Clinical and microbiological effect of a combination of hydroxychloroquine and azithromycin in 80 COVID-19 patients with at least a six-day follow up: A pilot observational study

Abstract

Background:We need an effective treatment to cure COVID-19 patients and to decrease virus carriage duration. Methods: We conducted an uncontrolled non-comparative observational study in a cohort of 80 relatively mildly infected inpatients treated with a combination of hydroxychloroquine and azithromycin over a period of at least three days, with three main measurements: clinical outcome, contagiousness as assessed by PCR and culture, and length of stay in infectious disease unit (IDU). Results: All patients improved clinically except one 86 year-old patient who died, and one 74 year-old patient still in intensive care. A rapid fall of nasopharyngeal viral load was noted, with 83% negative at Day7, and 93% at Day8. Virus cultures from patient respiratory samples were negative in 97.5% of patients at Day5. Consequently patients were able to be rapidly discharged from IDU with a mean length of stay of five days. Conclusion:We believe there is urgency to evaluate the effectiveness of this potentially-life saving therapeutic strategy at a larger scale, both to treat and cure patients at an early stage before irreversible severe respiratory complications take hold and to decrease duration of carriage and avoid the spread of the disease. Furthermore, the cost of treatment is negligible.

Update on use of chloroquine/hydroxychloroquine to treat coronavirus disease 2019 (COVID-19)

“…That study also revealed that adding azithromycin to hydroxychloroquine appears to more efficiently clear the virus. A subsequent study by Raoult et al (14) involving 80 patients with COVID-19 found that treatment with hydroxychloroquine and azithromycin resulted in a rapid decline in the nasopharyngeal viral load, with a virusnegative rate of 83% on day 7 and a rate of 93% on day 8. Although a control group was not included in that study, its results suggest the potential of hydroxychloroquine to treat COVID-19 given that the recorded median duration of viral shedding is 20 days in survivors (15).…”

COVID-19 and the Rationale for Pharmacotherapy: A South African Perspective

“…(21) More recently, an extension of the previous French study was published, which suggested an efficacy of HCHQ. (26) In this study, a rapid fall of nasopharyngeal viral load tested by polymerase chain reaction was noted, with 83% negative at Day 7, 93% at Day 8, and virus cultures from respiratory samples were negative in 97.5% at Day 5. There were numerous problems with this study, the most important of which was a lack of outcome data and some confusion as to patient numbers with some dropping out and others only just starting therapy after the 6-day period ended.…”

Chloroquine paradox may cause more damage than help fight COVID-19

“…However, no direct comparison with non-drug treated COVID-19 patients was made. Although most patients recovered, three HCHL treated COVID-19 patients progressed to severe disease including one death [26]. A randomized clinical study in with 62 COVID-19 patients reported beneficial effect of HCHL treatment compared to standard clinical care of COVID-19 [29].…”