Assessment of COVID‐19 Treatment containing both Hydroxychloroquine and Azithromycin: A natural clinical trial

Abstract

The goal of this study was to assess the clinical effectiveness and safety profile of the COVID‐19 treatment protocol (containing both hydroxychloroquine (HCQ) and azithromycin) in an Iraqi specialised hospital. Methods This prospective study used a pre‐ and post‐intervention design without a comparison group. The intervention was routine Ministry of Health (MOH) approved the management of COVID‐19 for all patients. The study was conducted in a public healthcare setting in Baghdad, Iraq from March 1st to May 25, 2020. The study outcome measures included the changes in clinical and biochemical parameters during the hospitalisation period. Paired t‐test and Chi‐square test were used to compare the measures of vital signs, lab tests and symptoms before and after treatment. Results The study included 161 patients who were admitted with positive RT‐PCR and clinical symptoms of COVID‐19. In terms of severity, 53 (32.9%) patients had amild condition, 47 (29.2%) had moderate condition, 35 (21.7%) had severe condition and 26 (16.1%) had critical condition. Most patients (84.5%) recovered and were discharged without symptoms after testing negative with RT‐PCR, while 11 (6.8%) patients died during the study period. The signs and symptoms of COVID‐19 were reduced significantly in response to a therapy regimen containing HCQ and azithromycin. The most common reported side effects were stomach pain, hypoglycemia, dizziness, itching, skin rash, QT prolongation, arrhythmia, and conjunctivitis. Conclusions This natural trial showed that the COVID‐19 regimen containing both HCQ and azithromycin can be helpful to promote the recovery of most patients and reduced their signs and symptoms significantly. It also shows some manageable side effects mostly those related to heart rhythm. In the absence of FDA‐approved medications to treat COVID‐19, the repurposing of HCQ and azithromycin to control the disease signs and symptoms can be useful.

Chloroquine/Hydroxychloroquine Use and Suicide Risk: Hypotheses for Confluent Etiopathogenetic Mechanisms?

“…Alternatively, several other well-documented side effects of HCQ might also potentiate the risk of developing neuropsychiatric AEs, particularly SI/SB. For instance, (ii) HCQ treatment can cause hypoglycemia [ 42 ], which could trigger dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis, and, subsequently, cortisol rhythm [ 43 , 44 ] ( Figure 1 ). Notably, alterations in these signaling pathways have been associated with increased suicide risk [ 45 , 46 , 47 ].…”

A critical analysis about the supposed role of azithromycin in the treatment of covid-19

“…Moreover, the study had two main limitations: a small sample size (36 patients, of which only six were assigned to receive HCQ-AZM), a limited follow-up, and safety data not sufficiently reported. Likewise, another trial conducted by Abbas et al 47 (2020), involving 161 patients, demonstrated that HCQ-AZM was useful to improve time to resolution of symptoms. However, it was a singlecenter study conducted without a control group.…”

A short focus, azithromycin in the treatment of respiratory viral infection COVID-19: efficacy or inefficacy?

“…A clinical study demonstrated that signs and symptoms of SARS-CoV-2 infection were significantly reduced in response to a treatment regimen containing hydroxychloroquine and azithromycin. The most common side effects reported were stomach pain, hypoglycemia, dizziness, pruritus, rash, and QT prolongation [33]. Another study conducted demonstrated the efficacy of the combination of hydroxychloroquine and azithromycin on both viral clearance and shorter hospitalization time for COVID-19 patients [34].…”