Doxycycline for the prevention of progression of COVID-19 to severe disease requiring intensive care unit (ICU) admission: A randomized, controlled, open-label, parallel group trial (DOXPREVENT.ICU) Article Swipe
Raja Dhar
,
John Kirkpatrick
,
Laura Gilbert
,
Arjun Khanna
,
Mahavir Modi
,
Rakesh Chawla
,
Sonia Dalal
,
Venkata Nagarjuna Maturu
,
Marcel Stern
,
Oliver T. Keppler
,
Ratko Djukanović
,
Stephan D. Gadola
·
YOU?
·
· 2023
· Open Access
·
· DOI: https://doi.org/10.1371/journal.pone.0280745
YOU?
·
· 2023
· Open Access
·
· DOI: https://doi.org/10.1371/journal.pone.0280745
Background After admission to hospital, COVID-19 progresses in a substantial proportion of patients to critical disease that requires intensive care unit (ICU) admission. Methods In a pragmatic, non-blinded trial, 387 patients aged 40–90 years were randomised to receive treatment with SoC plus doxycycline (n = 192) or SoC only (n = 195). The primary outcome was the need for ICU admission as judged by the attending physicians. Three types of analyses were carried out for the primary outcome: “Intention to treat” (ITT) based on randomisation; “Per protocol” (PP), excluding patients not treated according to randomisation; and “As treated” (AT), based on actual treatment received. The trial was undertaken in six hospitals in India with high-quality ICU facilities. An online application serving as the electronic case report form was developed to enable screening, randomisation and collection of outcomes data. Results Adherence to treatment per protocol was 95.1%. Among all 387 participants, 77 (19.9%) developed critical disease needing ICU admission. In all three primary outcome analyses, doxycycline was associated with a relative risk reduction (RRR) and absolute risk reduction (ARR): ITT 31.6% RRR, 7.4% ARR (P = 0.063); PP 40.7% RRR, 9.6% ARR (P = 0.017); AT 43.2% RRR, 10.8% ARR (P = 0.007), with numbers needed to treat (NTT) of 13.4 (ITT), 10.4 (PP), and 9.3 (AT), respectively. Doxycycline was well tolerated with not a single patient stopping treatment due to adverse events. Conclusions In hospitalized COVID-19 patients, doxycycline, a safe, inexpensive, and widely available antibiotic with anti-inflammatory properties, reduces the need for ICU admission when added to SoC.
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Metadata
- Type
- article
- Language
- en
- Landing Page
- https://doi.org/10.1371/journal.pone.0280745
- OA Status
- gold
- Cited By
- 12
- References
- 34
- Related Works
- 10
- OpenAlex ID
- https://openalex.org/W4317759510
All OpenAlex metadata
Raw OpenAlex JSON
- OpenAlex ID
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https://openalex.org/W4317759510Canonical identifier for this work in OpenAlex
- DOI
-
https://doi.org/10.1371/journal.pone.0280745Digital Object Identifier
- Title
-
Doxycycline for the prevention of progression of COVID-19 to severe disease requiring intensive care unit (ICU) admission: A randomized, controlled, open-label, parallel group trial (DOXPREVENT.ICU)Work title
- Type
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articleOpenAlex work type
- Language
-
enPrimary language
- Publication year
-
2023Year of publication
- Publication date
-
2023-01-23Full publication date if available
- Authors
-
Raja Dhar, John Kirkpatrick, Laura Gilbert, Arjun Khanna, Mahavir Modi, Rakesh Chawla, Sonia Dalal, Venkata Nagarjuna Maturu, Marcel Stern, Oliver T. Keppler, Ratko Djukanović, Stephan D. GadolaList of authors in order
- Landing page
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https://doi.org/10.1371/journal.pone.0280745Publisher landing page
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YesWhether a free full text is available
- OA status
-
goldOpen access status per OpenAlex
- OA URL
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https://doi.org/10.1371/journal.pone.0280745Direct OA link when available
- Concepts
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Intensive care unit, Medicine, Randomized controlled trial, Coronavirus disease 2019 (COVID-19), Intensive care medicine, Doxycycline, Emergency medicine, Open label, Internal medicine, Disease, Infectious disease (medical specialty), Antibiotics, Biology, MicrobiologyTop concepts (fields/topics) attached by OpenAlex
