Abstract: braz j infect dis ( 2 0 2 1 );2 5(2):101549 The Brazilian Journal of INFECTIOUS DISEASES www.elsevier.com/locate/bjid Original article Hydroxychloroquine with azithromycin in patients hospitalized for mild and moderate COVID-19 Elisa Baranski Lamback a,b,∗ , Monica Amorim de Oliveira a,c , Andrea Ferreira Haddad a , André Filipe Marcondes Vieira a,c,d , Armando Leão Ferreira Neto a,e , Taciana da Silva Maia e , Juliana de Rezende Chrisman f , Pedro Pimenta de Mello Spineti a,e , Marco Antonio de Mattos a , Eduardo Costa e,f a Hospital Unimed Rio, Rio de Janeiro, RJ, Brazil Instituto Estadual do Cérebro Paulo Niemeyer, Rio de Janeiro, RJ, Brazil c Universidade Estácio de Sá, Rio de Janeiro, RJ, Brazil d Universidade Federal Fluminense, Niterói, RJ, Brazil e Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brazil f Instituto Unimed-Rio, Rio de Janeiro, RJ, Brazil b a r t i c l e i n f o a b s t r a c t Article history: Objectives: To assess the efficacy of hydroxychloroquine in combination with azithromycin Received 6 November 2020 in terms of clinical and biochemical outcomes in adult patients with COVID-19 hospitalized Accepted 4 February 2021 for acute respiratory distress syndrome (ARDS), and to describe the occurrence of adverse Available online 19 February 2021 events. Keywords: Janeiro, Brazil, involving 193 adult patients hospitalized for mild and moderate COVID-19 Method: Retrospective comparative study, based in a quaternary private hospital in Rio de COVID-19 related ARSD, analyzing treatment efficacy based on clinical and biochemical outcomes. Severe acute respiratory syndrome Results: The active group comprised 101 (52.3%) patients using hydroxychloroquine associ- coronavirus 2 ated with azithromycin and the control group 92 (47.7%) patients who did not take these Hydroxychloroquine medications. Median age was 59 (47–70) in the active group and 65 (47−77) in the control Azithromycin group (p < 0.05). Patients in the control group had greater extent of pulmonary involvement on baseline chest CT scans (p < 0.05). All other baseline variables (BMI, comorbidities, previous use of medications and biochemical assessments) were similar between groups. In the medication group, 25% (25 out of 101) were admitted to the ICU, compared to 21% (19 out of 92) in the control group (p > 0.05). No difference in mortality, duration of non-invasive oxygen use or duration of hospitalization was seen between groups. The therapeutic regimen was well tolerated, with only eight (7.9%) patients presenting gastrointestinal symptoms and eight (7.9%) patients withdrawn treatment due to QTc prolongation. Conclusions: Patients treated with hydroxychloroquine combined with azithromycin and the control group had similar clinical outcomes. This therapeutic regimen was considered ∗ Corresponding author at: Hospital Unimed Rio, Rio de Janeiro, RJ, Brazil. E-mail address: elisalamback@gmail.com (E.B. Lamback). https://doi.org/10.1016/j.bjid.2021.101549 1413-8670/© 2021 Sociedade Brasileira de Infectologia. Published by Elsevier España, S.L.U. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). 2 b r a z j i n f e c t d i s . ( 2 0 2 1 );2 5(2):101549 ineffective in hospitalized patients with mild to moderate COVID-19 related ARDS and was associated with few non-severe adverse events. © 2021 Sociedade Brasileira de Infectologia. Published by Elsevier..