Empirical treatment with hydroxychloroquine and azithromycin for suspected cases of COVID-19 followed-up by telemedicine
M.D Rodrigo Barbosa Esper, Ph.D Rafael Souza Da Silva, M.D Fernando Teiichi Costa Oikawa, Ph.D Marcelo Machado Castro, M.D Alvaro Razuk-Filho, Ph.D Pedro Benedito Batista, M.D Sergio Wilhelm Lotze, M.D Cleber Nunes Da Rocha, Roberto De Sá, M.D Cunha Filho, Saulo Emanuel Barbosa De Oliveira, Philipe Leitão Ribeiro, M.D Valéria Cristina, M.D Vigar Martins, Fernando Silva, M.D Braga Bueno, Priscila Ligeiro, M.D Gonçalves Esper, Eduardo Fagundes, Avenida Lourenço Marques, São Paulo -Brazil, Clinicaltrials Gov Identifier
Background: Telemedicine can facilitate patient's assessment with initial flu-like symptoms in the COVID-19 pandemic, moreover it promotes social isolation. Hydroxychloroquine and azithromycin are associated with reduction in COVID-19 patients' viral load. This study aims to assess whether empirical prescription of hydroxychloroquine and azithromycin for patients with suspected COVID-19 is associated with less need for hospitalization Methods: A telemedicine team evaluated suspected COVID-19 outpatients with flu-like symptoms, if no contraindications were detected, treatment with hydroxychloroquine and azithromycin was prescribed after consent from subjects. Patients were monitored daily by telemedicine appointments. Results: Of the 636 symptomatic outpatients, 412 started treatment with hydroxychloroquine and azithromycin and 224 refused medications (control group). Need for hospitalization was 1.9% in the treatment group and 5.4% in the control group (2.8 times greater) and number needed to treat was 28 (NNT = 28). In those who started treatment before versus after the seventh day of symptoms, the need for hospitalization was 1.17% and 3.2%, respectively.
Conclusion: Empirical treatment with hydroxychloroquine associated with azithromycin for suspected cases of COVID-19 infection reduces the need for hospitalization (p< 0.001).
Contributors
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