Hydroxychloroquine plus azithromycin and early hospital admission are beneficial in COVID-19 patients: Turkish experience with real-life data

Abstract

Background/aim New treatment regimens for COVID-19, which has threatened the world recently, continue to be investigated. Although some of the treatments are promising, it is thought to be early to state that there is definitive treatment. Experiences and treatment protocol studies from treatment centers are still important. The aim of this study is to evaluate factors affecting the treatment process of the first cases followed in our clinic. Materials and methods The consecutive hospitalized patients with COVID-19 pneumonia were analyzed in this retrospective and cross-sectional study. Data were recorded from the electronic and written files of patients. Results Eighty-three patients were evaluated. The median age was 50 ± 15 years. Forty-eight (57.8%) patients had one or more comorbidities. The most common comorbidity was hypertension. The most common symptom was cough in 58 patients (70%). The overall mortality was 15%, and 85% of the patients were discharged. The time between the onset of symptoms and hospitalization was statistically significantly longer in deceased patients (P = 0.039). Age, D-Dimer, troponin, CK, CK-MB, ferritin, procalcitonin, and neutrophil to lymphocyte ratio were statistically significantly higher in deceased patients than survivor patients. In subgroup analysis, in the patients receiving azithromycin plus hydroxychloroquine and other antibiotics plus hydroxychloroquine, the duration of hospitalization was shorter in the azithromycin group (P = 0.027). Conclusion Early treatment and early admission to the hospital can be crucial for the better treatment process. Combination therapy with azithromycin may be preferred in the first treatment choice because it can shorten the length of hospital stay.

Assessing the Elevation of Cardiac Biomarkers and the Severity of COVID-19 Infection: A Meta-analysis

“…Four studies did not find significant association between the infection severity and the patients' comorbidities (30)(31)(32)(33). Tanriverdi et al study only found the overall significant association of all comorbidities combined with the infection severity (27). The most common initial symptoms reported were high fever, dry cough, and dyspnea.…”

“…Various comorbidities were assessed and compared between two groups, except Medetalibeyoglu et al and Zheng et al studies which did not assess comorbidities of the subjects (12,13). The comorbidities that were more significantly common in the severe groups included cardiovascular diseases (i.e., coronary artery disease, heart failure) in ten studies (14-24), hypertension in nine studies (14, 16-19, 21, 22, 24, 25), chronic respiratory diseases in nine studies (17,19,20,(23)(24)(25)(26)(27)(28), diabetes mellitus in seven studies (11,16,18,21,22,25,29), cerebrovascular diseases in five studies (15,16,18,21,24), chronic kidney disease in four studies (18,(22)(23)(24), cancer in one study (25), and immunosuppression in one study (17). Four studies did not find significant association between the infection severity and the patients' comorbidities (30)(31)(32)(33).…”

Efficacy and Safety of Azithromycin for the Treatment of COVID-19: A Systematic Review and Meta-analysis

“…The included studies were conducted in various regions, such as American, 11,13,14,17,[22][23][24] European, 10,12,15,16,20,21 and Middle East countries. 18,19,25,26 All of the studies recruited adults with age ranging from 45-83 years old. Included patients also revealed common underlying conditions, such as hypertension, diabetes mellitus, chronic obstructive pulmonary disease and cardiovascular disease.…”

“…9 Yet, several clinical trials have shown conflicting results and it is not clear whether the available evidence is in favour or against the use of Azithromycin in COVID-19 patients. [10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26] Therefore, we design a systematic review of existing clinical studies and perform a meta-analysis to further investigate and measure the efficacy and safety of Azithromycin in COVID-19 patients.…”

Hydroxychloroquine versus hydroxychloroquine-azithromycin combination therapy on QT interval prolongation of COVID-19 patients: a systematic review and meta-analysis

“…3 Although several researches have been conducted to investigate the usage of hydroxychloroquine in decreasing the mortality rate, there are still arguments in its result. 6 A study conducted in Turkey showed that combining hydroxychloroquine with azithromycin could increase its effectiveness and decrease patients' length of stay in hospital. 6 Azithromycin, a macrolide antibiotic, has in vitro antiviral properties such as decreasing viral replication, blocking entrance into host cells, and a potential immunomodulating effect.…”