Viral Dynamics Matter in COVID-19 Pneumonia: the success of early treatment with hydroxychloroquine and azithromycin in Lebanon
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Abstract
Background/Purpose
We share our experience in COVID-19 pneumonia management at Saint George Hospital University Medical Center (SGHUMC) in Lebanon. In the absence of a standard of care, early diagnosis and opt-in therapy with Hydroxychloroquine and Azithromycin were offered.
Methods
We reviewed records of COVID-19 pneumonia patients from March 16-April 26 2020. Based on NEWS score, we stratified patients as A: low B: medium, and C: high clinical severity and obtained pharmacotherapy data. Chest-CT-severity-score (CTSS) was used. We defined clinical cure as resolution of symptoms and biomarkers and virologic cure as a PCR above 35 cycles(Ct).
Results
We recorded 21 COVID-19 pneumonia patients of whom 19 opted for treatment. Clinical symptoms and laboratory markers at presentation did not significantly correlate with severity. Lower initial viral load significantly correlated with lower levels of clinical and radiological severity (p=0.038). Virologic cure, Ct>35, by day 10, was only 33% in high severity significantly less than categories A and B. We observed 100% clinical cure at day 10 in Category-A, 67% in B, and 33% in C(p<0.05). Patients with the lowest severity had the fastest virologic cure in a mean of 5.8 days from diagnosis, shortest hospitalization and earlier radiological improvement(p<0.005). Ultimately, 18 patients were discharged home in good condition and one remains in the ICU.
Conclusion
Viral dynamics matter in COVID-19 pneumonia. An early control of replication may be crucial in averting complications. Early administration of Hydroxychloroquine and Azithromycin potentially explains our 94.7% success rate in treating a fairly complex cohort of COVID-19 pneumonia.
Article activity feed
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SciScore for 10.1101/2020.05.28.20114835: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Institutional Review Board Statement Consent: It is standard procedure that all patients sign a general informed consent for receiving medical acts and care. Randomization not detected. Blinding not detected. Power Analysis not detected. Sex as a biological variable not detected. Table 2: Resources
Software and Algorithms Sentences Resources We also tested for other pathogens using Biofire® FilmArray® Respiratoy 2 Panel (BioMerieux, France) following manufacturer’s instructions. 3.6. Radiologic Assessment: Non-enhanced low-dose chest CT scans were obtained in supine position on a "GE Healthcare: Discovery CT750 HD” CT scanner, dedicated for confirmed or suspected COVID-19 patients. Biofire®suggested: NoneResult…
SciScore for 10.1101/2020.05.28.20114835: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Institutional Review Board Statement Consent: It is standard procedure that all patients sign a general informed consent for receiving medical acts and care. Randomization not detected. Blinding not detected. Power Analysis not detected. Sex as a biological variable not detected. Table 2: Resources
Software and Algorithms Sentences Resources We also tested for other pathogens using Biofire® FilmArray® Respiratoy 2 Panel (BioMerieux, France) following manufacturer’s instructions. 3.6. Radiologic Assessment: Non-enhanced low-dose chest CT scans were obtained in supine position on a "GE Healthcare: Discovery CT750 HD” CT scanner, dedicated for confirmed or suspected COVID-19 patients. Biofire®suggested: NoneResults from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).
Results from LimitationRecognizer: An explicit section about the limitations of the techniques employed in this study was not found. We encourage authors to address study limitations.Results from TrialIdentifier: No clinical trial numbers were referenced.
Results from Barzooka: We did not find any issues relating to the usage of bar graphs.
Results from JetFighter: We did not find any issues relating to colormaps.
Results from rtransparent:- Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
- Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
- No protocol registration statement was detected.
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SciScore for 10.1101/2020.05.28.20114835: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Institutional Review Board Statement It is standard procedure that all patients sign a general informed consent for receiving medical acts and care. Randomization not detected. Blinding not detected. Power Analysis not detected. Sex as a biological variable Category A of low clinical severity was composed of 4 males and 6 females , with a median age of 51 [ 28;85] . Table 2: Resources
Software and Algorithms Sentences Resources We also tested for other pathogens using Biofire® FilmArray® Respiratoy 2 Panel ( BioMerieux , France ) following manufacturer’s instructions . 3.6 . Radiologic Assessment: Non-enhanced low-dose chest CT scans were obtained in supine position on a " GE Healthcare: … SciScore for 10.1101/2020.05.28.20114835: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Institutional Review Board Statement It is standard procedure that all patients sign a general informed consent for receiving medical acts and care. Randomization not detected. Blinding not detected. Power Analysis not detected. Sex as a biological variable Category A of low clinical severity was composed of 4 males and 6 females , with a median age of 51 [ 28;85] . Table 2: Resources
Software and Algorithms Sentences Resources We also tested for other pathogens using Biofire® FilmArray® Respiratoy 2 Panel ( BioMerieux , France ) following manufacturer’s instructions . 3.6 . Radiologic Assessment: Non-enhanced low-dose chest CT scans were obtained in supine position on a " GE Healthcare: Discovery CT750 HD” CT scanner , dedicated for confirmed or suspected COVID-19 patients . Biofire®suggested: NoneResults from OddPub: We did not find a statement about open data. We also did not find a statement about open code. Researchers are encouraged to share open data when possible (see Nature blog).
About SciScore
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