Impact of medical care including anti-infective agents use on the prognosis of COVID-19 hospitalized patients over time
Benjamin Davido, Ghilas Boussaid, Isabelle Vaugier, Thibaud Lansaman, Frédérique Bouchand, Christine Lawrence, Jean-Claude Alvarez, Pierre Moine, Véronique Perronne, Frédéric Barbot, Azzam Saleh-Mghir, Christian Perronne, Djillali Annane, Pierre De Truchis
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 5 th to April 25 th 2020, in adults hospitalized in a medicine ward for a COVID-19. Patient characteristics were compared between 2 periods (before/after March 19 th ) considering French guidelines issued by learned societies. Aim of the study was to 3 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 years, mean CRP level was 84.0±71.1 mg/L, 46% had a lymphocyte count<1000/mm 3 . 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/mm 3 or CRP≥100 mg/L).
Conclusion: The present study revealed a significant decrease of admission in ICU over time probably related to multiple factors, including a better indication of pulmonary CT-scan, of oxygen therapy, and a suitable prescription of anti-infective agents.
Declarations Funding: The authors have no financial relationships relevant to this article to disclose. Competing Interests: BD has received consulting fees or travel grants from ViiV Healthcare and Gilead Sc. PdT has received consulting fees or travel grants from ViiV Healthcare, M.S.D and Gilead Sc. The remaining authors have no specific conflict of interest.
Ethical Approval: Not required
References
Ambrosi, None, MD
Amthor, None, MD
Arshad, Kilgore, Chaudhry, Jacobsen, Wang et al., Treatment with Hydroxychloroquine, Azithromycin, and Combination in Patients Hospitalized with COVID-19, Int J Infect Dis,
doi:10.1016/j.ijid.2020.06.099Barbarin, None
Beigel, Tomashek, Dodd, Mehta, Zingman et al., Remdesivir for the Treatment of Covid-19 -Preliminary Report, N Engl J Med,
doi:10.1056/nejmoa2007764Berradja, None, MD
Borba, Val, Sampaio, Alexandre, Melo et al., Effect of High vs Low Doses of Chloroquine Diphosphate as Adjunctive Therapy for Patients Hospitalized With Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Infection, JAMA Netw Open,
doi:10.1001/jamanetworkopen.2020.8857Bounab, None, MD
Cao, Wang, Wen, Liu, Wang et al., A Trial of Lopinavir-Ritonavir in Adults Hospitalized with Severe Covid-19, N Engl J Med,
doi:10.1056/NEJMoa2001282Carlier, None, MD
Charlson, Pompei, Ales, Mackenzie, A new method of classifying prognostic comorbidity in longitudinal studies: development and validation, J Chronic Dis
Chentouh, None, MD
Chetrit, None, MD
Chkron, Céline Karabulut
Clair, None, MD
Coester, None, MD
Davido, Md, None, MS
Defouchecour, None, MD
Denys, Md, None, PhD
Dh, Azithromycin, a 15-membered Macrolide Antibiotic, Inhibits Influenza A(H1N1)pdm09 Virus Infection by Interfering With Virus Internalization Process, J Antibiot,
doi:10.1038/S41429-019-0204-XDiffre, None, MD
Djebrani, Pharmd, Emmanuelli, None
Dosne, None, MD
Edjlali, Md, None, PhD
El, None, MD
Farcy-Afif, None, PharmD
Fayssoil, None, MD
Felter, None, MD
Foch, None
Friedman, None, MD
Gault, Md, None, PhD
Gautret, Lagier, Parola, Hoang, Meddeb et al., Clinical and microbiological effect of a combination of hydroxychloroquine and azithromycin in 80 COVID-19 patients with at least a six-day follow up: A pilot observational study, Travel Med Infect Dis,
doi:10.1016/j.tmaid.2020.101663Gautret, Lagier, Parola, Hoang, Meddeb et al., Hydroxychloroquine and azithromycin as a treatment of COVID-19: results of an open-label non-randomized clinical trial, Int J Antimicrob Agents,
