Impact of medical care including anti-infective agents use on the prognosis of COVID-19 hospitalized patients over time
Davido et al.
, Impact of medical care including anti-infective agents use on the prognosis of COVID-19 hospitalized patients..
, Int. J. Antimicrobial Agents, 2020, doi:10.1016/j.ijantimicag.2020.106129
Retrospective of 132 hospitalized patients. HCQ+AZ(52)/AZ(28) significantly reduced death/ICU, HR=0.45, p=0.04. Adjusted for Charlson Comorbidity Index (including age), obesity, O2, lymphocyte count, and treatments. Mean delay from admission to treatment 0.7 days.
risk of intubation/hospitalization, 55.0% lower, HR 0.45, p = 0.04, treatment 12 of 80 (15.0%), control 13 of 40 (32.5%), NNT 5.7.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Davido et al., 2 Aug 2020, retrospective, France, peer-reviewed, 14 authors.
Abstract: Version of Record: https://www.sciencedirect.com/science/article/pii/S0924857920303125
Impact of medical care including anti-infective agents use on the prognosis of
COVID-19 hospitalized patients over time
Benjamin Davido1, Ghilas Boussaid2, Isabelle Vaugier3, Thibaud Lansaman4,
Frédérique Bouchand5, Christine Lawrence6, Jean-Claude Alvarez7, Pierre Moine8,
Véronique Perronne1, Frédéric Barbot3, Azzam Saleh-Mghir1, Christian Perronne1,
Djillali Annane8, Pierre De Truchis1, on behalf of the COVID-19 RPC Team*
Université Paris-Saclay, UVSQ, Erphan, 78000, Versailles, France.
Centre d’Investigation Clinique (Inserm CIC 1429), Université Paris-Saclay, AP-HP
Hôpital Raymond Poincaré, Garches, France
Poincaré, Garches, France
Poincaré, Garches, France
EOH, Université Paris-Saclay, AP-HP Hôpital Raymond Poincaré, Garches, France
Pharmaco-toxicologie, Université Paris-Saclay, AP-HP Hôpital Raymond Poincaré,
Maladies Infectieuses, Université Paris-Saclay, AP-HP Hôpital Raymond Poincaré,
Rééducation fonctionnelle, Université Paris-Saclay, AP-HP Hôpital Raymond
Pharmacie Hospitalière, Université Paris-Saclay, AP-HP Hôpital Raymond
Réanimation médicale, Université Paris-Saclay, AP-HP Hôpital Raymond Poincaré,
Keywords: azithromycin, hydroxychloroquine, Covid-19, pneumonia
© 2020 published by Elsevier. This manuscript is made available under the Elsevier user license
Benjamin Davido, Service de Maladies Infectieuses et Tropicales
Hôpital Raymond-Poincaré, Garches 92380, France.
Tel: +33-1-47107758, e-mail: firstname.lastname@example.org
Introduction: Interest of anti-infective agents in COVD-19 showed discrepant results.
However, there is no evaluation about the impact in changes of practices on the
prognosis over time.
Methods: Single center, retrospective study, conducted from March 5th to April 25th
2020, in adults hospitalized in a medicine ward for a COVID-19. Patient
characteristics were compared between 2 periods (before/after March 19th)
considering French guidelines issued by learned societies. Aim of the study was to
evaluate how medical care impacted unfavorable outcome, namely admission in
intensive care unit (ICU) and/or death.
Results: One hundred thirty-two patients were admitted, mean age was 59.0 ± 16.3
count<1000/mm3. When prescribed, anti-infective agents were lopinavir-ritonavir
(n=12), azithromycin (AZI) (n=28) and AZI combined with hydroxychloroquine (HCQ)
(n=52). Between the 2 periods we noted a significant decrease of ICU admission,
from 43% to 12% (p<0.0001). Delays until transfer in ICU were similar between
periods (p=0.86). Pulmonary CT-scan were significantly more performed (from 50%
to 90%, p<0.0001), as oxygen-dependency (53% vs 80%, p=0.001) and prescription
of AZI±HCQ (from 25% to 76%, p<0.0001) were greater over time. Multivariate
analyses showed a reduction of unfavorable outcome in patients receiving AZI±HCQ
(HR=0.45, 95%IC [0.21-0.97], p=0.04), especially among an identified category of
individuals (lymphocyte≥1000/mm3 or CRP≥100..
is less effective
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