Hydroxychloroquine and azithromycin as a treatment of COVID-19: results of an open-label non-randomized clinical trial
et al., International Journal of Antimicrobial Agents, doi:10.1016/j.ijantimicag.2020.105949, Mar 2020 (preprint)
HCQ for COVID-19
1st treatment shown to reduce risk in
March 2020, now with p < 0.00000000001 from 424 studies, used in 59 countries.
No treatment is 100% effective. Protocols
combine treatments.
6,300+ studies for
210+ treatments. c19early.org
|
HCQ was significantly associated with reduction / elimination of viral load, which was enhanced with AZ. Responses to this paper have raised methodological issues1-3. There are unadjusted differences between groups.
Despite the limitations, this early observational study was an important part of the early analysis of SARS-CoV-2 treatment efficacy, including detailed daily evolution of PCR positivity. This study should be viewed in the context of the series of studies from this group. An update to this paper, including originally excluded patients, confirms the effectiveness of HCQ+AZ on viral clearance and early discharge4. Also see5 and the response from the authors6.
This paper was retracted in 2024. The retraction appears highly political. While there are some reasonable concerns, similar concerns apply to many other papers which have not been targeted. This study is not included in meta analysis. See 7 for a response to the retraction.
|
risk of no virological cure at day 6, 66.0% lower, RR 0.34, p = 0.001, treatment 6 of 20 (30.0%), control 14 of 16 (87.5%), NNT 1.7.
|
| Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates |
Gautret et al., 17 Mar 2020, prospective, France, peer-reviewed, 18 authors, average treatment delay 4.1 days, dosage 200mg tid days 1-10.
Hydroxychloroquine and azithromycin as a treatment of COVID-19: results of an open-label non-randomized clinical trial
International Journal of Antimicrobial Agents, doi:10.1016/j.ijantimicag.2020.105949
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 16 th , 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.
Declarations
Supplementary material Supplementary material associated with this article can be found, in the online version, at doi: 10.1016/j.ijantimicag.2020. 105949 .
References
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