doi:10.1016/j.ijantimicag.2020.105949Geleris, Sun, Platt, Zucker, Baldwin et al., Observational Study of Hydroxychloroquine in Hospitalized Patients with Covid-19, N Engl J Med,
doi:10.1056/NEJMoa2012410Girardot, None, MD
Guichard, None, MD
Guillon, Omar, Md, Laboratory of Physiology Frédéric Lofaso, PhD
Hamon Pietrin, Md, None, PhD
Heming, Md, None, PhD
Herrmann, None, PharmD
Hôpital, Poincaré, Aphp, None
Jabbour, None, PharmD
Joussain, Md, None, PhD
Jouvenet, Santé, Clinique de la Muette
Kagane, None, MD
Khiter, None, MD
Kirchner, None
Kumar, Early versus late oseltamivir treatment in severely ill patients with 2009 pandemic influenza A (H1N1): speed is life,
doi:10.1093/jac/dkr090Lagier, Million, Gautret, Colson, Cortaredona et al., Outcomes of 3,737 COVID-19 patients treated with hydroxychloroquine/azithromycin and other regimens in Marseille, France: A retrospective analysis, Travel Med Infect Dis,
doi:10.1016/J.TMAID.2020.101791Lahjomri, None, MD
Lamy, None
Landowski, None, MD
Lanore, None
Lansaman, None, MD
Lawrence, None, PharmD
Lb, Tw, Dt, Am, Early Administration of Azithromycin and Prevention of Severe Lower Respiratory Tract Illnesses in Preschool Children With a History of Such Illnesses: A Randomized Clinical Trial, JAMA,
doi:10.1001/JAMA.2015.13896Le Liepvre, Md ; Leotard, None, MS
Le, None
Lebidois, None, PharmD
Lemoine, None
Levy, Md, None, MS
Louis Gaillard, Md, None, PhD
Lyse, None, MD
Mahévas, Tran, Roumier, Chabrol, Paule et al., Clinical efficacy of hydroxychloroquine in patients with covid-19 pneumonia who require oxygen: observational comparative study using routine care data, BMJ,
doi:10.1136/bmj.m1844Malot, None, MD
Mantaise, Mantes-La-Jolie
Martinez, Md, None, PhD
Maxime, Md, None
Mekki, Md, None, MS
Meuleye, None, MD
Michelon, Pharmd, None, MSc
Million, Lagier, Gautret, Colson, Fournier et al., Early treatment of COVID-19 patients with hydroxychloroquine and azithromycin: A retrospective analysis of 1061 cases in Marseille, France, Travel Med Infect Dis,
doi:10.1016/j.tmaid.2020.101738Moine, Md, None, PhD
Mompoint, None, MD
Nguyen, Thang, Department of Microbiology and Innovative Biomarkers Platform Coralie Favier
Niel, None, MD
Noussair, None, MD
Orlikowski, Md, None, PhD
Paquereau, None, MD
Parent, Md, And the nonmedical staff of the Department Department of Radiology Amine Ammar
Perronne, Md, None, PhD
Perronne, None, MD
Pierre De Truchis, Md, None, MS
Prigent, Md, None, MD, PhD
Rech, Md, None
Reysz, None, MD
Roquencourt, None, MD
Rosenberg, Dufort, Udo, Wilberschied, Kumar et al., Association of Treatment With Hydroxychloroquine or Azithromycin With In-Hospital Mortality in Patients With COVID-19 in New York State, JAMA,
doi:10.1001/jama.2020.8630Rottman, Md, None, PhD
Roux, None, PharmD
Safa, None, MD
Saffroy, None
Santi, Md, Pharmacy Frédérique Bouchand, PharmD
Schitter, None, MD
Stanislas Grassin, None, MCUPH
Tan, Wang, Zhang, Ding, Huang et al., Lymphopenia predicts disease severity of COVID-19: a descriptive and predictive study, Signal Transduct Target Ther,
doi:10.1038/s41392-020-0148-4Thevenot, Department of Intensive Care Interns Baptiste Abbar
Thiry, Md, Department of Radiology Interns Margot Armani (1) Olivier de Barry
Tocqueville, None
Touret, Gilles, Barral, Nougairède, Decroly et al., In vitro screening of a FDA approved chemical library reveals potential inhibitors of SARS-CoV-2 replication, BioRxiv,
doi:10.1101/2020.04.03.023846Trabelsi, Md, Pediatric Critical Care Unit Helge Amthor, MD, PhD
Vibert, Department of Infectious Diseases Pascal Crenn, PhD
