Introduction: The effects of the SARS-CoV-2 pandemic continue to disrupt health systems worldwide, leading to population lockdowns in many countries. Preventing hospitalisation, death and long-COVID with repurposed drugs remains a valuable research goal. To respond to this priority, the use of azithromycin (AZM) is one of the most common treatments worldwide, in combination with hydroxychloroquine (HCQ) or as standalone molecule. With the aim of decentralizing early treatment to family practitioners, we address the question: Can early home administration of AZM with zinc help prevent severe COVID-19 disease progression and long-COVID?
Methodology: We conducted a scoping review of articles published from 31 December 2019 to 5 November 2020 in the PubMed, Google Scholar, MedRxiv, and BioRxiv databases, and a review of ongoing clinical trials published in the Clinicaltrial.gov database.
Results: Many studies report on outpatient treatment with a combination of AZM + HCQ versus AZM alone, and a few studies propose the addition of zinc (Zn) to AZM. Studies using HCQ were not considered in this review. We failed to identify any study reporting results of home-based utilisation of AZM administrated by family practitioners. In addition, we identified seven clinical trials currently recruiting individuals for early outpatient treatment with AZM, but results have not yet been published.
Discussion: The antiviral, anti-inflammatory, immunomodulatory benefits of AZM + Zn make this drugs combination a good candidate therapy to treat flu-like COVID-19 and atypical pneumoniae. The antibacterial action of AZM is expected to disrupt the poorly-documented bacteria-virus cooperation. Considering the pros and cons of macrolide use (including antimicrobial resistance), we call for further research on the early use of this therapy by family practitioners for the home treatment of individuals presenting mild or moderate symptoms to prevent hospitalisation, death and long-COVID.
COVID-19; Azithromycin; Early treatment; Family practitioners