Background : Previous studies ruled out the benefits of azithromycin for COVID-19 treatment in hospitalized patients. However, the effects of azithromycin for treatment of SARS-CoV-2 positive patients in the community is still a matter of debate. This study aimed at assessing whether azithromycin is associated with a reduced risk of hospitalization, in-hospital COVID-19 outcomes, and death when used in subjects after positive testing for SARS-CoV-2. Methods : Two study cohorts were selected: cohort A, SARS-CoV-2 subjects tested positive between 20/02/2020 and 10/12/2020; cohort B, subjects infected with SARS-CoV-2 and hospitalized between 20/02/2020 and 31/12/2020. We compared the risk of hospitalization, intensive care unit (ICU) access, need of mechanical ventilation (MV), and death in azithromycin users vs. nonusers. A clustered Fine-Gray analysis was employed to assess the risk of hospitalization; logistic and Cox regressions were performed to assess the risk of ICU access, MV and death. Results : In cohort A, among 4,861 azithromycin users and 4,861 propensity-matched nonusers, azithromycin was associated with higher risk of hospitalization (Hazard-Ratio [HR]:1∙59; 95%CI:1∙45-1∙75) compared to non-use. In cohort B, among 997 subjects selected in both groups, azithromycin use was not significantly associated with ICU access (Odds-Ratio [OR]:1∙22; 0∙93-1∙56), MV (OR:1∙30; 0∙99-1∙70), 14-day (HR:0∙88; 0∙74-1∙05) and 30-day mortality (HR:0∙89; 0∙77-1∙03). Conclusion : Our findings confirm the lack of benefits of azithromycin treatment among community patients infected with SARS-CoV-2, thus raising concern on potential risks associated with its inappropriate use.

Antonazzo, I., Fornari, C., Rozza, D., Conti, S., Pasquale, R., Cortesi, P., et al. (2022). Azithromycin use and outcomes in COVID-19 patients: an observational real-world study. INTERNATIONAL JOURNAL OF INFECTIOUS DISEASES [10.1016/j.ijid.2022.09.005].

Azithromycin use and outcomes in COVID-19 patients: an observational real-world study

Antonazzo, Ippazio Cosimo;Fornari, Carla;Rozza, Davide
;
Conti, Sara;Pasquale, Raffaella di;Cortesi, Paolo;Kaleci, Shaniko;Ferrara, Pietro;Silenzi, Andrea;Cesana, Giancarlo;Mantovani, Lorenzo Giovanni;Mazzaglia, Giampiero
2022

Abstract

Background : Previous studies ruled out the benefits of azithromycin for COVID-19 treatment in hospitalized patients. However, the effects of azithromycin for treatment of SARS-CoV-2 positive patients in the community is still a matter of debate. This study aimed at assessing whether azithromycin is associated with a reduced risk of hospitalization, in-hospital COVID-19 outcomes, and death when used in subjects after positive testing for SARS-CoV-2. Methods : Two study cohorts were selected: cohort A, SARS-CoV-2 subjects tested positive between 20/02/2020 and 10/12/2020; cohort B, subjects infected with SARS-CoV-2 and hospitalized between 20/02/2020 and 31/12/2020. We compared the risk of hospitalization, intensive care unit (ICU) access, need of mechanical ventilation (MV), and death in azithromycin users vs. nonusers. A clustered Fine-Gray analysis was employed to assess the risk of hospitalization; logistic and Cox regressions were performed to assess the risk of ICU access, MV and death. Results : In cohort A, among 4,861 azithromycin users and 4,861 propensity-matched nonusers, azithromycin was associated with higher risk of hospitalization (Hazard-Ratio [HR]:1∙59; 95%CI:1∙45-1∙75) compared to non-use. In cohort B, among 997 subjects selected in both groups, azithromycin use was not significantly associated with ICU access (Odds-Ratio [OR]:1∙22; 0∙93-1∙56), MV (OR:1∙30; 0∙99-1∙70), 14-day (HR:0∙88; 0∙74-1∙05) and 30-day mortality (HR:0∙89; 0∙77-1∙03). Conclusion : Our findings confirm the lack of benefits of azithromycin treatment among community patients infected with SARS-CoV-2, thus raising concern on potential risks associated with its inappropriate use.
No
Articolo in rivista - Articolo scientifico
Scientifica
Azithromycin; COVID-19; Hospitalization; ICU access; Mechanical ventilation; mortality; Italy
English
Antonazzo, I., Fornari, C., Rozza, D., Conti, S., Pasquale, R., Cortesi, P., et al. (2022). Azithromycin use and outcomes in COVID-19 patients: an observational real-world study. INTERNATIONAL JOURNAL OF INFECTIOUS DISEASES [10.1016/j.ijid.2022.09.005].
Antonazzo, I; Fornari, C; Rozza, D; Conti, S; Pasquale, R; Cortesi, P; Kaleci, S; Ferrara, P; Zucchi, A; Maifredi, G; Silenzi, A; Cesana, G; Mantovani, L; Mazzaglia, G
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/10281/392090
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