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Early treatment of COVID-19 patients with hydroxychloroquine and azithromycin: A retrospective analysis of 1061 cases in Marseille, France.
Million, Matthieu; Lagier, Jean-Christophe; Gautret, Philippe; Colson, Philippe; Fournier, Pierre-Edouard; Amrane, Sophie; Hocquart, Marie; Mailhe, Morgane; Esteves-Vieira, Vera; Doudier, Barbara; Aubry, Camille; Correard, Florian; Giraud-Gatineau, Audrey; Roussel, Yanis; Berenger, Cyril; Cassir, Nadim; Seng, Piseth; Zandotti, Christine; Dhiver, Catherine; Ravaux, Isabelle; Tomei, Christelle; Eldin, Carole; Tissot-Dupont, Hervé; Honoré, Stéphane; Stein, Andreas; Jacquier, Alexis; Deharo, Jean-Claude; Chabrière, Eric; Levasseur, Anthony; Fenollar, Florence; Rolain, Jean-Marc; Obadia, Yolande; Brouqui, Philippe; Drancourt, Michel; La Scola, Bernard; Parola, Philippe; Raoult, Didier.
  • Million M; IHU-Méditerranée Infection, Marseille, France; Aix Marseille Univ., IRD, AP-HM, MEPHI, Marseille, France.
  • Lagier JC; IHU-Méditerranée Infection, Marseille, France; Aix Marseille Univ., IRD, AP-HM, MEPHI, Marseille, France.
  • Gautret P; IHU-Méditerranée Infection, Marseille, France; Aix Marseille Univ., IRD, AP-HM, SSA, VITROME, Marseille, France.
  • Colson P; IHU-Méditerranée Infection, Marseille, France; Aix Marseille Univ., IRD, AP-HM, MEPHI, Marseille, France.
  • Fournier PE; IHU-Méditerranée Infection, Marseille, France; Aix Marseille Univ., IRD, AP-HM, SSA, VITROME, Marseille, France.
  • Amrane S; IHU-Méditerranée Infection, Marseille, France; Aix Marseille Univ., IRD, AP-HM, MEPHI, Marseille, France.
  • Hocquart M; IHU-Méditerranée Infection, Marseille, France.
  • Mailhe M; IHU-Méditerranée Infection, Marseille, France.
  • Esteves-Vieira V; IHU-Méditerranée Infection, Marseille, France.
  • Doudier B; IHU-Méditerranée Infection, Marseille, France.
  • Aubry C; IHU-Méditerranée Infection, Marseille, France.
  • Correard F; Aix Marseille Univ., Laboratoire de Pharmacie Clinique, Marseille, France; AP-HM, hôpital Timone, service Pharmacie, Marseille, France.
  • Giraud-Gatineau A; IHU-Méditerranée Infection, Marseille, France; Aix Marseille Univ., IRD, AP-HM, SSA, VITROME, Marseille, France; Centre d'Epidémiologie et de Santé Publique des Armées (CESPA), Marseille, France; AP-HM, Marseille, France.
  • Roussel Y; IHU-Méditerranée Infection, Marseille, France; Aix Marseille Univ., IRD, AP-HM, MEPHI, Marseille, France.
  • Berenger C; IHU-Méditerranée Infection, Marseille, France; Aix Marseille Univ., IRD, AP-HM, SSA, VITROME, Marseille, France.
  • Cassir N; IHU-Méditerranée Infection, Marseille, France; Aix Marseille Univ., IRD, AP-HM, MEPHI, Marseille, France.
  • Seng P; IHU-Méditerranée Infection, Marseille, France; Aix Marseille Univ., IRD, AP-HM, MEPHI, Marseille, France.
  • Zandotti C; IHU-Méditerranée Infection, Marseille, France.
  • Dhiver C; IHU-Méditerranée Infection, Marseille, France.
  • Ravaux I; IHU-Méditerranée Infection, Marseille, France.
  • Tomei C; IHU-Méditerranée Infection, Marseille, France.
  • Eldin C; IHU-Méditerranée Infection, Marseille, France; Aix Marseille Univ., IRD, AP-HM, SSA, VITROME, Marseille, France.
  • Tissot-Dupont H; IHU-Méditerranée Infection, Marseille, France.
  • Honoré S; Aix Marseille Univ., Laboratoire de Pharmacie Clinique, Marseille, France; AP-HM, hôpital Timone, service Pharmacie, Marseille, France.
  • Stein A; IHU-Méditerranée Infection, Marseille, France; Aix Marseille Univ., IRD, AP-HM, MEPHI, Marseille, France.
  • Jacquier A; Department of Radiology and Cardiovascular Imaging, Aix-Marseille Univ., UMR 7339, CNRS, CRMBM-CEMEREM (Centre de Résonance Magnétique Biologique et Médicale-Centre d'Exploration Métaboliques par Résonance Magnétique), Marseille, France.
  • Deharo JC; AP-HM, Aix Marseille Univ., hôpital Timone, Cardiologie, Rythmologie, Marseille, France.
