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Hydroxychloroquine and azithromycin as a treatment of COVID-19: results of an open-label non-randomized clinical trial.
Int J Antimicrob Agents. 2020 Mar 20 [Online ahead of print]IJ

Abstract

BACKGROUND

Chloroquine and hydroxychloroquine have been found to be efficient on SARS-CoV-2, and reported to be efficient in Chinese COV-19 patients. We evaluate the role of hydroxychloroquine on respiratory viral loads.

PATIENTS AND METHODS

French Confirmed COVID-19 patients were included in a single arm protocol from early March to March 16th, to receive 600mg of hydroxychloroquine daily and their viral load in nasopharyngeal swabs was tested daily in a hospital setting. Depending on their clinical presentation, azithromycin was added to the treatment. Untreated patients from another center and cases refusing the protocol were included as negative controls. Presence and absence of virus at Day6-post inclusion was considered the end point.

RESULTS

Six patients were asymptomatic, 22 had upper respiratory tract infection symptoms and eight had lower respiratory tract infection symptoms. Twenty cases were treated in this study and showed a significant reduction of the viral carriage at D6-post inclusion compared to controls, and much lower average carrying duration than reported of untreated patients in the literature. Azithromycin added to hydroxychloroquine was significantly more efficient for virus elimination.

CONCLUSION

Despite its small sample size our survey shows that hydroxychloroquine treatment is significantly associated with viral load reduction/disappearance in COVID-19 patients and its effect is reinforced by azithromycin.

Authors+Show Affiliations

IHU-Méditerranée Infection, Marseille, France; Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, Marseille, France.IHU-Méditerranée Infection, Marseille, France; Aix Marseille Univ, IRD, APHM, MEPHI, Marseille, France.IHU-Méditerranée Infection, Marseille, France; Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, Marseille, France.IHU-Méditerranée Infection, Marseille, France; Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, Marseille, France; Thai Binh University of Medicine and Pharmacy, Thai Binh, Viet Nam.IHU-Méditerranée Infection, Marseille, France.IHU-Méditerranée Infection, Marseille, France.IHU-Méditerranée Infection, Marseille, France.Infectiologie, Hôpital de l'Archet, Centre Hospitalier Universitaire de Nice, Nice, France; Université Côte d'Azur, Nice, France; U1065, Centre Méditerranéen de Médecine Moléculaire, C3M, Virulence Microbienne et Signalisation Inflammatoire, INSERM, Nice, France.Department of Virology, Biological and Pathological Center, Centre Hospitalier Universitaire de Nice, 06200 Nice, France.IHU-Méditerranée Infection, Marseille, France.IHU-Méditerranée Infection, Marseille, France; Aix Marseille Univ, IRD, APHM, MEPHI, Marseille, France.Service Pharmacie, Hôpital Timone, AP-HM, Marseille, France; Laboratoire de Pharmacie Clinique, Aix Marseille Université, Marseille, France.IHU-Méditerranée Infection, Marseille, France; Aix Marseille Univ, IRD, APHM, MEPHI, Marseille, France.IHU-Méditerranée Infection, Marseille, France; Aix Marseille Univ, IRD, APHM, MEPHI, Marseille, France.IHU-Méditerranée Infection, Marseille, France; Aix Marseille Univ, IRD, APHM, MEPHI, Marseille, France.IHU-Méditerranée Infection, Marseille, France; Aix Marseille Univ, IRD, APHM, MEPHI, Marseille, France.IHU-Méditerranée Infection, Marseille, France; Aix Marseille Univ, IRD, APHM, MEPHI, Marseille, France.IHU-Méditerranée Infection, Marseille, France; Aix Marseille Univ, IRD, APHM, MEPHI, Marseille, France. Electronic address: Didier.raoult@gmail.com.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32205204

