Hydroxychloroquine, azithromycin and methylprednisolone and in hospital survival in severe COVID-19 pneumonia
Go et al.
, Hydroxychloroquine, azithromycin and methylprednisolone and in hospital survival in severe COVID-19 pneumonia
, Frontiers in Pharmacology, doi:10.3389/fphar.2022.935370
Retrospective 759 hospitalized patients in the USA, showing lower mortality with combined HCQ+AZ+methylprednisolone treatment compared to methylprednisolone monotherapy.
risk of death, 55.0% lower, HR 0.45, p = 0.03, adjusted per study, multivariable, Cox proportional hazards.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Go et al., 27 Sep 2022, retrospective, USA, peer-reviewed, 2 authors, study period March 2020 - June 2020, this trial uses multiple treatments in the treatment arm (combined with AZ) - results of individual treatments may vary.
Abstract: TYPE Original Research
PUBLISHED 27 September 2022
Sudarshan Singh Rathore,
Central Institute of Mining and Fuel
Vitaliano Nicola Quaranta,
University of Bari Aldo Moro, Italy
Baptist Health South Florida,
Asim Bikas Das,
National Institute of Technology
Ronaldo C. Go,
This article was submitted to Respiratory
a section of the journal
Frontiers in Pharmacology
RECEIVED 09 May 2022
ACCEPTED 07 September 2022
PUBLISHED 27 September 2022
Go RC and Nyirenda T (2022),
Hydroxychloroquine, azithromycin and
methylprednisolone and in hospital
survival in severe COVID19 pneumonia.
Front. Pharmacol. 13:935370.
© 2022 Go and Nyirenda. This is an
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methylprednisolone and in
hospital survival in severe
Ronaldo C. Go 1,2,3* and Themba Nyirenda 1,2
Hackensack Meridian School of Medicine, Nutley, NJ, United States, 2Hackensack University Medical
Center, Hackensack, NJ, United States, 3Department of Critical Care, Robert Wood Johnson Barnabas
Health, Hamilton, NJ, United States
Introduction: Severe COVID-19 pneumonia has two phases that are not
mutually exclusive. Repurposed drugs target only one phase and the
association of combination therapy to survival is unknown.
Objective: To determine the association of hydroxychloroquine, azithromycin,
and methylprednisolone versus methylprednisolone only to in hospital survival.
Methods: This is a secondary analysis of a retrospective cohort of patients
admitted for severe covid-19 in 13 hospitals in New Jersey, United States from
March–June 2020. Propensity score match with 11 variables was constructed
between those who received no methylprednisolone and methylprednisolone.
Multivariate Cox regression was used for risk of in hospital mortality.
Measurements and main results: There were 759 patients, 380 in no
methylprednisolone and 379 with methylprednisolone. Multivariate Cox
regression shows that methylprednisolone, hydroxychloroquine, and
azithromycin had prolonged survival compared to methylprednisolone alone
[HR 0.45 (95% CI 0.22,0.91 p < 0.03)]. In patients who received
hydroxychloroquine and azithromycin, those who also received high dose
methylprednisolone were associated with worse survival compared to those
who received low dose methylprednisolone (HR = 1.642; 95% CI 1.053 to 2.562;
p = 0.0287). Nursing home residents [HR 2.77 (95% CI 1.67, 4.59 p < 0.0001)],
coronary artery disease [HR 2.93 (95% CI 1.31, 3.15 p = 0.001), and invasive
mechanical ventilation [HR 3.02 (95% CI 1.71,5.34 p = 0.0001)] were
independently associated with worse survival.
Abbreviations: ABG, arterial blood gas; ACE2, angiotensin converting enzyme 2; ARDS, acute
respiratory distress syndrome; BMI, body mass index; BPM, breaths per minute; CAD, coronary
artery disease; CBC,..
is less effective
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