Hydroxychloroquine plus azithromycin and early hospital admission are beneficial in COVID-19 patients: Turkish experience with real-life data
Elif Tanriverdi, Mustafa Çörtük, Binnaz Zeynep Yildirim, Efsun Gonca Uğur Chousein, Demet Turan, Halit Çinarka, Mehmet Akif Özgül, Erdoğan Çetinkaya
TURKISH JOURNAL OF MEDICAL SCIENCES, doi:10.3906/sag-2005-82
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.
Each author has participated sufficiently in the work to take public responsibility for appropriate portions of the content.
Conflicts of interest The authors do not have any conflict of interest or financial disclosure. No funding was received for the study. The article or the content is not under consideration or has not been published by any other journal.
Ethical approval Ethics committee approval was received for this study from Hamidiye Scientific Research Ethics Committee of University of Health Sciences Turkey (2020/3/54). Consent form from patients was not received because of being a retrospective study.
References
Dai, Zhang, Xia, Zhang, Shang, High-resolution chest CT features and clinical characteristics of patients infected with COVID-19 in Jiangsu, China, International Journal of Infectious Disease,
doi:10.1016/j.ijid.2020.04.003Du, Liang, Yang, Wang, Cao, Predictors of mortality for patients with COVID-19 pneumonia caused by SARS-CoV-2: a prospective cohort study, European Respiratory Journal,
doi:10.1183/13993003.00524-2020Gautret, Lagier, Parola, Hoang, Meddeb, Clinical and microbiological effect of a combination of hydroxychloroquine and azithromycin in 80 COVID-19 patients with at least a six-day follow up: A pilot observational study, Travel Medicine and Infectious Disease,
doi:10.1016/j.tmaid.2020.101663Kim, Chin, Kang, Kim, Kang, Clinical course and outcomes of patients with severe acute respiratory syndrome coronavirus 2 infection: a preliminary report of the first 28 patients from the Korean cohort study on COVID-19, Journal of Korean Medical Science,
doi:10.3346/jkms.2020.35.e142Li, Chen, Critical patients with coronavirus disease 2019: Risk factors and outcome nomogram, The Journal of Infection,
doi:10.1016/j.jinf.2020.03.025Liu, Du, Chen, Jin, Peng, Neutrophil-tolymphocyte ratio as an independent risk factor for mortality in hospitalized patients with COVID-19, The Journal of Infection,
doi:10.1016/j.jinf.2020.04.002Megarbane, Scherrmann, Hydroxychloroquine and azithromycin to treat patients with COVID-19: both friends and foes?, Journal of Clinical Pharmacology,
doi:10.1002/jcph.1646Ministry, COVID-19 (SARS-CoV2 Infection) Guide
Molina, Delaugerre, Goff, Lima, Ponscarme, No evidence of rapid antiviral clearance or clinical benefit with the combination of hydroxychloroquine and azithromycin in patients with severe COVID-19 infection, Medecine et Maladies Infectieuses,
doi:10.1016/j.medmal.2020.03.006Yang, Yang, Wang, Wu, Xu, Thrombocytopenia and its association with mortality in patients with COVID-19, Journal of Thrombosis and Haemostasis,
doi:10.1111/jth.14848Yi, Lagniton, Ye, Li, Xu, COVID-19: what has been learned and to be learned about the novel coronavirus disease, Int J Biol Sci,
doi:10.7150/ijbs.45134Zheng, Tang, Li, Huang, Xie, Clinical characteristics of 161 cases of corona virus disease 2019 (COVID-19) in Changsha, European Review for Medical and Pharmacological Sciences,
doi:10.26355/eurrev_202003_20711{ 'indexed': {'date-parts': [[2023, 12, 4]], 'date-time': '2023-12-04T13:40:00Z', 'timestamp': 1701697200925},
'reference-count': 0,
'publisher': 'The Scientific and Technological Research Council of Turkey (TUBITAK-ULAKBIM) - DIGITAL '
'COMMONS JOURNALS',
'issue': '1',
'content-domain': {'domain': [], 'crossmark-restriction': False},
'DOI': '10.3906/sag-2005-82',
'type': 'journal-article',
'created': {'date-parts': [[2020, 7, 19]], 'date-time': '2020-07-19T07:09:42Z', 'timestamp': 1595142582000},
'page': '10-15',
'source': 'Crossref',
'is-referenced-by-count': 8,
'title': 'Hydroxychloroquine plus azithromycin and early hospital admission are beneficial in COVID-19 '
'patients: Turkish experience with real-life data',
'prefix': '10.55730',
'volume': '51',
'author': [ { 'ORCID': 'http://orcid.org/0000-0002-6049-7229',
'authenticated-orcid': False,
'given': 'Elif',
'family': 'TANRIVERDİ',
'sequence': 'first',
'affiliation': []},
{ 'ORCID': 'http://orcid.org/0000-0002-6923-736X',
'authenticated-orcid': False,
'given': 'Mustafa',
'family': 'ÇÖRTÜK',
'sequence': 'additional',
'affiliation': []},
{ 'ORCID': 'http://orcid.org/0000-0002-2228-8215',
'authenticated-orcid': False,
'given': 'Binnaz Zeynep',
'family': 'YILDIRIM',
'sequence': 'additional',
'affiliation': []},
{ 'ORCID': 'http://orcid.org/0000-0002-8029-6627',
'authenticated-orcid': False,
'given': 'Efsun Gonca',
'family': 'UĞUR CHOUSEIN',
'sequence': 'additional',
'affiliation': []},
{ 'ORCID': 'http://orcid.org/0000-0002-2401-9385',
'authenticated-orcid': False,
'given': 'Demet',
'family': 'TURAN',
'sequence': 'additional',
'affiliation': []},
{ 'ORCID': 'http://orcid.org/0000-0002-4910-149X',
'authenticated-orcid': False,
'given': 'Halit',
'family': 'ÇINARKA',
'sequence': 'additional',
'affiliation': []},
{ 'ORCID': 'http://orcid.org/0000-0003-1110-6823',
'authenticated-orcid': False,
'given': 'Mehmet Akif',
'family': 'ÖZGÜL',
'sequence': 'additional',
'affiliation': []},
{ 'ORCID': 'http://orcid.org/0000-0002-0891-0020',
'authenticated-orcid': False,
'given': 'Erdoğan',
'family': 'ÇETİNKAYA',
'sequence': 'additional',
'affiliation': []}],
'member': '34691',
'published-online': {'date-parts': [[2021, 2, 26]]},
'container-title': 'TURKISH JOURNAL OF MEDICAL SCIENCES',
'original-title': [],
'deposited': { 'date-parts': [[2022, 6, 20]],
'date-time': '2022-06-20T07:23:58Z',
'timestamp': 1655709838000},
'score': 1,
'resource': {'primary': {'URL': 'https://journals.tubitak.gov.tr/medical/vol51/iss1/2'}},
'subtitle': [],
'short-title': [],
'issued': {'date-parts': [[2021, 2, 26]]},
'references-count': 0,
'journal-issue': {'issue': '1', 'published-online': {'date-parts': [[2021, 2, 26]]}},
'URL': 'http://dx.doi.org/10.3906/sag-2005-82',
'relation': {},
'ISSN': ['1303-6165'],
'subject': [],
'container-title-short': 'Turk J Med Sci',
'published': {'date-parts': [[2021, 2, 26]]}}