Citation

Gautret, Philippe, et al. "Hydroxychloroquine and Azithromycin as a Treatment of COVID-19: Results of an Open-label Non-randomized Clinical Trial." International Journal of Antimicrobial Agents, 2020, p. 105949.
Gautret P, Lagier JC, Parola P, et al. Hydroxychloroquine and azithromycin as a treatment of COVID-19: results of an open-label non-randomized clinical trial. Int J Antimicrob Agents. 2020.
Gautret, P., Lagier, J. C., Parola, P., Hoang, V. T., Meddeb, L., Mailhe, M., Doudier, B., Courjon, J., Giordanengo, V., Vieira, V. E., Dupont, H. T., Honoré, S., Colson, P., Chabrière, E., La Scola, B., Rolain, J. M., Brouqui, P., & Raoult, D. (2020). Hydroxychloroquine and azithromycin as a treatment of COVID-19: results of an open-label non-randomized clinical trial. International Journal of Antimicrobial Agents, 105949. https://doi.org/10.1016/j.ijantimicag.2020.105949
Gautret P, et al. Hydroxychloroquine and Azithromycin as a Treatment of COVID-19: Results of an Open-label Non-randomized Clinical Trial. Int J Antimicrob Agents. 2020 Mar 20;105949. PubMed PMID: 32205204.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Hydroxychloroquine and azithromycin as a treatment of COVID-19: results of an open-label non-randomized clinical trial. AU - Gautret,Philippe, AU - Lagier,Jean-Christophe, AU - Parola,Philippe, AU - Hoang,Van Thuan, AU - Meddeb,Line, AU - Mailhe,Morgane, AU - Doudier,Barbara, AU - Courjon,Johan, AU - Giordanengo,Valérie, AU - Vieira,Vera Esteves, AU - Dupont,Hervé Tissot, AU - Honoré,Stéphane, AU - Colson,Philippe, AU - Chabrière,Eric, AU - La Scola,Bernard, AU - Rolain,Jean-Marc, AU - Brouqui,Philippe, AU - Raoult,Didier, Y1 - 2020/03/20/ PY - 2020/03/16/received PY - 2020/03/17/revised PY - 2020/03/17/accepted PY - 2020/3/25/entrez PY - 2020/3/25/pubmed PY - 2020/3/25/medline KW - 2019-nCoV KW - COVID-19 KW - SARS-CoV-2 KW - azithomycin KW - clinical trial KW - hydroxychloroquine SP - 105949 EP - 105949 JF - International journal of antimicrobial agents JO - Int. J. Antimicrob. Agents N2 - BACKGROUND: Chloroquine and hydroxychloroquine have been found to be efficient on SARS-CoV-2, and reported to be efficient in Chinese COV-19 patients. We evaluate the role of hydroxychloroquine on respiratory viral loads. PATIENTS AND METHODS: French Confirmed COVID-19 patients were included in a single arm protocol from early March to March 16th, to receive 600mg of hydroxychloroquine daily and their viral load in nasopharyngeal swabs was tested daily in a hospital setting. Depending on their clinical presentation, azithromycin was added to the treatment. Untreated patients from another center and cases refusing the protocol were included as negative controls. Presence and absence of virus at Day6-post inclusion was considered the end point. RESULTS: Six patients were asymptomatic, 22 had upper respiratory tract infection symptoms and eight had lower respiratory tract infection symptoms. Twenty cases were treated in this study and showed a significant reduction of the viral carriage at D6-post inclusion compared to controls, and much lower average carrying duration than reported of untreated patients in the literature. Azithromycin added to hydroxychloroquine was significantly more efficient for virus elimination. CONCLUSION: Despite its small sample size our survey shows that hydroxychloroquine treatment is significantly associated with viral load reduction/disappearance in COVID-19 patients and its effect is reinforced by azithromycin. SN - 1872-7913 UR - https://www.unboundmedicine.com/medline/citation/32205204/full_citation L2 - https://linkinghub.elsevier.com/retrieve/pii/S0924-8579(20)30099-6 DB - PRIME DP - Unbound Medicine ER -