Villart, None, PharmD
Wang, Zhang, Du, Du, Zhao et al., Remdesivir in adults with severe COVID-19: a randomised, double-blind, placebo-controlled, multicentre trial, Lancet,
doi:10.1016/S0140-6736(20)31022-9Welti, Md, And the nonmedical staff of the Department Department of Laboratory Medicine and Pharmacology Jean Claude Alvarez, PhD
Zhou, Department of Forensic Medicine Geoffroy Lorin de La Grandmaison MD, PhD
Zini, Department of Anesthesia, Perioperative Care, and Pain Marie Boutros
DOI record:
{
"DOI": "10.1016/j.ijantimicag.2020.106129",
"ISSN": [
"0924-8579"
],
"URL": "http://dx.doi.org/10.1016/j.ijantimicag.2020.106129",
"alternative-id": [
"S0924857920303125"
],
"article-number": "106129",
"assertion": [
{
"label": "This article is maintained by",
"name": "publisher",
"value": "Elsevier"
},
{
"label": "Article Title",
"name": "articletitle",
"value": "Impact of medical care, including use of anti-infective agents, on prognosis of COVID-19 hospitalized patients over time"
},
{
"label": "Journal Title",
"name": "journaltitle",
"value": "International Journal of Antimicrobial Agents"
},
{
"label": "CrossRef DOI link to publisher maintained version",
"name": "articlelink",
"value": "https://doi.org/10.1016/j.ijantimicag.2020.106129"
},
{
"label": "Content Type",
"name": "content_type",
"value": "article"
},
{
"label": "Copyright",
"name": "copyright",
"value": "© 2020 Elsevier Ltd and International Society of Antimicrobial Chemotherapy. All rights reserved."
}
],
"author": [
{
"ORCID": "http://orcid.org/0000-0002-2859-8417",
"affiliation": [],
"authenticated-orcid": false,
"family": "Davido",
"given": "Benjamin",
"sequence": "first"
},
{
"affiliation": [],
"family": "Boussaid",
"given": "Ghilas",
"sequence": "additional"
},
{
"affiliation": [],
"family": "Vaugier",
"given": "Isabelle",
"sequence": "additional"
},
{
"affiliation": [],
"family": "Lansaman",
"given": "Thibaud",
"sequence": "additional"
},
{
"affiliation": [],
"family": "Bouchand",
"given": "Frédérique",
"sequence": "additional"
},
{
"affiliation": [],
"family": "Lawrence",
"given": "Christine",
"sequence": "additional"
},
{
"affiliation": [],
"family": "Alvarez",
"given": "Jean-Claude",
"sequence": "additional"
},
{
"affiliation": [],
"family": "Moine",
"given": "Pierre",
"sequence": "additional"
},
{
"affiliation": [],
"family": "Perronne",
"given": "Véronique",
"sequence": "additional"
},
{
"affiliation": [],
"family": "Barbot",
"given": "Frédéric",
"sequence": "additional"
},
{
"affiliation": [],
"family": "Saleh-Mghir",
"given": "Azzam",
"sequence": "additional"
},
{
"affiliation": [],
"family": "Perronne",
"given": "Christian",
"sequence": "additional"
},
{
"affiliation": [],
"family": "Annane",
"given": "Djillali",
"sequence": "additional"
},
{
"affiliation": [],
"family": "De Truchis",
"given": "Pierre",
"sequence": "additional"
}
],
"container-title": "International Journal of Antimicrobial Agents",
"container-title-short": "International Journal of Antimicrobial Agents",
"content-domain": {
"crossmark-restriction": true,
"domain": [
"clinicalkey.jp",
"clinicalkey.com",
"clinicalkey.es",
"clinicalkey.com.au",
"clinicalkey.fr",
"elsevier.com",
"sciencedirect.com"
]
},
"created": {
"date-parts": [
[
2020,
8,
2
]
],
"date-time": "2020-08-02T14:31:27Z",
"timestamp": 1596378687000
},
"deposited": {
"date-parts": [
[
2021,
4,
18
]
],
"date-time": "2021-04-18T20:56:18Z",
"timestamp": 1618779378000
},
"funder": [
{
"DOI": "10.13039/100005564",
"award": [
"NCT04453501"
],
"doi-asserted-by": "publisher",
"name": "Gilead Sciences"
