Adjunctive therapy with azithromycin for moderate and severe acute respiratory distress syndrome: a retrospective, propensity score-matching analysis of prospectively collected data at a single center

Kawamura, Kodai; Ichikado, Kazuya; Takaki, Makoto; Eguchi, Yoshitomo; Anan, Keisuke; Suga, Moritaka

doi:10.1016/j.ijantimicag.2018.02.009

Cited by 55 publications

(51 citation statements)

References 27 publications

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“…Azithromycin polarizes macrophages towards an anti-inflammatory M2 phenotype, and inhibits pro-inflammatory STAT1 and NFκB signaling pathways [139,140]. In the context of anti-inflammatory effects, it is of particular interest that azithromycin is used in patients requiring intensive care for non-COVID-19 related ARDS and is associated with a significant reduction in mortality and shorter time to extubation [141][142][143].…”

Section: Azithromycinmentioning

confidence: 99%

COVID-19: Immunology and treatment options

Felsenstein

Herbert

McNamara

et al. 2020

Clinical Immunology

583

618

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The novel coronavirus SARS-CoV2 causes COVID-19, a pandemic threatening millions. As protective immunity does not exist in humans and the virus is capable of escaping innate immune responses, it can proliferate, unhindered, in primarily infected tissues. Subsequent cell death results in the release of virus particles and intracellular components to the extracellular space, which result in immune cell recruitment, the generation of immune complexes and associated damage. Infection of monocytes/macrophages and/or recruitment of uninfected immune cells can result in massive inflammatory responses later in the disease. Uncontrolled production of pro-inflammatory mediators contributes to ARDS and cytokine storm syndrome. Antiviral agents and immune modulating treatments are currently being trialled. Understanding immune evasion strategies of SARS-CoV2 and the resulting delayed massive immune response will result in the identification of biomarkers that predict outcomes as well as phenotype and disease stage specific treatments that will likely include both antiviral and immune modulating agents.

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Section: Azithromycinmentioning

confidence: 99%

COVID-19: Immunology and treatment options

Felsenstein

Herbert

McNamara

et al. 2020

Clinical Immunology

583

618

View full text Add to dashboard Cite

show abstract

“…Azithromycin, a macrolide antibiotic, has long been touted for its anti-inflammatory effect and has been used as adjunctive therapy in treatment of community acquired pneumonia and chronic obstructive pulmonary disease exacerbations (147). Limited data suggest that adjunctive azithromycin in moderate-severe ARDS is associated with improved outcomes (148). A small non-randomized study showed that combination azithromycin and hydroxychloroquine was associated with more effective SARS-CoV2 clearance in COVID-19 patients compared with either monotherapy with hydroxychloroquine or standard of care; however, numerous limitations of this study render the data uninterpretable (140).…”

Section: Azithromycinmentioning

confidence: 99%

COVID-19 for the Cardiologist

Atri

Siddiqi

Lang

et al. 2020

JACC: Basic to Translational Science

270

137

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Highlights-Severe acute respiratory virus-2 (SARS-CoV2), the infection responsible for coronavirus disease-2019 (COVID-19), has spread globally leading to a devastating loss of life. In a few short months, the clinical and scientific communities have rallied to rapidly evolve our understanding of the mechanism(s) of disease and potential therapeutics. -This review discusses the current understanding of the basis virology of SARS-CoV2 and the epidemiology, clinical manifestations, including cardiovascular, and mortality of COVID-19. A detailed review of the viral life cycle and putative mechanism(s) of injury frames the discussion of possible preventative and therapeutic strategies. -The ongoing, unprecedented collective effort will, without a doubt, advance our ability to prevent the spread and optimally care for patients suffering from COVID-19. SummaryThe coronavirus disease-2019 (COVID-19), a contagious disease caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV2), has reached pandemic status. As it spreads across the world, it has overwhelmed healthcare systems, strangled the global economy and led to a devastating loss of life. Widespread efforts from regulators, clinicians and scientists are driving a rapid expansion of knowledge of the SARS-CoV2 virus and the COVID-19 disease.We review the most current data with a focus on our basic understanding of the mechanism(s) of disease and translation to the clinical syndrome and potential therapeutics. We discuss the basic virology, epidemiology, clinical manifestation, multi-organ consequences, and outcomes. With a focus on cardiovascular complications, we propose several mechanisms of injury. The virology and potential mechanism of injury form the basis for a discussion of potential disease-modifying therapies.

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“…clini caltr ials.gov). Azithromycin is a macrolide antibiotic that may be able to suppress inflammation [78] and be effective as adjunctive therapy in ARDS [79]. It is now being studied as an adjunctive treatment for patients with COVID-19, with apparently positive results, but validation in randomized trials is needed [60,61].…”

Section: Treatments For Sars-cov-2 and Nmd Diseasesmentioning

confidence: 99%

Management of patients with neuromuscular disorders at the time of the SARS-CoV-2 pandemic

et al. 2020

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The novel Coronavirus disease-19 (COVID-19) pandemic has posed several challenges for neuromuscular disorder (NMD) patients. The risk of a severe course of SARS-CoV-2 infection is increased in all but the mildest forms of NMDs. High-risk conditions include reduced airway clearance due to oropharyngeal weakness and risk of worsening with fever, fasting or infection Isolation requirements may have an impact on treatment regimens administered in hospital settings, such as nusinersen, glucosidase alfa, intravenous immunoglobulin, and rituximab infusions. In addition, specific drugs for SARS-CoV2 infection under investigation impair neuromuscular function significantly; chloroquine and azithromycin are not recommended in myasthenia gravis without available ventilatory support and prolonged prone positioning may influence options for treatment. Other therapeutics may affect specific NMDs (metabolic, mitochondrial, myotonic diseases) and experimental approaches for Coronavirus disease 2019 may be offered "compassionately" only after consulting the patient's NMD specialist. In parallel, the reorganization of hospital and outpatient services may change the management of non-infected NMD patients and their caregivers, favouring at-distance approaches. However, the literature on the validation of telehealth in this subgroup of patients is scant. Thus, as the first wave of the pandemic is progressing, clinicians and researchers should address these crucial open issues to ensure adequate caring for NMD patients. This manuscript summarizes available evidence so far and provides guidance for both general neurologists and NMD specialists dealing with NMD patients in the time of COVID-19.

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Adjunctive therapy with azithromycin for moderate and severe acute respiratory distress syndrome: a retrospective, propensity score-matching analysis of prospectively collected data at a single center

Cited by 55 publications

References 27 publications

COVID-19: Immunology and treatment options

COVID-19: Immunology and treatment options

COVID-19 for the Cardiologist

Management of patients with neuromuscular disorders at the time of the SARS-CoV-2 pandemic

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