Heterogeneity in susceptibility to hydroxychloroquine of SARS-CoV-2 isolates

Boschi, Céline; Bideau, Marion Le; Andréani, Julien; Aherfi, Sarah; Jardot, Priscilla; Delerce, Jérémy; Gendrot, Mathieu; Pradines, Bruno; Colson, Philippe; Levasseur, Anthony; Scola, Bernard La

doi:10.52586/5043

Cited by 3 publications

(1 citation statement)

References 47 publications

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“…Thus, chloroquine and HCQ have been repeatedly found to be some of the most effective potential repurposed drugs by different approaches, such as large-scale SARS-CoV-2 protein interaction map analysis (14,15) and network medicine frameworks (16), by several teams in the USA and other countries (9). In vitro antiviral efficacy at the micromolar range has been confirmed by multiple teams outside (9,14,15) and in our centre (17,18,19,20,21) for HCQ and compounds of the same 4-aminoquinoline family, notably amodiaquine (15,18). Thus, we previously reported in the clinical setting that off-label HCQ, particularly when associated with azithromycin (AZ), was associated with improved viral clearance (22).…”

Section: Introductionmentioning

confidence: 59%

Early Treatment with Hydroxychloroquine and Azithromycin: A ‘Real-World’ Monocentric Retrospective Cohort Study of 30,423 COVID-19 Patients

Million

Cortaredona

Delorme

et al. 2023

Preprint

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Objective To estimate the comparative effectiveness of combination therapy with hydroxychloroquine (HCQ) and azithromycin for coronavirus disease 2019 (COVID-19)-related death based on a large monocentric cohort independent of investigators putative biases in a real-world setting. Design Retrospective monocentric cohort study, with comprehensive data collection authenticated by an external bailiff and death reports from a national database (French National Death Registry). Setting Institut Hospitalo-Universitaire Mediterranee Infection Center in Marseille, France. Participants All adults older than 18 years with PCR-proven COVID-19 who were treated directly in our centre between 2 March 2020 and 31 December 2021 and did not refuse the use of their data. Interventions HCQ and azithromycin (HCQ-AZ) as a reference treatment were compared to other regimens containing HCQ, ivermectin and azithromycin alone, combined, or none of these three drugs. The effect of vaccination was also evaluated. Main outcome measures 6-week all-cause mortality. Multivariable logistic regression estimated treatment effectiveness with adjustments for age, sex, comorbidities, vaccination, period of infection or virus variant, and outpatient or inpatient care. Results Total 30,423 COVID-19 patients were analysed (86 refused the analysis of their data) including 30,202 with available treatment data, and 535 died (1.77%). All-cause mortality was very low among patients < 50 years (8/15,925 (0.05%)) and among outpatients treated with HCQ-AZ (21 deaths out of 21,135 (0.1%), never exceeding 0.2% regardless of epidemic period). HCQ-AZ treatment was associated with a significantly lower mortality rate than no HCQ-AZ after adjustment for sex, age, period and patient care setting (adjusted OR (aOR) 95% confidence interval (CI) 0.55, 0.45-0.68). The effect was greater among outpatients (71% death protection rate) than among inpatients (45%). In a subset of 16,063 patients with available comorbidities and vaccinations status, obesity (2.01, 1.23-3.29), chronic respiratory disease (2.93, 1.29-6.64), and immunodeficiency (4.01, 1.69-9.50), on the one hand, and vaccination (0.29, 0.12-0.67) and HCQ-AZ treatment (0.47, 0.29-0.76), on the other hand, were independent factors associated with mortality. HCQ, alone or in any association, was associated with significant protection from death among outpatients (0.41, 0.21-0.79) and inpatients (0.59, 0.47-0.73). Conclusions HCQ prescribed early or late protects in part from COVID-19-related death. During pandemic health crises, financial stakes are enormous. Authentication of the data by an independent external judicial officer should be required. Public sharing of anonymized databases, ensuring their verifiability, should be mandatory in this context to avoid fake publications.

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Section: Introductionmentioning

confidence: 59%

Early Treatment with Hydroxychloroquine and Azithromycin: A ‘Real-World’ Monocentric Retrospective Cohort Study of 30,423 COVID-19 Patients

Million

Cortaredona

Delorme

et al. 2023

Preprint

Self Cite

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The emergence, dynamics and significance of SARS-CoV-2 variants

Colson

Parola

Raoult

2022

New Microbes and New Infections

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COVID-19 Management at IHU Méditerranée Infection: A One-Year Experience

Brouqui¹,

Drancourt²,

Raoult³

2021

JCM

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Background: The Hospital-University Institute (IHU) Méditerranée Infection features a 27,000 square meter building hosting 700 employees and 75 hospitalized patients in the center of Marseille, France. Method: Previous preparedness in contagious disease management allowed the IHU to manage the COVID-19 outbreak by continuing adaptation for optimal diagnosis, care and outcome. We report here the output of this management. Results: From 5 March 2020, and 26 April 2021, 608,313 PCR tests were provided for 424,919 patients and 44,089 returned positive. A total of 23,390 patients with COVID-19 were followed at IHU with an overall case fatality ratio of 1.7%. Of them 20,270 were followed as outpatients with an overall CFR of 0.17%. We performed 24,807 EKG, 5759 low dose CT Scanner, and 18,344 serology. Of the 7643 nasopharyngeal samples inoculated in cell cultures 3317 (43.3%) yielded SARS-Cov-2 isolates. Finally, 7370 SARS-Cov-2 genomes were analyzed, allowing description of the first genetic variants and their implication in the epidemiologic curves. Continuous clinical care quality evaluation provided the opportunity for 155 publications allowing a better understanding of the disease and improvement of care and 132 videos posted on the IHU Facebook network, totaling 60 million views and 390,000 followers, and dealing with COVID-19, outbreaks, epistemology, and ethics in medicine. Conclusions: During this epidemic, IHU Méditerranée Infection played the role for which it has been created; useful clinical research to guarantee a high-quality diagnostic and care for patient and a recognized expertise.

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Heterogeneity in susceptibility to hydroxychloroquine of SARS-CoV-2 isolates

Cited by 3 publications

References 47 publications

Early Treatment with Hydroxychloroquine and Azithromycin: A ‘Real-World’ Monocentric Retrospective Cohort Study of 30,423 COVID-19 Patients

Early Treatment with Hydroxychloroquine and Azithromycin: A ‘Real-World’ Monocentric Retrospective Cohort Study of 30,423 COVID-19 Patients

The emergence, dynamics and significance of SARS-CoV-2 variants

COVID-19 Management at IHU Méditerranée Infection: A One-Year Experience

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