}
],
"indexed": {
"date-parts": [
[
2023,
4,
7
]
],
"date-time": "2023-04-07T10:54:05Z",
"timestamp": 1680864845281
},
"is-referenced-by-count": 11,
"issue": "4",
"issued": {
"date-parts": [
[
2020,
10
]
]
},
"journal-issue": {
"issue": "4",
"published-print": {
"date-parts": [
[
2020,
10
]
]
}
},
"language": "en",
"license": [
{
"URL": "https://www.elsevier.com/tdm/userlicense/1.0/",
"content-version": "tdm",
"delay-in-days": 0,
"start": {
"date-parts": [
[
2020,
10,
1
]
],
"date-time": "2020-10-01T00:00:00Z",
"timestamp": 1601510400000
}
},
{
"URL": "http://www.elsevier.com/open-access/userlicense/1.0/",
"content-version": "am",
"delay-in-days": 349,
"start": {
"date-parts": [
[
2021,
9,
15
]
],
"date-time": "2021-09-15T00:00:00Z",
"timestamp": 1631664000000
}
}
],
"link": [
{
"URL": "https://api.elsevier.com/content/article/PII:S0924857920303125?httpAccept=text/xml",
"content-type": "text/xml",
"content-version": "vor",
"intended-application": "text-mining"
},
{
"URL": "https://api.elsevier.com/content/article/PII:S0924857920303125?httpAccept=text/plain",
"content-type": "text/plain",
"content-version": "vor",
"intended-application": "text-mining"
}
],
"member": "78",
"original-title": [],
"page": "106129",
"prefix": "10.1016",
"published": {
"date-parts": [
[
2020,
10
]
]
},
"published-print": {
"date-parts": [
[
2020,
10
]
]
},
"publisher": "Elsevier BV",
"reference": [
{
"DOI": "10.1016/j.tmaid.2020.101663",
"article-title": "Clinical and microbiological effect of a combination of hydroxychloroquine and azithromycin in 80 COVID-19 patients with at least a six-day follow up: A pilot observational study",
"author": "Gautret",
"doi-asserted-by": "crossref",
"journal-title": "Travel Med Infect Dis",
"key": "10.1016/j.ijantimicag.2020.106129_bib0001",
"volume": "34",
"year": "2020"
},
{
"DOI": "10.1016/j.ijantimicag.2020.105949",
"article-title": "Hydroxychloroquine and azithromycin as a treatment of COVID-19: results of an open-label non-randomized clinical trial",
"author": "Gautret",
"doi-asserted-by": "crossref",
"issue": "1",
"journal-title": "Int J Antimicrob Agents",
"key": "10.1016/j.ijantimicag.2020.106129_bib0002",
"volume": "56",
"year": "2020"
},
{
"DOI": "10.1016/j.tmaid.2020.101738",
"article-title": "Early treatment of COVID-19 patients with hydroxychloroquine and azithromycin: A retrospective analysis of 1061 cases in Marseille, France",
"author": "Million",
"doi-asserted-by": "crossref",
"journal-title": "Travel Med Infect Dis",
"key": "10.1016/j.ijantimicag.2020.106129_bib0003",
"volume": "35",
"year": "2020"
},
{
"DOI": "10.1136/bmj.m1844",
"article-title": "Clinical efficacy of hydroxychloroquine in patients with covid-19 pneumonia who require oxygen: observational comparative study using routine care data",
"author": "Mahévas",
"doi-asserted-by": "crossref",
"first-page": "m1844",
"journal-title": "BMJ",
"key": "10.1016/j.ijantimicag.2020.106129_bib0004",
"volume": "369",
"year": "2020"
},
{
"DOI": "10.1056/NEJMoa2012410",
"article-title": "Observational study of hydroxychloroquine in hospitalized patients with Covid-19",
"author": "Geleris",
"doi-asserted-by": "crossref",
"first-page": "2411",
"issue": "25",
"journal-title": "N Engl J Med",
"key": "10.1016/j.ijantimicag.2020.106129_bib0005",
"volume": "382",
"year": "2020"
},
{
"DOI": "10.1016/S0140-6736(20)30317-2",
"article-title": "Clinical evidence does not support corticosteroid treatment for 2019-nCoV lung injury",
"author": "Russell",
"doi-asserted-by": "crossref",
"first-page": "473",
"journal-title": "Lancet",