- Cited by
-
12Total citation count in OpenAlex
- Citations by year (recent)
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2025: 1, 2024: 7, 2023: 4Per-year citation counts (last 5 years)
- References (count)
-
34Number of works referenced by this work
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-
10Other works algorithmically related by OpenAlex
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| abstract_inverted_index.outcomes | 136 |
| abstract_inverted_index.patients | 12, 30, 89 |
| abstract_inverted_index.protocol | 143 |
| abstract_inverted_index.relative | 169 |
| abstract_inverted_index.requires | 17 |
| abstract_inverted_index.stopping | 226 |
| abstract_inverted_index.treat” | 80 |
| abstract_inverted_index.Adherence | 139 |
| abstract_inverted_index.according | 92 |
| abstract_inverted_index.admission | 2, 60, 253 |
| abstract_inverted_index.analyses, | 163 |
| abstract_inverted_index.attending | 65 |
| abstract_inverted_index.available | 243 |
| abstract_inverted_index.developed | 128, 152 |
| abstract_inverted_index.excluding | 88 |
| abstract_inverted_index.hospital, | 4 |
| abstract_inverted_index.hospitals | 110 |
| abstract_inverted_index.intensive | 18 |
| abstract_inverted_index.patients, | 236 |
| abstract_inverted_index.received. | 103 |
| abstract_inverted_index.reduction | 171, 176 |
| abstract_inverted_index.tolerated | 220 |
| abstract_inverted_index.treatment | 38, 102, 141, 227 |
| abstract_inverted_index.Background | 0 |
| abstract_inverted_index.admission. | 22, 157 |
| abstract_inverted_index.antibiotic | 244 |
| abstract_inverted_index.associated | 166 |
| abstract_inverted_index.collection | 134 |
| abstract_inverted_index.electronic | 123 |
| abstract_inverted_index.pragmatic, | 26 |
| abstract_inverted_index.progresses | 6 |
| abstract_inverted_index.proportion | 10 |
| abstract_inverted_index.randomised | 35 |
| abstract_inverted_index.screening, | 131 |
| abstract_inverted_index.treated” | 97 |
| abstract_inverted_index.undertaken | 107 |
| abstract_inverted_index.Conclusions | 232 |
| abstract_inverted_index.Doxycycline | 217 |
| abstract_inverted_index.application | 119 |
| abstract_inverted_index.doxycycline | 42, 164 |
| abstract_inverted_index.facilities. | 116 |
| abstract_inverted_index.non-blinded | 27 |
| abstract_inverted_index.physicians. | 66 |
| abstract_inverted_index.properties, | 247 |
| abstract_inverted_index.protocol” | 86 |
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| abstract_inverted_index.inexpensive, | 240 |
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| abstract_inverted_index.randomisation | 132 |
| abstract_inverted_index.respectively. | 216 |
| abstract_inverted_index.randomisation; | 84, 94 |
| abstract_inverted_index.anti-inflammatory | 246 |
| cited_by_percentile_year.max | 99 |
| cited_by_percentile_year.min | 91 |
| corresponding_author_ids | https://openalex.org/A5026960985, https://openalex.org/A5017321882, https://openalex.org/A5102805309, https://openalex.org/A5080275082, https://openalex.org/A5063418266, https://openalex.org/A5012228972, https://openalex.org/A5043576559, https://openalex.org/A5077572851, https://openalex.org/A5046066094, https://openalex.org/A5048457625, https://openalex.org/A5101581099, https://openalex.org/A5015767421 |
| countries_distinct_count | 4 |
| institutions_distinct_count | 12 |
| corresponding_institution_ids | https://openalex.org/I1332791849, https://openalex.org/I2801897644, https://openalex.org/I4210118229, https://openalex.org/I4210120374, https://openalex.org/I4210129842, https://openalex.org/I4210152508, https://openalex.org/I43439940, https://openalex.org/I46827455, https://openalex.org/I8204097 |
| sustainable_development_goals[0].id | https://metadata.un.org/sdg/3 |
| sustainable_development_goals[0].score | 0.5799999833106995 |
| sustainable_development_goals[0].display_name | Good health and well-being |
| citation_normalized_percentile.value | 0.90065672 |
| citation_normalized_percentile.is_in_top_1_percent | False |
| citation_normalized_percentile.is_in_top_10_percent | True |