Bibliographic Details
| Title: |
Early Start of Oral Clarithromycin Is Associated with Better Outcome in COVID-19 of Moderate Severity: The ACHIEVE Open-Label Single-Arm Trial. |
| Authors: |
Tsiakos, Konstantinos, Tsakiris, Antonios, Tsibris, Georgios, Voutsinas, Pantazis-Michael, Panagopoulos, Periklis, Kosmidou, Maria, Petrakis, Vasileios, Gravvani, Areti, Gkavogianni, Theologia, Klouras, Eleftherios, Katrini, Konstantina, Koufargyris, Panagiotis, Rapti, Iro, Karageorgos, Athanassios, Vrentzos, Emmanouil, Damoulari, Christina, Zarkada, Vagia, Sidiropoulou, Chrysanthi, Artemi, Sofia, Ioannidis, Anastasios |
| Source: |
Infectious Diseases & Therapy; Dec2021, Vol. 10 Issue 4, p2333-2351, 19p |
| Subject Terms: |
COVID-19, RESPIRATORY infections, CLARITHROMYCIN, VIRAL load |
| Abstract: |
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 [ABSTRACT FROM AUTHOR] |
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| Database: |
Complementary Index |
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