"key": "10.1016/j.ijantimicag.2020.106129_bib0006",
"volume": "395",
"year": "2020"
},
{
"DOI": "10.1016/j.ijid.2020.06.099",
"article-title": "Treatment with hydroxychloroquine, azithromycin, and combination in patients hospitalized with COVID-19",
"author": "Arshad",
"doi-asserted-by": "crossref",
"first-page": "396",
"journal-title": "Int J Infect Dis",
"key": "10.1016/j.ijantimicag.2020.106129_bib0007",
"volume": "97",
"year": "2020"
},
{
"DOI": "10.1056/NEJMoa2001282",
"article-title": "A trial of lopinavir–ritonavir in adults hospitalized with severe Covid-19",
"author": "Cao",
"doi-asserted-by": "crossref",
"first-page": "1787",
"issue": "19",
"journal-title": "N Engl J Med",
"key": "10.1016/j.ijantimicag.2020.106129_bib0008",
"volume": "382",
"year": "2020"
},
{
"DOI": "10.1016/S0140-6736(20)31022-9",
"article-title": "Remdesivir in adults with severe COVID-19: a randomised, double-blind, placebo-controlled, multicentre trial",
"author": "Wang",
"doi-asserted-by": "crossref",
"first-page": "1569",
"journal-title": "Lancet",
"key": "10.1016/j.ijantimicag.2020.106129_bib0009",
"volume": "395",
"year": "2020"
},
{
"DOI": "10.1056/NEJMoa2007764",
"article-title": "Remdesivir for the treatment of Covid-19 — preliminary report",
"author": "Beigel",
"doi-asserted-by": "crossref",
"journal-title": "N Engl J Med",
"key": "10.1016/j.ijantimicag.2020.106129_bib0010",
"year": "2020"
},
{
"DOI": "10.1016/0021-9681(87)90171-8",
"article-title": "A new method of classifying prognostic comorbidity in longitudinal studies: development and validation",
"author": "Charlson",
"doi-asserted-by": "crossref",
"first-page": "373",
"journal-title": "J Chronic Dis",
"key": "10.1016/j.ijantimicag.2020.106129_bib0011",
"volume": "40",
"year": "1987"
},
{
"DOI": "10.1016/S0140-6736(20)31210-1",
"article-title": "Assistance Publique–Hôpitaux de Paris’ response to the COVID-19 pandemic",
"author": "Group",
"doi-asserted-by": "crossref",
"first-page": "1760",
"issue": "10239",
"journal-title": "Lancet",
"key": "10.1016/j.ijantimicag.2020.106129_bib0012",
"volume": "395",
"year": "2020"
},
{
"key": "10.1016/j.ijantimicag.2020.106129_bib0013",
"unstructured": "SRLF-SFAR-SFMU-GFRUP-SPILF-SPLF. Recommandations d'experts portant sur la prise en charge en réanimation des patients en période d’épidémie à SARS-CoV22020:29. https://www.srlf.org/wp-content/uploads/2020/03/RFE-COVID_V3_FINAL-1.pdf."
},
{
"DOI": "10.1002/ajh.25829",
"article-title": "Hematological findings and complications of COVID-19",
"author": "Terpos",
"doi-asserted-by": "crossref",
"first-page": "834",
"issue": "7",
"journal-title": "Am J Hematol",
"key": "10.1016/j.ijantimicag.2020.106129_bib0014",
"volume": "95",
"year": "2020"
},
{
"DOI": "10.1038/s41392-020-0148-4",
"article-title": "Lymphopenia predicts disease severity of COVID-19: a descriptive and predictive study",
"author": "Tan",
"doi-asserted-by": "crossref",
"first-page": "33",
"journal-title": "Signal Transduct Target Ther",
"key": "10.1016/j.ijantimicag.2020.106129_bib0015",
"volume": "5",
"year": "2020"
},
{
"DOI": "10.1093/jac/dkr090",
"article-title": "Early versus late oseltamivir treatment in severely ill patients with 2009 pandemic influenza A (H1N1): speed is life",
"author": "Kumar",
"doi-asserted-by": "crossref",
"first-page": "959",
"issue": "5",
"journal-title": "J Antimicrob Chemother",
"key": "10.1016/j.ijantimicag.2020.106129_bib0016",
"volume": "66",
"year": "2011"
},
{
"DOI": "10.1016/j.ijantimicag.2020.105982",
"article-title": "Cytokine storm and immunomodulatory therapy in COVID-19: Role of chloroquine and anti-IL-6 monoclonal antibodies",
