022-12-21T23:08:53ZengPublic Library of Science (PLoS)PLoS ONE1932-62032020-01-01159e023868110.1371/journal.pone.0238681Observational study of azithromycin in hospitalized patients with COVID-19.Alejandro Rodríguez-MolineroCarlos Pérez-LópezCésar Gálvez-BarrónAntonio MiñarroOscar MachoGabriela F LópezMaria Teresa RoblesMaría Dolores DapenaSergi MartínezEzequiel RodríguezIsabel ColladoCOVID-19 research group of CSAPG<h4>Background</h4>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.<h4>Methods</h4>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.<h4>Results</h4>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.<h4>Conclusions</h4>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.https://doi.org/10.1371/journal.pone.0238681 |
| spellingShingle | Alejandro Rodríguez-Molinero Carlos Pérez-López César Gálvez-Barrón Antonio Miñarro Oscar Macho Gabriela F López Maria Teresa Robles María Dolores Dapena Sergi Martínez Ezequiel Rodríguez Isabel Collado COVID-19 research group of CSAPG Observational study of azithromycin in hospitalized patients with COVID-19. PLoS ONE |
| title | Observational study of azithromycin in hospitalized patients with COVID-19. |
| title_full | Observational study of azithromycin in hospitalized patients with COVID-19. |
| title_fullStr | Observational study of azithromycin in hospitalized patients with COVID-19. |
| title_full_unstemmed | Observational study of azithromycin in hospitalized patients with COVID-19. |
| title_short | Observational study of azithromycin in hospitalized patients with COVID-19. |
| title_sort | observational study of azithromycin in hospitalized patients with covid 19 |
| url | https://doi.org/10.1371/journal.pone.0238681 |
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