Impact of medical care including anti-infective agents use on the prognosis of COVID-19 hospitalized patients over time
et al., Int. J. Antimicrobial Agents, 2020, doi:10.1016/j.ijantimicag.2020.106129
, 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.
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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.
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| 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
Manuscript_8414355259043bebf7cba1d22abeb157
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Impact of medical care including anti-infective agents use on the prognosis of
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COVID-19 hospitalized patients over time
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Benjamin Davido1, Ghilas Boussaid2, Isabelle Vaugier3, Thibaud Lansaman4,
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Frédérique Bouchand5, Christine Lawrence6, Jean-Claude Alvarez7, Pierre Moine8,
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Véronique Perronne1, Frédéric Barbot3, Azzam Saleh-Mghir1, Christian Perronne1,
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Djillali Annane8, Pierre De Truchis1, on behalf of the COVID-19 RPC Team*
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Garches, France
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Université Paris-Saclay, UVSQ, Erphan, 78000, Versailles, France.
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Centre d’Investigation Clinique (Inserm CIC 1429), Université Paris-Saclay, AP-HP
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Hôpital Raymond Poincaré, Garches, France
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Poincaré, Garches, France
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Poincaré, Garches, France
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EOH, Université Paris-Saclay, AP-HP Hôpital Raymond Poincaré, Garches, France
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Pharmaco-toxicologie, Université Paris-Saclay, AP-HP Hôpital Raymond Poincaré,
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Garches, France
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Garches, France
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,
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Keywords: azithromycin, hydroxychloroquine, Covid-19, pneumonia
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© 2020 published by Elsevier. This manuscript is made available under the Elsevier user license
https://www.elsevier.com/open-access/userlicense/1.0/
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Corresponding author:
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Benjamin Davido, Service de Maladies Infectieuses et Tropicales
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Hôpital Raymond-Poincaré, Garches 92380, France.
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Tel: +33-1-47107758, e-mail: benjamin.davido@aphp.fr
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Abstract:
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Introduction: Interest of anti-infective agents in COVD-19 showed discrepant results.
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However, there is no evaluation about the impact in changes of practices on the
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prognosis over time.
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Methods: Single center, retrospective study, conducted from March 5th to April 25th
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2020, in adults hospitalized in a medicine ward for a COVID-19. Patient
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characteristics were compared between 2 periods (before/after March 19th)
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considering French guidelines issued by learned societies. Aim of the study was to
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evaluate how medical care impacted unfavorable outcome, namely admission in
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intensive care unit (ICU) and/or death.
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Results: One hundred thirty-two patients were admitted, mean age was 59.0 ± 16.3
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years,
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count<1000/mm3. When prescribed, anti-infective agents were lopinavir-ritonavir
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(n=12), azithromycin (AZI) (n=28) and AZI combined with hydroxychloroquine (HCQ)
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(n=52). Between the 2 periods we noted a significant decrease of ICU admission,
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from 43% to 12% (p<0.0001). Delays until transfer in ICU were similar between
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periods (p=0.86). Pulmonary CT-scan were significantly more performed (from 50%
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to 90%, p<0.0001), as oxygen-dependency (53% vs 80%, p=0.001) and prescription
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of AZI±HCQ (from 25% to 76%, p<0.0001) were greater over time. Multivariate
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analyses showed a reduction of unfavorable outcome in patients receiving AZI±HCQ
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(HR=0.45, 95%IC [0.21-0.97], p=0.04), especially among an identified category of
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individuals (lymphocyte≥1000/mm3 or CRP≥100..
Late treatment
is less effective
is less effective
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