Abstract: Received: 25 June 2020 | Accepted: 18 November 2020 DOI: 10.1111/ijcp.13856 ORIG INAL PAPER INFECTIOUS DISEASES Assessment of COVID-19 Treatment containing both Hydroxychloroquine and Azithromycin: A natural clinical trial Hassan M. Abbas1 | Ali Azeez Al-Jumaili2,3 | Kawthar F. Nassir4 | 5 5,6 Muhammed Waheeb Al-Obaidy | Adnan Mohammed Al Jubouri | 7 8 Basim Dhawi Dakhil | Mohammed Mahir Abdulelah | Qutaiba Ahmed Al Khames9 1 Headquarter, Ministry of Health, Baghdad, Iraq Abstract 2 The goal of this study was to assess the clinical effectiveness and safety profile of College of Pharmacy, University of Iowa, Iowa City, IA, USA 3 Clinical Pharmacy Department, University of Baghdad College of Pharmacy, Baghdad, Iraq 4 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 Therapeutic Drug Monitoring Center, Baghdad Teaching Hospital, Medical City Complex, Baghdad, Iraq comparison group. The intervention was routine Ministry of Health (MOH) approved 5 healthcare setting in Baghdad, Iraq from March 1st to May 25, 2020. The study out- University of Baghdad College of Medicine, Baghdad, Iraq 6 Baghdad Teaching Hospital, Medical City Teaching Complex, Baghdad, Iraq 7 Critical Care Unit, Bagdad Teaching Hospital, Medical City Complex, Internal Medicine Department in Al-Shifa center for the treatment of COVID-19, Baghdad, Iraq 8 Intensive Care Unit, Bagdad Teaching Hospital, Medical City Complex, Baghdad, Iraq 9 Faculty of Pharmacy, Philadelphia University, Amman, Jordan Correspondence Ali Azeez Al-Jumaili, University of Iowa, Iowa City, Iowa, USA. Email: Aliazeezali-aljumaili@uiowa.edu, ali. baraak@copharm.uobaghdad.edu.iq the management of COVID-19 for all patients. The study was conducted in a public come 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. 1 | I NTRO D U C TI O N 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 Coronavirus disease..