Background
In France, the combination hydroxychloroquine (HCQ) and azithromycin (AZ) is used in the treatment of COVID-19.
Methods
We retrospectively report on 1061 SARS-CoV-2 positive tested patients treated for at least three days with the following regimen: HCQ (200 mg three times daily for ten days) + AZ (500 mg on day 1 followed by 250 mg daily for the next four days). Outcomes were death, clinical worsening (transfer to ICU, and >10 day hospitalization) and viral shedding persistence (>10 days).
Results
A total of 1061 patients were included in this analysis (46.4% male, mean age 43.6 years – range 14–95 years). Good clinical outcome and virological cure were obtained in 973 patients within 10 days (91.7%). Prolonged viral carriage was observed in 47 patients (4.4%) and was associated to a higher viral load at diagnosis (p < .001) but viral culture was negative at day 10. All but one, were PCR-cleared at day 15. A poor clinical outcome (PClinO) was observed for 46 patients (4.3%) and 8 died (0.75%) (74–95 years old). All deaths resulted from respiratory failure and not from cardiac toxicity. Five patients are still hospitalized (98.7% of patients cured so far). PClinO was associated with older age (OR 1.11), severity of illness at admission (OR 10.05) and low HCQ serum concentration. PClinO was independently associated with the use of selective beta-blocking agents and angiotensin II receptor blockers (p < .05). A total of 2.3% of patients reported mild adverse events (gastrointestinal or skin symptoms, headache, insomnia and transient blurred vision).
Conclusion
Administration of the HCQ+AZ combination before COVID-19 complications occur is safe and associated with a very low fatality rate in patients.
Description
Early treatment of COVID-19 patients with hydroxychloroquine and azithromycin: A retrospective analysis of 1061 cases in Marseille, France - ScienceDirect
%0 Journal Article
%1 MILLION2020101738
%A Million, Matthieu
%A Lagier, Jean-Christophe
%A Gautret, Philippe
%A Colson, Philippe
%A Fournier, Pierre-Edouard
%A Amrane, Sophie
%A Hocquart, Marie
%A Mailhe, Morgane
%A Esteves-Vieira, Vera
%A Doudier, Barbara
%A Aubry, Camille
%A Correard, Florian
%A Giraud-Gatineau, Audrey
%A Roussel, Yanis
%A Berenger, Cyril
%A Cassir, Nadim
%A Seng, Piseth
%A Zandotti, Christine
%A Dhiver, Catherine
%A Ravaux, Isabelle
%A Tomei, Christelle
%A Eldin, Carole
%A Tissot-Dupont, Hervé
%A Honoré, Stéphane
%A Stein, Andreas
%A Jacquier, Alexis
%A Deharo, Jean-Claude
%A Chabrière, Eric
%A Levasseur, Anthony
%A Fenollar, Florence
%A Rolain, Jean-Marc
%A Obadia, Yolande
%A Brouqui, Philippe
%A Drancourt, Michel
%A Scola, Bernard La
%A Parola, Philippe
%A Raoult, Didier
%D 2020
%J Travel Medicine and Infectious Disease
%K (h)cq azm covid-19 raoult
%P 101738
%R https://doi.org/10.1016/j.tmaid.2020.101738
%T Early treatment of COVID-19 patients with hydroxychloroquine and azithromycin: A retrospective analysis of 1061 cases in Marseille, France
%U http://www.sciencedirect.com/science/article/pii/S1477893920302179
%X Background
In France, the combination hydroxychloroquine (HCQ) and azithromycin (AZ) is used in the treatment of COVID-19.
Methods
We retrospectively report on 1061 SARS-CoV-2 positive tested patients treated for at least three days with the following regimen: HCQ (200 mg three times daily for ten days) + AZ (500 mg on day 1 followed by 250 mg daily for the next four days). Outcomes were death, clinical worsening (transfer to ICU, and >10 day hospitalization) and viral shedding persistence (>10 days).
