A comprehensive strategy for the early treatment of COVID-19 with azithromycin/hydroxychloroquine and/or corticosteroids: Results of a retrospective observational study in the French overseas department of Réunion Island

Abstract

Background This study aimed to evaluate the prognosis of COVID-19 patients in Reunion Island, with a particular focus on the management of patients with hypoxemic pneumonia. Methods This retrospective observational study was conducted from 11 March to 17 April 2020 at the only hospital authorized to manage patients with COVID-19 in Reunion Island. Results Over the study period, 164 out of 398 patients (41.2%) infected with COVID-19 were admitted to Félix Guyon University Hospital. Of these, 36 (22%) developed hypoxemic pneumonia. Patients with hypoxemic pneumonia were aged 66 [56–77] years, 69% were male and 33% had hypertension. Ten patients (27.8%) were hospitalized in intensive care unit (ICU). Hydroxychloroquine/azithromycin treatment was associated with a lower ICU admission rate ( P = 0.008). None of the 6 patients treated with corticosteroids were hospitalized in ICU ( P = 0.16). There were no deaths at follow up (minimum 80 days). Conclusions Despite the risk profile of COVID-19 patients with severe hypoxemic pneumonia, the mortality rate of the disease in Reunion Island was 0%. This may be due to the care bundle used in our hospital (early hospitalisation, treatment with hydroxychloroquine/azithromycin and/or corticosteroids, non-invasive respiratory support, etc).

Antibiotics Prescribing in Intensive Care Settings during the COVID-19 Era: A Systematic Review

“…The remaining studies were from Brazil, Oman, Congo, Turkey, UK, Colombia, Kosovo, and Indonesia. Detailed data on the characteristics of the conclusive studies are given in Table S1 [ 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 ].…”

“…Nevertheless, more detailed evaluations are needed mainly for associated adverse events such as antimicrobial-induced acute kidney injuries in critical care settings [ 61 ]. Moreover, there is a difference in reporting mortality rates from previously reviewed studies covering a wide range between 0% and 100% of the ICU patients [ 28 , 34 , 45 ] (see Table S1 ). This mortality rate variation appeared to be affected by various clinical and social factors, such as age, comorbidities, regional COVID-19 pandemic situation, and timely access to optimal healthcare [ 20 ].…”

A critical review on environmental presence of pharmaceutical drugs tested for the covid-19 treatment

“…AZT is being clinically tested to treat the coronavirus disease, alone or in combination with other drugs, such as HCQ ( Arshad et al, 2020 ; Dubernet et al, 2020 ; Fiolet et al, 2019 ; Gautret et al, 2020a ; Mori et al, 2020 ). However, its effectiveness in the treatment of COVID-19 is still uncertain and its use is viewed with caution by the scientific community, since the drug has potential side effects and the evidence on its safe use is still controversial ( Furtado et al, 2020 ; Molina et al, 2020 ; Pani et al, 2020 ).…”

“…To date, there are no exact specific antiviral treatments or vaccines for the COVID-19 disease (M. Kumar et al, 2020a , 2020b ). Therefore, to treat or alleviate its symptoms, some drugs are being clinically evaluated, including chloroquine (CQ) and hydroxychloroquine (HCQ) ( Borba et al, 2020 ; Gao et al, 2020 ; Magagnoli et al, 2020 ; Tang et al, 2020 ), azithromycin (AZT) ( Arshad et al, 2020 ; Dubernet et al, 2020 ), ivermectin (IVM) ( Caly et al, 2020 ; Yang et al, 2020 ), dexamethasone (DEX) ( Hassan et al, 2020 ; Johnson and Vinetz, 2020 ; Lester et al, 2020 ; Selvaraj, 2020 ) and some HIV antivirals ( Agrawal et al, 2020 ; Alvi et al, 2020 ).…”

Assessment of mortality from COVID-19 in a multicultural multi-ethnic patient population

“…The design comprised a retrospective observational study of patients who tested positive for SARS-CoV-2 virus strain [16]. The retrospective nature of the study restricted the involvement of patients or the public in the design.…”