Medicina Pulmonar e Respiratória

Role of Quinolone in Management of (COVID-19) Patients

Abstract

Dalia El Embaby*, Mai Samy Azab and Marwa Sayed Daif

Background: Since the beginning of the COVID-19 pandemic, researchers have focused on repurposing of existing antibiotics, antivirals and anti-inflammatory drugs to find an effective therapy. Fluoroquinolones are broad spectrum synthetic antimicrobial agents, being chemical derivatives of quinoline, the prodrome of chloroquine.

Objectives: This study to determine if respiratory fluoroquinolones as Levofloxacin have a beneficial as an adjunct treatment in COVID-19 and their impact on COVID-19 morbidity and mortality.

Methods: We conducted a retrospective study on patients ≥ 18 years with acute pneumonic (COVID-19) positive PCR with their radiological findings at Ain Shams university isolation hospitals. We compared between HRCT chest severity score at time of diagnosis of COVID-19 and post COVID-19 by 3 months as follow up HRCT severity Score in two different groups (group of azithromycin and group of levofloxacin), We also conducted a comparison of respiratory morbidity of both groups as result of COVID-19 infection in form ICU admission and needing O₂ therapy.

Results: This study included n=101 patients in each group of two antibiotics, in first group of azithromycin where there was 48 cases were male and 53 cases were female, the second group of quinolone as levofloxacin where there was 43 cases were male and 58 were female, there was also highly significant correlation between two groups according age and its mean and standard deviation p value=0.001. We found highly significant results when we comparied between HRCT chest severity score at time of diagnosis of COVID-19 and post COVID-19 by 3 months as follow up HRCT severity score in both groups but there was a highly significant results in group of levofloxacin than the group of azithromycin p value=0.001. We also found that the baseline HRCT severity score at levofloxacin gp was higher than baseline HRCT severity score at azithromycin gp and after treatment there is significant decrease at follow up HRCT severity score between the two groups. We also conducted a comparison of respiratory morbidity of both group as result of COVID-19 infection in form ICU admission and needing O₂ therapy and there was no significant value in both groups in this study results.

Conclusion: Respiratory Fluoroquinolones (Levofloxacin ) prove to be beneficial as an adjunct treatment in COVID-19.