Results
A total of 1061 patients were included in this analysis (46.4% male, mean age 43.6 years – range 14–95 years). Good clinical outcome and virological cure were obtained in 973 patients within 10 days (91.7%). Prolonged viral carriage was observed in 47 patients (4.4%) and was associated to a higher viral load at diagnosis (p < .001) but viral culture was negative at day 10. All but one, were PCR-cleared at day 15. A poor clinical outcome (PClinO) was observed for 46 patients (4.3%) and 8 died (0.75%) (74–95 years old). All deaths resulted from respiratory failure and not from cardiac toxicity. Five patients are still hospitalized (98.7% of patients cured so far). PClinO was associated with older age (OR 1.11), severity of illness at admission (OR 10.05) and low HCQ serum concentration. PClinO was independently associated with the use of selective beta-blocking agents and angiotensin II receptor blockers (p < .05). A total of 2.3% of patients reported mild adverse events (gastrointestinal or skin symptoms, headache, insomnia and transient blurred vision).
Conclusion
Administration of the HCQ+AZ combination before COVID-19 complications occur is safe and associated with a very low fatality rate in patients.
@article{MILLION2020101738,
abstract = {Background
In France, the combination hydroxychloroquine (HCQ) and azithromycin (AZ) is used in the treatment of COVID-19.
Methods
We retrospectively report on 1061 SARS-CoV-2 positive tested patients treated for at least three days with the following regimen: HCQ (200 mg three times daily for ten days) + AZ (500 mg on day 1 followed by 250 mg daily for the next four days). Outcomes were death, clinical worsening (transfer to ICU, and >10 day hospitalization) and viral shedding persistence (>10 days).
Results
A total of 1061 patients were included in this analysis (46.4% male, mean age 43.6 years – range 14–95 years). Good clinical outcome and virological cure were obtained in 973 patients within 10 days (91.7%). Prolonged viral carriage was observed in 47 patients (4.4%) and was associated to a higher viral load at diagnosis (p < .001) but viral culture was negative at day 10. All but one, were PCR-cleared at day 15. A poor clinical outcome (PClinO) was observed for 46 patients (4.3%) and 8 died (0.75%) (74–95 years old). All deaths resulted from respiratory failure and not from cardiac toxicity. Five patients are still hospitalized (98.7% of patients cured so far). PClinO was associated with older age (OR 1.11), severity of illness at admission (OR 10.05) and low HCQ serum concentration. PClinO was independently associated with the use of selective beta-blocking agents and angiotensin II receptor blockers (p < .05). A total of 2.3% of patients reported mild adverse events (gastrointestinal or skin symptoms, headache, insomnia and transient blurred vision).
Conclusion
Administration of the HCQ+AZ combination before COVID-19 complications occur is safe and associated with a very low fatality rate in patients.},
added-at = {2020-05-18T09:09:23.000+0200},
author = {Million, Matthieu and Lagier, Jean-Christophe and Gautret, Philippe and Colson, Philippe and Fournier, Pierre-Edouard and Amrane, Sophie and Hocquart, Marie and Mailhe, Morgane and Esteves-Vieira, Vera and Doudier, Barbara and Aubry, Camille and Correard, Florian and Giraud-Gatineau, Audrey and Roussel, Yanis and Berenger, Cyril and Cassir, Nadim and Seng, Piseth and Zandotti, Christine and Dhiver, Catherine and Ravaux, Isabelle and Tomei, Christelle and Eldin, Carole and Tissot-Dupont, Hervé and Honoré, Stéphane and Stein, Andreas and Jacquier, Alexis and Deharo, Jean-Claude and Chabrière, Eric and Levasseur, Anthony and Fenollar, Florence and Rolain, Jean-Marc and Obadia, Yolande and Brouqui, Philippe and Drancourt, Michel and Scola], Bernard [La and Parola, Philippe and Raoult, Didier},
biburl = {https://www.bibsonomy.org/bibtex/21f38dbeb9ddfaa0ed9d3e01ec0d67d6a/fordham1},
description = {Early treatment of COVID-19 patients with hydroxychloroquine and azithromycin: A retrospective analysis of 1061 cases in Marseille, France - ScienceDirect},
doi = {https://doi.org/10.1016/j.tmaid.2020.101738},
interhash = {5e1878d27e5a445dbd2d5185abcff383},
intrahash = {1f38dbeb9ddfaa0ed9d3e01ec0d67d6a},
issn = {1477-8939},
journal = {Travel Medicine and Infectious Disease},
keywords = {(h)cq azm covid-19 raoult},
pages = 101738,
timestamp = {2020-05-18T09:09:23.000+0200},
title = {Early treatment of COVID-19 patients with hydroxychloroquine and azithromycin: A retrospective analysis of 1061 cases in Marseille, France},
url = {http://www.sciencedirect.com/science/article/pii/S1477893920302179},
year = 2020
}