Therapeutic efficacy of macrolides in management of patients with mild COVID-19

Abstract Evidence on the efficacy of adding macrolides (azithromycin or clarithromycin) to the treatment regimen for COVID-19 is limited. We testify whether adding azithromycin or clarithromycin to a standard of care regimen was superior to standard of supportive care alone in patients with mild COV...

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Autores principales:	Alaa Rashad, Asmaa Nafady, Mohammed H. Hassan, Haggagy Mansour, Usama Taya, Shamardan Ezzeldin S. Bazeed, Zaki F. Aref, Mennatallah Ali Abdelrhman Sayed, Hanaa Nafady-Hego, Aida A. Abdelmaksoud
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/3ec6355f17034a7da6b25ea25f3716d9
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spelling	oai:doaj.org-article:3ec6355f17034a7da6b25ea25f3716d92021-12-02T16:28:50ZTherapeutic efficacy of macrolides in management of patients with mild COVID-1910.1038/s41598-021-95900-z2045-2322https://doaj.org/article/3ec6355f17034a7da6b25ea25f3716d92021-08-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-95900-zhttps://doaj.org/toc/2045-2322Abstract Evidence on the efficacy of adding macrolides (azithromycin or clarithromycin) to the treatment regimen for COVID-19 is limited. We testify whether adding azithromycin or clarithromycin to a standard of care regimen was superior to standard of supportive care alone in patients with mild COVID-19.This randomized trial included three groups of patients with COVID-19. The azithromycin group included, 107 patients who received azithromycin 500 mg/24 h for 7 days, the clarithromycin group included 99 patients who received clarithromycin 500 /12 h for 7 days, and the control group included 99 patients who received standard care only. All three groups received only symptomatic treatment for control of fever and cough .Clinical and biochemical evaluations of the study participants including assessment of the symptoms duration, real-time reverse transcription-polymerase chain reaction (rRT-PCR), C-reactive protein (CRP), serum ferritin, D-dimer, complete blood count (CBC), in addition to non-contrast chest computed tomography (CT), were performed. The overall results revealed significant early improvement of symptoms (fever, dyspnea and cough) in patients treated with either azithromycin or clarithromycin compared to control group, also there was significant early conversion of SARS-CoV-2 PCR to negative in patients treated with either azithromycin or clarithromycin compared to control group (p < 0.05 for all).There was no significant difference in time to improvement of fever, cough, dyspnea, anosmia, gastrointestinal tract "GIT" symptoms and time to PCR negative conversion between patients treated with azithromycin compared to patients treated with clarithromycin (p > 0.05 for all). Follow up chest CT done after 2 weeks of start of treatment showed significant improvement in patients treated with either azithromycin or clarithromycin compared to control group (p < 0.05 for all).Adding Clarithromycin or azithromycin to the therapeutic protocols for COVID-19 could be beneficial for early control of fever and early PCR negative conversion in Mild COVID-19. Trial registration: (NCT04622891) www.ClinicalTrials.gov retrospectively registered (November 10, 2020).Alaa RashadAsmaa NafadyMohammed H. HassanHaggagy MansourUsama TayaShamardan Ezzeldin S. BazeedZaki F. ArefMennatallah Ali Abdelrhman SayedHanaa Nafady-HegoAida A. AbdelmaksoudNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-7 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Alaa Rashad Asmaa Nafady Mohammed H. Hassan Haggagy Mansour Usama Taya Shamardan Ezzeldin S. Bazeed Zaki F. Aref Mennatallah Ali Abdelrhman Sayed Hanaa Nafady-Hego Aida A. Abdelmaksoud Therapeutic efficacy of macrolides in management of patients with mild COVID-19
description	Abstract Evidence on the efficacy of adding macrolides (azithromycin or clarithromycin) to the treatment regimen for COVID-19 is limited. We testify whether adding azithromycin or clarithromycin to a standard of care regimen was superior to standard of supportive care alone in patients with mild COVID-19.This randomized trial included three groups of patients with COVID-19. The azithromycin group included, 107 patients who received azithromycin 500 mg/24 h for 7 days, the clarithromycin group included 99 patients who received clarithromycin 500 /12 h for 7 days, and the control group included 99 patients who received standard care only. All three groups received only symptomatic treatment for control of fever and cough .Clinical and biochemical evaluations of the study participants including assessment of the symptoms duration, real-time reverse transcription-polymerase chain reaction (rRT-PCR), C-reactive protein (CRP), serum ferritin, D-dimer, complete blood count (CBC), in addition to non-contrast chest computed tomography (CT), were performed. The overall results revealed significant early improvement of symptoms (fever, dyspnea and cough) in patients treated with either azithromycin or clarithromycin compared to control group, also there was significant early conversion of SARS-CoV-2 PCR to negative in patients treated with either azithromycin or clarithromycin compared to control group (p < 0.05 for all).There was no significant difference in time to improvement of fever, cough, dyspnea, anosmia, gastrointestinal tract "GIT" symptoms and time to PCR negative conversion between patients treated with azithromycin compared to patients treated with clarithromycin (p > 0.05 for all). Follow up chest CT done after 2 weeks of start of treatment showed significant improvement in patients treated with either azithromycin or clarithromycin compared to control group (p < 0.05 for all).Adding Clarithromycin or azithromycin to the therapeutic protocols for COVID-19 could be beneficial for early control of fever and early PCR negative conversion in Mild COVID-19. Trial registration: (NCT04622891) www.ClinicalTrials.gov retrospectively registered (November 10, 2020).
format	article
author	Alaa Rashad Asmaa Nafady Mohammed H. Hassan Haggagy Mansour Usama Taya Shamardan Ezzeldin S. Bazeed Zaki F. Aref Mennatallah Ali Abdelrhman Sayed Hanaa Nafady-Hego Aida A. Abdelmaksoud
author_facet	Alaa Rashad Asmaa Nafady Mohammed H. Hassan Haggagy Mansour Usama Taya Shamardan Ezzeldin S. Bazeed Zaki F. Aref Mennatallah Ali Abdelrhman Sayed Hanaa Nafady-Hego Aida A. Abdelmaksoud
author_sort	Alaa Rashad
title	Therapeutic efficacy of macrolides in management of patients with mild COVID-19
title_short	Therapeutic efficacy of macrolides in management of patients with mild COVID-19
title_full	Therapeutic efficacy of macrolides in management of patients with mild COVID-19
title_fullStr	Therapeutic efficacy of macrolides in management of patients with mild COVID-19
title_full_unstemmed	Therapeutic efficacy of macrolides in management of patients with mild COVID-19
title_sort	therapeutic efficacy of macrolides in management of patients with mild covid-19
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/3ec6355f17034a7da6b25ea25f3716d9
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Therapeutic efficacy of macrolides in management of patients with mild COVID-19

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