%0 Journal Article %1 davido2020impact %A Davido, Benjamin %A Boussaid, Ghilas %A Vaugier, Isabelle %A Lansaman, Thibaud %A Bouchand, Frédérique %A Lawrence, Christine %A Alvarez, Jean-Claude %A Moine, Pierre %A Perronne, Véronique %A Barbot, Frédéric %A Saleh-Mghir, Azzam %A Perronne, Christian %A Annane, Djillali %A De Truchis, Pierre %D 2020 %J International Journal of Antimicrobial Agents %K (h)cq azm covid-19 peronne %P 106129 %R https://doi.org/10.1016/j.ijantimicag.2020.106129 %T Impact of medical care including anti-infective agents use on the prognosis of COVID-19 hospitalized patients over time %U http://www.sciencedirect.com/science/article/pii/S0924857920303125 %X Introduction Interest of anti-infective agents in COVD-19 showed discrepant results. However, there is no evaluation about the impact in changes of practices on the prognosis over time. Methods Single center, retrospective study, conducted from March 5th to April 25th 2020, in adults hospitalized in a medicine ward for a COVID-19. Patient characteristics were compared between 2 periods (before/after March 19th) considering French guidelines issued by learned societies. Aim of the study was to evaluate how medical care impacted unfavorable outcome, namely admission in intensive care unit (ICU) and/or death. Results One hundred thirty-two patients were admitted, mean age was 59.0 ± 16.3 years, mean CRP level was 84.0±71.1 mg/L, 46% had a lymphocyte count<1000/mm3. When prescribed, anti-infective agents were lopinavir-ritonavir (n=12), azithromycin (AZI) (n=28) and AZI combined with hydroxychloroquine (HCQ) (n=52). Between the 2 periods we noted a significant decrease of ICU admission, from 43% to 12% (p<0.0001). Delays until transfer in ICU were similar between periods (p=0.86). Pulmonary CT-scan were significantly more performed (from 50% to 90%, p<0.0001), as oxygen-dependency (53% vs 80%, p=0.001) and prescription of AZI±HCQ (from 25% to 76%, p<0.0001) were greater over time. Multivariate analyses showed a reduction of unfavorable outcome in patients receiving AZI±HCQ (HR=0.45, 95%IC 0.21-0.97, p=0.04), especially among an identified category of individuals (lymphocyte≥1000/mm3 or CRP≥100 mg/L). Conclusion The present study revealed a significant decrease of admission in ICU over time probably related to multiple factors, including a better indication of pulmonary CT-scan, of oxygen therapy, and a suitable prescription of anti-infective agents.

@article{davido2020impact, abstract = {Introduction Interest of anti-infective agents in COVD-19 showed discrepant results. However, there is no evaluation about the impact in changes of practices on the prognosis over time. Methods Single center, retrospective study, conducted from March 5th to April 25th 2020, in adults hospitalized in a medicine ward for a COVID-19. Patient characteristics were compared between 2 periods (before/after March 19th) considering French guidelines issued by learned societies. Aim of the study was to evaluate how medical care impacted unfavorable outcome, namely admission in intensive care unit (ICU) and/or death. Results One hundred thirty-two patients were admitted, mean age was 59.0 ± 16.3 years, mean CRP level was 84.0±71.1 mg/L, 46% had a lymphocyte count<1000/mm3. When prescribed, anti-infective agents were lopinavir-ritonavir (n=12), azithromycin (AZI) (n=28) and AZI combined with hydroxychloroquine (HCQ) (n=52). Between the 2 periods we noted a significant decrease of ICU admission, from 43% to 12% (p<0.0001). Delays until transfer in ICU were similar between periods (p=0.86). Pulmonary CT-scan were significantly more performed (from 50% to 90%, p<0.0001), as oxygen-dependency (53% vs 80%, p=0.001) and prescription of AZI±HCQ (from 25% to 76%, p<0.0001) were greater over time. Multivariate analyses showed a reduction of unfavorable outcome in patients receiving AZI±HCQ (HR=0.45, 95%IC [0.21-0.97], p=0.04), especially among an identified category of individuals (lymphocyte≥1000/mm3 or CRP≥100 mg/L). Conclusion The present study revealed a significant decrease of admission in ICU over time probably related to multiple factors, including a better indication of pulmonary CT-scan, of oxygen therapy, and a suitable prescription of anti-infective agents.}, added-at = {2020-08-08T19:04:51.000+0200}, author = {Davido, Benjamin and Boussaid, Ghilas and Vaugier, Isabelle and Lansaman, Thibaud and Bouchand, Frédérique and Lawrence, Christine and Alvarez, Jean-Claude and Moine, Pierre and Perronne, Véronique and Barbot, Frédéric and Saleh-Mghir, Azzam and Perronne, Christian and Annane, Djillali and {De Truchis}, Pierre}, biburl = {https://www.bibsonomy.org/bibtex/2c76c2270d2e1823164c3d1ea67465624/fordham1}, description = {nImpact of medical care including anti-infective agents use on the prognosis of COVID-19 hospitalized patients over time - ScienceDirect}, doi = {https://doi.org/10.1016/j.ijantimicag.2020.106129}, interhash = {cf6e718e5f541eea567cc8f8820e052f}, intrahash = {c76c2270d2e1823164c3d1ea67465624}, issn = {0924-8579}, journal = {International Journal of Antimicrobial Agents}, keywords = {(h)cq azm covid-19 peronne}, pages = 106129, timestamp = {2020-08-08T19:04:51.000+0200}, title = {Impact of medical care including anti-infective agents use on the prognosis of COVID-19 hospitalized patients over time}, url = {http://www.sciencedirect.com/science/article/pii/S0924857920303125}, year = 2020 }