Hydroxychloroquine and azithromycin as a treatment of COVID-19: results of an open-label non-randomized clinical trial
By P. Gautret, J. Lagier, P. Parola, V. Hoang, L. Meddeb, M. Mailhe, B. Doudier, J. Courjon, V. Giordanengo, V. E. Vieira and 8 more. International Journal of Antimicrobial Agents, 2020
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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 effect 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 in the litterature for untreated patients. 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.
Subfields: Infectious Diseases, Molecular Biology, Neurology
View Paper: https://www.semanticscholar.org/paper/5973278f9a9657d8fbdb161cd2c6c33ba0bceac2
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Citations in the corpus
- COVID‐19 and Older Adults: What We Know (2020, background): “1% of patients were virus free in 6 days.(33) Another drug with promising results is remdesivir, an intravenous drug that inhibits SARS-CoV-2 replication through premature termination of viral RNA.”
- Bacterial and fungal co-infection in individuals with coronavirus: A rapid review to support COVID-19 antimicrobial prescribing (2020, background): “Given the suggested use of broad-spectrum agents and macrolides; [9] [10] [11] this is important to prevent unintended consequences of antimicrobial therapy including toxicity (such as QT prolongation), [12] antibiotic associated diarrhoea, and the propagation of antimicrobial resistance through inc”
- Outcomes of Hydroxychloroquine Usage in United States Veterans Hospitalized with COVID-19 (2020, background): “5% of patients that were started on HCQ were discontinued at a median of 4 days (3-9) due to EKG changes.”
- Intensive care management of coronavirus disease 2019 (COVID-19): challenges and recommendations (2020, neutral): “…Table 3 summarises the evidence for some of the more prominent therapies: remdesivir, 67–70 lopinavir–ritonavir, 71–74 chloroquine, 75–77 hydroxychloroquine, 79,80 intra venous immunoglobulin, 81,82 convalescent plasma, 83–85 tocilizumab, 57,86 favipiravir, 87 and traditional Chinese medicines.”
- COVID-19 pathophysiology: A review (2020, neutral): “Several drugs including lopinavir-ritonavir, remdesivir, hydroxychloroquine, and azithromycin have been tested in clinical trials [8,11,12], but none of them have been proven to be a definite therapy yet.”
- Viral RNA load as determined by cell culture as a management tool for discharge of SARS-CoV-2 patients from infectious disease wards (2020, methodology): “In 6 patients under the current therapeutic protocol used at our institute (hydroxychloroquine and azithromycin), Ct values > 34 were obtained between days 2 and 4 post-treatment [6].”
- Infectious Diseases Society of America Guidelines on the Treatment and Management of Patients with COVID-19 (2022, background): “, significant QT prolongation leading to treatment discontinuation) [13-16] (Table 2).”