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Assessment of COVID-19 Treatment containing both Hydroxychloroquine and Azithromycin: A Natural Clinical Trial

Abbas et al., Int. J. Clin. Pract., doi:10.1111/ijcp.13856
Nov 2020  
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Prospective study of 161 hospitalized patients in Iraq showing HCQ+AZ appears to help recovery. Most mortality was in patients that were already in critical condition on admission and died before treatment could be effective.
Abbas et al., 24 Nov 2020, prospective, Iraq, peer-reviewed, 8 authors.
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Assessment of COVID‐19 Treatment containing both Hydroxychloroquine and Azithromycin: A natural clinical trial
Hassan M Abbas, Ali Azeez Al‐jumaili, Kawthar F Nassir, Muhammed Waheeb Al‐obaidy, Adnan Mohammed Al Jubouri, Basim Dhawi Dakhil, Mohammed Mahir Abdulelah, Qutaiba Ahmed Al Khames
International Journal of Clinical Practice, doi:10.1111/ijcp.13856
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. | INTRODUC TI ON Coronavirus disease 2019 (COVID-19) is a respiratory tract infection caused by a newly emergent coronavirus that was first recognised in Wuhan, China, in December 2019. 1 Genetic sequencing of the virus suggests that it is a beta-corona virus closely linked to the SARS virus. 2 While most people with COVID-19 develop the only mild or uncomplicated illness, approximately 14% develop a severe disease that requires hospitalisation and oxygen support, and 5% require admission to an intensive care unit. 3 In severe cases, COVID-19 can be
and symptoms is potentially useful. The study showed that using this therapy combination (HCQ and azithromycin) is promising and can fill the gap until more effective treatments are found. Future randomised controlled trial can give more definite answers about the effectiveness and safety of such therapy protocol. ACK N OWLED G EM ENTS The authors would like to thank Dr Jawad Rasheed, Dr Ali AL-Garrawy and all the physicians and healthcare provider in Al-Shifaa Centre for Corona pandemic at Medical City, Baghdad who helped the research team conduct the study. If they had not bravely risked their lives to treat the COVID-19 cases, there would not be such a high recovery rate amongst patients. CO N FLI C T O F I NTE R E S T No conflict of interest to declare and the study received no fund.
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Late treatment
is less effective
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