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| - BACKGROUND: As no specific pharmacologic treatment has been validated for use in COVID-19, we aimed to assess the effectiveness of azithromycin in these patients at a referral center in Iran. METHODS: An open-label, randomized, and controlled trial was conducted on patients with laboratory confirmed COVID-19. The 55 patients of the control group receiving hydroxychloroquine and lopinavir / ritonavir were compared with the 56 patients of the case group who in addition to the same regimen were also receiving azithromycin. Patients with prior cardiac disease were excluded from the study. Furthermore, patients from the case group were assessed for cardiac arrythmia risk based on the American college of cardiology (ACC) risk assessment for use of azithromycin and hydroxychloroquine. The main outcome measures were vital signs, SpO2 levels, duration of hospitalization, need for and length of intensive care unit (ICU) admission, mortality rates, and results of 30-day follow-up after discharge. RESULTS: Initially, there was no significant difference between the general conditions and vital signs of the two groups. The SpO2 levels at discharge were significantly higher, the respiratory rate was lower, and the duration of admission was shorter in the case group. There was no significant difference in the mortality rate between the two groups. CONCLUSION: Patients who received azithromycin in addition to the hydroxychloroquine and Kaletra regimen had a better general condition. he hydroxychloroquine-azithromycin combination may be beneficial for individuals who are known to have a very low underlying risk for cardiac arrhythmias based on the ACC criteria.
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