Early Start of Oral Clarithromycin Is Associated with Better Outcome in COVID-19 of Moderate Severity: The ACHIEVE Open-Label Single-Arm Trial
| العنوان: | Early Start of Oral Clarithromycin Is Associated with Better Outcome in COVID-19 of Moderate Severity: The ACHIEVE Open-Label Single-Arm Trial |
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| المؤلفون: | Panteleimon Tsiamalos, Iro Rapti, Androniki Papapostolou, Thomas Nitsotolis, Chrysanthi Sidiropoulou, Haralampos Milionis, Konstantinos N. Syrigos, Antonios Tsakiris, Konstantina Katrini, Eleftherios Klouras, Evangelos J. Giamarellos-Bourboulis, Emmanouil Vrentzos, George Chrysos, Georgios Tsibris, Periklis Panagopoulos, Dimitra-Melia Myrodia, Vagia Zarkada, Theologia Gkavogianni, Garyphallia Poulakou, Evangelos Michelakis, Konstantinos Tsiakos, Maria Georgiopoulou, Christina Damoulari, Vasileios Petrakis, Maria Kosmidou, Sofia Artemi, Areti Gravvani, Panagiotis Koufargyris, Pantazis-Michael Voutsinas, Anastasios Ioannidis, Athanassios Karageorgos |
| المصدر: | Infectious Diseases and Therapy |
| بيانات النشر: | Springer Healthcare, 2021. |
| سنة النشر: | 2021 |
| مصطلحات موضوعية: | Microbiology (medical), medicine.medical_specialty, business.industry, COVID-19, Odds ratio, medicine.disease, Gastroenterology, Th1, Th2, Infectious Diseases, Upper respiratory tract infection, Respiratory failure, Internal medicine, Clarithromycin, Lower respiratory tract infection, medicine, Clinical endpoint, Viral load, Respiratory system, business, medicine.drug, Original Research |
| الوصف: | Introduction The anti-inflammatory effect of macrolides prompted the study of oral clarithromycin in moderate COVID-19. Methods An open-label non-randomized trial in 90 patients with COVID-19 of moderate severity was conducted between May and October 2020. The primary endpoint was defined at the end of treatment (EOT) as no need for hospital re-admission and no progression into lower respiratory tract infection (LRTI) for patients with upper respiratory tract infection and as at least 50% decrease of the respiratory symptoms score without progression into severe respiratory failure (SRF) for patients with LRTI. Viral load, biomarkers, the function of mononuclear cells and safety were assessed. Results The primary endpoint was attained in 86.7% of patients treated with clarithromycin (95% CIs 78.1–92.2%); this was 91.7% and 81.4% among patients starting clarithromycin the first 5 days from symptoms onset or later (odds ratio after multivariate analysis 6.62; p 0.030). The responses were better for patients infected by non-B1.1 variants. Clarithromycin use was associated with decreases in circulating C-reactive protein, tumour necrosis factor-alpha and interleukin (IL)-6; by increase of production of interferon-gamma and decrease of production of interleukin-6 by mononuclear cells; and by suppression of SARS-CoV-2 viral load. No safety concerns were reported. Conclusions Early clarithromycin treatment provides most of the clinical improvement in moderate COVID-19. Trial Registration ClinicalTrials.gov, NCT04398004 Supplementary Information The online version contains supplementary material available at 10.1007/s40121-021-00505-8. |
| اللغة: | English |
| تدمد: | 2193-6382 2193-8229 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::0b69d028684370e0c33c6cc98e1be123Test http://europepmc.org/articles/PMC8345236Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....0b69d028684370e0c33c6cc98e1be123 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 21936382 21938229 |
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