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Acta Médica Peruana
On-line version ISSN 1728-5917
Abstract
FERNANDEZ MERJILDO, Diana; LEVANO DIAZ, Lady and ZEGARRA PIEROLA, Jaime. Mortality with hydroxichloroquine and azythromycin use in COVID-19 patients undergoing mechanical ventilation in an intensive care unit in Lima. Acta méd. Peru [online]. 2021, vol.38, n.3, pp.163-168. ISSN 1728-5917. http://dx.doi.org/10.35663/amp.2021.383.2165.
Objective
: To estimate mortality rates associated with hydroxichloroquine and azithromycin use in Covid-19 patients undergoing mechanical ventilation in an intensive care unit in Lima.
Material and methods
: This is a retrospective analytical cohort. One hundred and five patients with Covid-19 undergoing invasive mechanical ventilation who were admitted with a diagnosis of acute respiratory insufficiency to the intensive care unit of Cayetano Heredia Hospital in Lima during 2020.
Results
: The overall mortality rate was 38%. Most patients (79%) were male, their mean age was 50 ± 13 years, two thirds (65%) did not have comorbidities; APACHE II and SOFA scores were 12 ± 6 points and 5 ± 3 points, respectively. Thirty percent of all patients received hydroxichloroquine, 32% received azithromycin, and 32% received both drugs. Mortality was significantly higher in those patients who received hydroxichloroquine (p= 0.001), azithromycin (p= 0.03), and the combination of hydroxichloroquine and azithromycin (p= 0.001). However, when a Cox regression analysis was performed, it was evidenced that deceased patients were more likely to have been exposed to hydroxichloroquine (p= 0.001) (HR: 21, CI: 3.4-131.3), but this was not the case with azithromycin (p= 0.22) (HR: 0.43, CI: 0.11-1.6).
Conclusion
: Mortality in Covid-19 patients undergoing invasive mechanical ventilation was higher in those who received hydroxichloroquine.
Keywords : Mortality; Covid-19; Mechanical ventilation; Hydroxichloroquine; Azithromycin.