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All Studies   Meta Analysis    Recent:   

Viral Dynamics Matter in COVID-19 Pneumonia: the success of early treatment with hydroxychloroquine and azithromycin in Lebanon

Chamieh et al., medRxiv 2020.05.28.20114835, doi:10.1101/2020.05.28.20114835
May 2020  
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HCQ for COVID-19
1st treatment shown to reduce risk in March 2020
 
*, now known with p < 0.00000000001 from 422 studies, recognized in 42 countries.
No treatment is 100% effective. Protocols combine complementary and synergistic treatments. * >10% efficacy in meta analysis with ≥3 clinical studies.
4,100+ studies for 60+ treatments. c19hcq.org
HCQ+AZ potentially explains 94.7% success in treating a fairly complex cohort.
Chamieh et al., 28 May 2020, preprint, 10 authors.
This PaperHCQAll
Abstract: medRxiv preprint doi: https://doi.org/10.1101/2020.05.28.20114835; this version posted June 2, 2020. The copyright holder for this preprint (which was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. It is made available under a CC-BY-NC-ND 4.0 International license . 1 Category : Original Article 2 Title: Viral Dynamics Matter in COVID-19 Pneumonia: the success of early treatment with 3 hydroxychloroquine and azithromycin in Lebanon. 4 5 Authors: 6 Amanda Chamieh1,2, Claude Afif2, Gerard El-Hajj3, Omar Zmerli2, Isabelle Djaffar- 7 Jureidini4, Roy A. Raad3, Raja Ashou3, Georges Juvelekian5, Jean-Marc Rolain1 and Eid 8 Azar2* 9 10 11 Affiliations: 1- Aix-Marseille Université, AP-HM, Institut de Recherche pour le Développement 12 (IRD), Microbes Evolution Phylogeny and Infections (MEPHI), Institut Hospitalo- 13 Universitaire Méditerranée-Infection, Marseille, France. 14 15 16 17 18 19 20 21 2- Division of Infectious Diseases, Saint George Hospital University Medical Center, Beirut, Lebanon. 3- Department of Radiology, Saint George Hospital University Medical Center, Beirut, Lebanon. 4- Department of Laboratory Medicine, Saint George Hospital University Medical Center, Beirut, Lebanon. 5- Department of Pulmonary and Critical Care Medicine, Saint George Hospital University Medical Center, Beirut, Lebanon. 22 23 Running Title: Viral Dynamics Matter in COVID-19 Pneumonia 24 25 Declarations of Interest and Funding/Support Statement: 3 NOTE: This preprint reports new research that has not been certified by peer review and should not be used to guide clinical practice. medRxiv preprint doi: https://doi.org/10.1101/2020.05.28.20114835; this version posted June 2, 2020. The copyright holder for this preprint (which was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. It is made available under a CC-BY-NC-ND 4.0 International license . 26 This research did not receive any specific grant from funding agencies in the public, 27 commercial, or not-for-profit sectors. 28 Acknowledgements: 29 This work was supported by the Saint George Hospital University Medical Center 30 Beirut, Lebanon. 31 *Corresponding Author: 32 Eid Azar, M.D. 33 Infectious Disease, Chief of Staff 34 Associate Chief Medical Officer for Safety, Risk Management, and Infection Prevention and 35 Control 36 Saint George Hospital University Medical Center, Youssef Sursock St. – Achrafieh, Beirut, 37 Lebanon; eeazar@stgeorgehospital.org; +961 03 665358 38 39 40 4 medRxiv preprint doi: https://doi.org/10.1101/2020.05.28.20114835; this version posted June 2, 2020. The copyright holder for this preprint (which was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. It is made available under a CC-BY-NC-ND 4.0 International license . 41 Category: Original Article 42 43 Title: Viral Dynamics Matter in COVID-19 Pneumonia: the success of early treatment with 44 hydroxychloroquine and azithromycin in Lebanon. 45 46 Running Title: Viral Dynamics Matter in COVID-19 Pneumonia 5 medRxiv preprint doi: https://doi.org/10.1101/2020.05.28.20114835; this version posted June 2, 2020. The copyright holder for this preprint (which was not certified by peer review) is the author/funder, who has granted medRxiv a license to..
