Sars-Cov-2 Infection in Patients on Long-Term Treatment with Macrolides in Spain: A National Cross-Sectional Study

Meseguer Barros, Carmen Marina; Alzueta Isturiz, Natalia; Sainz de Rozas Aparicio, Rita; Vizcaíno, Rafael Aguilella; López Esteban, Laura; Anaya Ordóñez, Sonia; Lekue Alkorta, Itxasne; Martín Suances, Salvadora; Jiménez Arce, Jorge Ignacio; Fernández Vicente, Maite; Borrego Izquierdo, Yolanda; Prieto Sánchez, Raquel; Casado Casuso, Silvia; Madridejos, Rosa; Verde, Carmen Marquina; Tomás Sanz, Rosa; Oro Fernández, María; Gallardo Borge, Sara; Lázaro López, Eva; Pina Gadea, María Belén; Pereira Pía, Mercedes; Maestre-Sánchez, María Victoria; Ribes-Murillo, Esther; Gómez de Oña, Constanza; María Jesús Lallana, Álvarez; Celaya Lecea, Concepción; Prado Prieto, María Ana; Aranguez Ruiz, Aranzazu; Olmo Quintana, Vicente; Villén Romero, Noemí; Payá Giner, Carolina; Lloret Callejo, Angeles; Fernández Ferreiro, Alvaro; Basagoiti Carreño, Blanca; Iglesias Iglesias, Ana Aurelia; Martín Alonso, Antonio; Díez Alcántara, Ana; Marco Tejón, Esther; Lestón Vázquez, Marta; Ariza Copado, Mª Ángeles; Aparicio Cueva, Marta; Escudero Vilaplana, Belén; Nicieza, Marisa; Picazo Sanchiz, Gracia; Silva Riádigos, Genma María; Sánchez, Lucía Jamart; García Álvarez, Ángel; García Bonilla, Antonio; Herrero Delicado, Rafael; Arroyo Pineda, Virginia; de la Hija, Belén; Troncoso Mariño, Amelia; Tofiño González, Isabel; Mateu García, Mónica Susana; García Vázquez, Pablo; Pérez Martín, Joaquín; Fernández-Urrusuno, Rocío

The aim of this study was to know the prevalence and severity of COVID-19 in patients treated with long-term macrolides and to describe the factors associated with worse outcomes. A cross-sectional study was conducted in Primary Care setting. Patients with macrolides dispensed continuously from 1 October 2019 to 31 March 2020, were considered. Main outcome: diagnosis of coronavirus disease-19 (COVID-19). Secondary outcomes: symptoms, severity, characteristics of patients, comorbidities, concomitant treatments. A total of 3057 patients met the inclusion criteria. Median age: 73 (64–81) years; 55% were men; 62% smokers/ex-smokers; 56% obese/overweight. Overall, 95% of patients had chronic respiratory diseases and four comorbidities as a median. Prevalence of COVID-19: 4.8%. This was in accordance with official data during the first wave of the pandemic. The most common symptoms were respiratory: shortness of breath, cough, and pneumonia. Additionally, 53% percent of patients had mild/moderate symptoms, 28% required hospital admission, and 19% died with COVID-19. The percentage of patients hospitalized and deaths were 2.6 and 5.8 times higher, respectively, in the COVID-19 group (p < 0.001). There was no evidence of a beneficial effect of long-term courses of macrolides in preventing SARS-CoV-2 infection or the progression to worse outcomes in old patients with underlying chronic respiratory diseases and a high burden of comorbidity.