"author": "Zhao",
"doi-asserted-by": "crossref",
"issue": "6",
"journal-title": "Int J Antimicrob Agents",
"key": "10.1016/j.ijantimicag.2020.106129_bib0017",
"volume": "55",
"year": "2020"
},
{
"DOI": "10.1016/j.tmaid.2020.101791",
"article-title": "Outcomes of 3,737 COVID-19 patients treated with hydroxychloroquine/azithromycin and other regimens in Marseille, France: A retrospective analysis",
"author": "Lagier",
"doi-asserted-by": "crossref",
"journal-title": "Travel Med Infect Dis",
"key": "10.1016/j.ijantimicag.2020.106129_bib0018",
"volume": "36",
"year": "2020"
},
{
"DOI": "10.1101/2020.04.03.023846",
"doi-asserted-by": "crossref",
"key": "10.1016/j.ijantimicag.2020.106129_bib0019",
"unstructured": "Touret F., Gilles M., Barral K., Nougairède A., Decroly E., Lamballerie X. de, et al. In vitro screening of a FDA approved chemical library reveals potential inhibitors of SARS-CoV-2 replication. BioRxiv 2020:2020.04.03.023846. doi:10.1101/2020.04.03.023846."
},
{
"DOI": "10.1038/s41429-019-0204-x",
"article-title": "Azithromycin, a 15-membered macrolide antibiotic, inhibits influenza A(H1N1)pdm09 virus infection by interfering with virus internalization process",
"author": "Tran",
"doi-asserted-by": "crossref",
"first-page": "759",
"issue": "10",
"journal-title": "J Antibiot (Tokyo)",
"key": "10.1016/j.ijantimicag.2020.106129_bib0020",
"volume": "72",
"year": "2019"
},
{
"DOI": "10.1001/jama.2015.13896",
"article-title": "Early administration of azithromycin and prevention of severe lower respiratory tract illnesses in preschool children with a history of such illnesses: a randomized clinical trial",
"author": "Bacharier",
"doi-asserted-by": "crossref",
"first-page": "2034",
"journal-title": "JAMA",
"key": "10.1016/j.ijantimicag.2020.106129_bib0021",
"volume": "314",
"year": "2015"
},
{
"DOI": "10.1007/s12015-020-09976-7",
"article-title": "CD147 as a target for COVID-19 Treatment: suggested effects of azithromycin and stem cell engagement",
"author": "Ulrich",
"doi-asserted-by": "crossref",
"first-page": "434",
"issue": "3",
"journal-title": "Stem Cell Rev Rep",
"key": "10.1016/j.ijantimicag.2020.106129_bib0022",
"volume": "16",
"year": "2020"
},
{
"DOI": "10.1001/jama.2020.8630",
"article-title": "Association of treatment with hydroxychloroquine or azithromycin with in-hospital mortality in patients with COVID-19 in New York State",
"author": "Rosenberg",
"doi-asserted-by": "crossref",
"first-page": "2493",
"journal-title": "JAMA",
"key": "10.1016/j.ijantimicag.2020.106129_bib0023",
"volume": "323",
"year": "2020"
},
{
"DOI": "10.1001/jamanetworkopen.2020.8857",
"article-title": "Effect of High vs low doses of chloroquine diphosphate as adjunctive therapy for patients hospitalized with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Infection",
"author": "Borba",
"doi-asserted-by": "crossref",
"journal-title": "JAMA Netw Open",
"key": "10.1016/j.ijantimicag.2020.106129_bib0024",
"volume": "3",
"year": "2020"
}
],
"reference-count": 24,
"references-count": 24,
"relation": {},
"resource": {
"primary": {
"URL": "https://linkinghub.elsevier.com/retrieve/pii/S0924857920303125"
}
},
"score": 1,
"short-title": [],
"source": "Crossref",
"subject": [
"Pharmacology (medical)",
"Infectious Diseases",
"Microbiology (medical)",
"General Medicine"
],
"subtitle": [],
"title": "Impact of medical care, including use of anti-infective agents, on prognosis of COVID-19 hospitalized patients over time",
"type": "journal-article",
"update-policy": "http://dx.doi.org/10.1016/elsevier_cm_policy",
"volume": "56"
}
