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Randomized double-blinded placebo-controlled trial of hydroxychloroquine with or without azithromycin for virologic cure of non-severe Covid-19

Omrani et al., eClinicalMedicine, doi:10.1016/j.eclinm.2020.100645, Q-PROTECT
Nov 2020  
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Hospitalization -33% Improvement Relative Risk Progression to pneumonia 67% Symptomatic at day 21 -100% Improvement in Ct -4% Azithromycin  Q-PROTECT  EARLY TREATMENT  DB RCT Is early treatment with azithromycin beneficial for COVID-19? Double-blind RCT 304 patients in Qatar (April - August 2020) Worse recovery with azithromycin (not stat. sig., p=0.5) c19early.org Omrani et al., eClinicalMedicine, November 2020 Favorsazithromycin Favorscontrol 0 0.5 1 1.5 2+
Low risk patient RCT for HCQ+AZ and HCQ vs. control, not showing any significant differences.
Authors note that the results are not applicable to higher risk patients, that positive PCR may simply reflect detection of inactive (non-infectious) viral remnants, that an alternative dosage regimen may be more effective, and that medication adherence was unknown.
HCQ dosing was 600mg/day for 1 week, therapeutic levels may not be reached for several days. There were no deaths or serious adverse events.
Viral load was already very high at baseline.
risk of hospitalization, 33.3% higher, RR 1.33, p = 1.00, treatment 4 of 152 (2.6%), control 3 of 152 (2.0%), HCQ+AZ vs. HCQ.
progression to pneumonia, 66.7% lower, RR 0.33, p = 0.62, treatment 1 of 152 (0.7%), control 3 of 152 (2.0%), NNT 76, HCQ+AZ vs. HCQ.
risk of symptomatic at day 21, 100% higher, RR 2.00, p = 0.50, treatment 6 of 152 (3.9%), control 3 of 152 (2.0%), HCQ+AZ vs. HCQ.
relative improvement in Ct, 4.2% worse, RR 1.04, p = 0.63, treatment 152, control 152, HCQ+AZ vs. HCQ, day 6.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Omrani et al., 20 Nov 2020, Double Blind Randomized Controlled Trial, placebo-controlled, Qatar, peer-reviewed, 19 authors, study period 13 April, 2020 - 1 August, 2020, Q-PROTECT trial.
This PaperAzithromycinAll
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