期刊
REVIEWS IN CARDIOVASCULAR MEDICINE
卷 22, 期 3, 页码 1063-1072出版社
IMR PRESS
DOI: 10.31083/j.rcm2203116
关键词
SARS-CoV-2; COVID-19; Hydroxychloroquine; Azithromycin; Ambulatory; Out-patients; Treatment
资金
- ANR Investissements d'avenir, Mediterranee infection [10IAHU-03]
- Region Provence-AlpesCote d'Azur
- Mediterranean Infection Foundation
- [ANR-15-CE36-0004-01]
The study evaluated the age-specific mortality of adult outpatients infected with SARS-CoV-2 early treated in a dedicated COVID-19 day hospital, and found that the use of HCQ+AZ was associated with improved survival. Older age and male sex were identified as risk factors for death, ICU transfer, and hospitalization. The meta-analysis showed that early ambulatory treatment with HCQ+AZ is associated with very low mortality and better survival compared to other regimens.
We evaluated the age-specific mortality of unselected adult outpatients infected with SARS-CoV-2 treated early in a dedicated COVID-19 day hospital and we assessed whether the use of hydroxychloroquine (HCQ) + azithromycin (AZ) was associated with improved survival in this cohort. A retrospective monocentric cohort study was conducted in the day hospital of our center from March to December 2020 in adults with PCR-proven infection who were treated as outpatients with a standardized protocol. The primary endpoint was 6-week mortality, and secondary endpoints were transfer to the intensive care unit and hospitalization rate. Among 10,429 patients (median age, 45 [IQR 32-57] years; 5597 [53.7%] women), 16 died (0.15%). The infection fatality rate was 0.06% among the 8315 patients treated with HCQ+AZ. No deaths occurred among the 8414 patients younger than 60 years. Older age and male sex were associated with a higher risk of death, ICU transfer, and hospitalization. Treatment with HCQ+AZ (0.17 [0.06-0.48]) was associated with a lower risk of death, independently of age, sex and epidemic period. Meta-analysis evidenced consistency with 4 previous outpatient studies (32,124 patients-Odds ratio 0.31 [0.20-0.47], I-2 = 0%). Early ambulatory treatment of COVID-19 with HCQ+AZ as a standard of care is associated with very low mortality, and HCQ+AZ improve COVID-19 survival compared to other regimens.
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