Hydroxychloroquine with azithromycin in patients hospitalized for mild and moderate COVID-19.
OBJECTIVES
To assess the efficacy of hydroxychloroquine in combination with azithromycin in terms of clinical and biochemical outcomes in adult patients with COVID-19 hospitalized for acute respiratory distress syndrome (ARDS), and to describe the occurrence of adverse events.


METHOD
Retrospective comparative study, based in a quaternary private hospital in Rio de Janeiro, Brazil, involving 193 adult patients hospitalized for mild and moderate COVID-19 related ARSD, analyzing treatment efficacy based on clinical and biochemical outcomes.


RESULTS
The active group comprised 101 (52.3%) patients using hydroxychloroquine associated with azithromycin and the control group 92 (47.7%) patients who did not take these medications. Median age was 59 (47-70) in the active group and 65 (47-77) in the control 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was well tolerated, with only eight (7.9%) patients presenting gastrointestinal symptoms and eight (7.9%) patients withdrawn treatment due to QTc prolongation.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 ineffective in hospitalized patients with mild to moderate COVID-19 related ARDS and was associated with few non-severe adverse events.
['Lamback|Elisa Baranski|EB|', 'Oliveira|Monica Amorim de|MA|', 'Haddad|Andrea Ferreira|AF|', 'Vieira|André Filipe Marcondes|AFM|', 'Neto|Armando Leão Ferreira|ALF|', 'Maia|Taciana da Silva|TDS|', 'Chrisman|Juliana de Rezende|JR|', 'Spineti|Pedro Pimenta de Mello|PPM|', 'Mattos|Marco Antonio de|MA|', 'Costa|Eduardo|E|']
D000328:Adult D017963:Azithromycin D001938:Brazil D000086382:COVID-19 D004359:Drug Therapy, Combination D006801:Humans D006886:Hydroxychloroquine D008875:Middle Aged D012189:Retrospective Studies D000086402:SARS-CoV-2
Hydroxychloroquine Azithromycin COVID-19 Severe acute respiratory syndrome coronavirus 2