  • Chabrière E; IHU-Méditerranée Infection, Marseille, France; Aix Marseille Univ., IRD, AP-HM, MEPHI, Marseille, France.
  • Levasseur A; IHU-Méditerranée Infection, Marseille, France; Aix Marseille Univ., IRD, AP-HM, MEPHI, Marseille, France.
  • Fenollar F; IHU-Méditerranée Infection, Marseille, France; Aix Marseille Univ., IRD, AP-HM, SSA, VITROME, Marseille, France.
  • Rolain JM; IHU-Méditerranée Infection, Marseille, France; Aix Marseille Univ., IRD, AP-HM, MEPHI, Marseille, France.
  • Obadia Y; IHU-Méditerranée Infection, Marseille, France.
  • Brouqui P; IHU-Méditerranée Infection, Marseille, France; Aix Marseille Univ., IRD, AP-HM, MEPHI, Marseille, France.
  • Drancourt M; IHU-Méditerranée Infection, Marseille, France; Aix Marseille Univ., IRD, AP-HM, MEPHI, Marseille, France.
  • La Scola B; IHU-Méditerranée Infection, Marseille, France; Aix Marseille Univ., IRD, AP-HM, MEPHI, Marseille, France.
  • Parola P; IHU-Méditerranée Infection, Marseille, France; Aix Marseille Univ., IRD, AP-HM, SSA, VITROME, Marseille, France.
  • Raoult D; IHU-Méditerranée Infection, Marseille, France; Aix Marseille Univ., IRD, AP-HM, MEPHI, Marseille, France. Electronic address: didier.raoult@gmail.com.
Travel Med Infect Dis ; 35: 101738, 2020.
Article in English | MEDLINE | ID: covidwho-398900
Semantic information from SemMedBD (by NLM)
1. hydroxychloroquine TREATS COVID-19
Subject
hydroxychloroquine
Predicate
TREATS
Object
COVID-19
2. COVID-19 PROCESS_OF Patients
Subject
COVID-19
Predicate
PROCESS_OF
Object
Patients
3. hydroxychloroquine TREATS Patients
Subject
hydroxychloroquine
Predicate
TREATS
Object
Patients
4. azithromycin TREATS Patients
Subject
azithromycin
Predicate
TREATS
Object
Patients
5. azithromycin TREATS COVID-19
Subject
azithromycin
Predicate
TREATS
Object
COVID-19
6. Treatment Protocols TREATS Patients
Subject
Treatment Protocols
Predicate
TREATS
Object
Patients
7. Respiratory Failure CAUSES Cessation of life
Subject
Respiratory Failure
Predicate
CAUSES
Object
Cessation of life
8. Complication PROCESS_OF Patients
Subject
Complication
Predicate
PROCESS_OF
Object
Patients
9. hydroxychloroquine TREATS COVID-19
Subject
hydroxychloroquine
Predicate
TREATS
Object
COVID-19
10. COVID-19 PROCESS_OF Patients
Subject
COVID-19
Predicate
PROCESS_OF
Object
Patients
11. hydroxychloroquine TREATS Patients
Subject
hydroxychloroquine
Predicate
TREATS
Object
Patients
12. azithromycin TREATS Patients
Subject
azithromycin
Predicate
TREATS
Object
Patients
13. azithromycin TREATS COVID-19
Subject
azithromycin
Predicate
TREATS
Object
COVID-19
14. Treatment Protocols TREATS Patients
Subject
Treatment Protocols
Predicate
TREATS
Object
Patients
15. Respiratory Failure CAUSES Cessation of life
Subject
Respiratory Failure
Predicate
CAUSES
Object
Cessation of life
16. Complication PROCESS_OF Patients
Subject
Complication
Predicate
PROCESS_OF
Object
Patients
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.
Subject(s)
Keywords

Full text: Available Collection: International databases Database: MEDLINE Main subject: Antiviral Agents / Pneumonia, Viral / Coronavirus Infections / Azithromycin / Betacoronavirus / Hydroxychloroquine Type of study: Observational study / Prognostic study / Risk factors Topics: Long Covid Limits: Adolescent / Adult / Aged / Female / Humans / Male / Middle aged / Young adult Country/Region as subject: Europa Language: English Journal: Travel Med Infect Dis Journal subject: Communicable Diseases Year: 2020 Document Type: Article Affiliation country: J.tmaid.2020.101738

Full text: Available Collection: International databases Database: MEDLINE Main subject: Antiviral Agents / Pneumonia, Viral / Coronavirus Infections / Azithromycin / Betacoronavirus / Hydroxychloroquine Type of study: Observational study / Prognostic study / Risk factors Topics: Long Covid Limits: Adolescent / Adult / Aged / Female / Humans / Male / Middle aged / Young adult Country/Region as subject: Europa Language: English Journal: Travel Med Infect Dis Journal subject: Communicable Diseases Year: 2020 Document Type: Article Affiliation country: J.tmaid.2020.101738