Moussa Riachy1*, Jacques Choucair2, Carine Harmouche1, Ghassan Sleilaty3, Marianne Abifadel4, Josette Najjar-Pellet4, May Fakhoury5, Georges Khayat1, Zeina Aoun-Bacha1, Georges Dabar1, Ihab Ibrahim1, Bassem Habr1, Elie Haddad2, Mouin Jammal6 and Fadi Haddad6
1Department of Pulmonary and Critical Care Medicine, Hotel Dieu de France Medical Center of the Saint-Joseph University, Lebanon 2Department of Infectious Disease, Hotel Dieu de France Medical Center of the Saint-Joseph University, Lebanon 3Department of Clinical Research, Hotel Dieu de France Medical Center of the Saint-Joseph University, Lebanon 4Rodolphe Mérieux laboratory, Faculty of Pharmacy, Saint-Joseph University, Lebanon 5Department of Pharmacy, Hotel Dieu de France Medical Center of the Saint-Joseph University, Lebanon 6Department of Clinical Immunology, Hotel Dieu de France Medical Center of the Saint-Joseph University, LebanonFulltext PDF
Objective: Outcome of a stepwise medical protocol in COVID-19 pneumonia patients admitted to hospital. Methods: A prospective cohort study was conducted between March 3rd, and April 16th, 2020 at Hotel-Dieu de France University Medical Center in Lebanon. Forty patients confirmed with COVID-19 and stratified into eight categories received a quadruple pharmacological therapy (hydroxychloroquine, azithromycin, pitavastatin, zinc). Other medications and procedures were added according to disease severity. QTc and Tisdale score were assessed at baseline and monitored regularly. Outcomes included mortality, hospital length of stay, ICU discharge, and time to negative PCR. Results: Mean age was 53•1 ± 18•3 years, and most patients (60%) were male. At database lock date, 32 (80%) patients were discharged with a median length of stay of 8 days (5; 11), five remained in isolation unit, one in ICU, and two patients were dead. Viral PCR outcome confirmed a long period of shedding (median 17 days). For ICU patients, median time from disease onset to invasive mechanical ventilation was nine days (6; 10). Length of stay was 13 days (7.2; 18•8) with prolonged need for mechanical ventilation, reaching a median of 8 days (5; 11). Conclusion: Stratifying patients at presentation and putting them early on adapted treatment was associated with favorable outcome.
Stepwise protocol; COVID-19; Pneumonia; ICU; Hydroxychloroquine; Azithromycin; Covid-19; Covid; Corona Virus; Coronavirus disease 2019
Riachy M, Choucair J, Harmouche C, Sleilaty G, Abifadel M, Najjar-Pellet J, et al. The Importance of a Stepwise Unified Protocol in the Management of Hospitalized COVID-19 Patients: Clinical and Virological Evidence. J Respir Med Lung Dis. 2020; 5(2): 1056.