The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has led to widespread use of hydroxychloroquine and azithromycin despite the lack of conclusive evidence for their safety and efficacy. We evaluated the association between treatment with hydroxychloroquine and/or azithromycin and hospital mortality as the primary outcome. We compared the hospital mortality of patients treated with hydroxychloroquine alone, azithromycin alone, or their combination to the mortality of patients who received neither drug. A logistic multivariate model with overlap weight propensity score was used for estimation of odds ratios (ORs) with 95% confidence intervals (95% CIs). One thousand four hundred and three patients with SARS-CoV-2 infection were admitted to the hospital. At the time of the analysis, the outcome was available for 1376 (98%) of them. Five hundred and eighty-seven patients (42%) received azithromycin and 377 patients (27%) received hydroxychloroquine, alone or in combination. In-hospital mortality was 26%. After the adjusted analysis, azithromycin alone was associated with lower mortality (OR 0.60, 95% CI 0.42–0.85) compared to no treatment. Hydroxychloroquine alone (OR 0.76, 95% CI 0.53–1.08) and the combination of azithromycin and hydroxychloroquine (OR 1.13, 95% CI 0.77–1.69) were not associated with hospital mortality. In this cohort of patients, azithromycin alone was associated with lower hospital mortality but hydroxychloroquine was not associated with increased or reduced mortality. While we await randomized clinical trials, these data support the use of azithromycin in novel coronavirus disease 2019 (COVID-19) and can contribute to better understanding of its role in further meta-analyses.

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Aim: To determine the depression in primary caregivers of patients of psychoactive substance use. Study design: Descriptive cross-sectional Place and duration of study: Department of Psychiatry, Jinnah Medical College Hospital Peshawar from 1st June 2020 to 31st December 2020. Methodology: One hundred and twenty patients of both genders were enrolled. Patients detailed demographics age, sex and body mass index were recorded after taking informed written consent. Patients were aged between 18-70 years of age. Depression and anxiety were calculated in primary caregivers of patients of psychoactive substance use. Results: Seventy (58.3%) patients were males and 50 (41.7%) patients were females. Mean age of the patients were 33.12±7.15 years with mean body mass index 25.08 ± 16.5 kg/m2. Psychoactive substance use resulted high level of depression and anxiety among the patients. 15 (12.5%) patients had mild, 30 (25%) showed moderate and 75 (62.5%) patients showed severe depression. Anxiety among patients was 12 (10%) mild, 26 (21.7%) moderate and 82 (68.3%) patients had severe. 30(25%) were illiterate and 90 (75%) were literate. Conclusion: The caregivers of patients of psychoactive substance use had severity of depression with negative intimation among the cases. In patients with substance use disorders, depression and anxiety are usually found. The development of anxiety and depression on the one hand is obviously associated with the seriousness of medication-related issues on the other side. Keywords: Anxiety, Depression, Substance use, Caregivers.