{ 'DOI': '10.1101/2020.05.28.20114835', 'URL': 'http://dx.doi.org/10.1101/2020.05.28.20114835', 'abstract': '<jats:label>1.</jats:label><jats:title>Abstract</jats:title><jats:sec><jats:label>1.1.</jats:label><jats:title>Background/Purpose</jats:title><jats:p>We ' 'share our experience in COVID-19 pneumonia management at Saint George Hospital University ' 'Medical Center (SGHUMC) in Lebanon. In the absence of a standard of care, early diagnosis and ' 'opt-in therapy with Hydroxychloroquine and Azithromycin were ' 'offered.</jats:p></jats:sec><jats:sec><jats:label>1.2.</jats:label><jats:title>Methods</jats:title><jats:p>We ' 'reviewed records of COVID-19 pneumonia patients from March 16-April 26 2020. Based on NEWS ' 'score, we stratified patients as A: low B: medium, and C: high clinical severity and obtained ' 'pharmacotherapy data. Chest-CT-severity-score (CTSS) was used. We defined clinical cure as ' 'resolution of symptoms and biomarkers and virologic cure as a PCR above 35 ' 'cycles(Ct).</jats:p></jats:sec><jats:sec><jats:label>1.3.</jats:label><jats:title>Results</jats:title><jats:p>We ' 'recorded 21 COVID-19 pneumonia patients of whom 19 opted for treatment. Clinical symptoms and ' 'laboratory markers at presentation did not significantly correlate with severity. Lower ' 'initial viral load significantly correlated with lower levels of clinical and radiological ' 'severity (p=0.038). Virologic cure, Ct&gt;35, by day 10, was only 33% in high severity ' 'significantly less than categories A and B. We observed 100% clinical cure at day 10 in ' 'Category-A, 67% in B, and 33% in C(p&lt;0.05). Patients with the lowest severity had the ' 'fastest virologic cure in a mean of 5.8 days from diagnosis, shortest hospitalization and ' 'earlier radiological improvement(p&lt;0.005). Ultimately, 18 patients were discharged home in ' 'good condition and one remains in the ' 'ICU.</jats:p></jats:sec><jats:sec><jats:label>1.4.</jats:label><jats:title>Conclusion</jats:title><jats:p>Viral ' 'dynamics matter in COVID-19 pneumonia. An early control of replication may be crucial in ' 'averting complications. Early administration of Hydroxychloroquine and Azithromycin ' 'potentially explains our 94.7% success rate in treating a fairly complex cohort of COVID-19 ' 'pneumonia.</jats:p></jats:sec>', 'accepted': {'date-parts': [[2020, 6, 2]]}, 'author': [ { 'ORCID': 'http://orcid.org/0000-0002-6158-8747', 'affiliation': [], 'authenticated-orcid': False, 'family': 'Chamieh', 'given': 'Amanda', 'sequence': 'first'}, {'affiliation': [], 'family': 'Afif', 'given': 'Claude', 'sequence': 'additional'}, { 'ORCID': 'http://orcid.org/0000-0002-8896-8280', 'affiliation': [], 'authenticated-orcid': False, 'family': 'El-Hajj', 'given': 'Gerard', 'sequence': 'additional'}, { 'ORCID': 'http://orcid.org/0000-0002-7908-0394', 'affiliation': [], 'authenticated-orcid': False, 'family': 'Zmerli', 'given': 'Omar', 'sequence': 'additional'}, { 'affiliation': [], 'family': 'Djaffar-Jureidini', 'given': 'Isabelle', 'sequence': 'additional'}, { 'ORCID': 'http://orcid.org/0000-0001-7561-6983', 'affiliation': [], 'authenticated-orcid': False, 'family': 'Raad', 'given': 'Roy A.', 'sequence': 'additional'}, {'affiliation': [], 'family': 'Ashou', 'given': 'Raja', 'sequence': 'additional'}, {'affiliation': [], 'family': 'Juvelekian', 'given': 'Georges', 'sequence': 'additional'}, { 'ORCID': 'http://orcid.org/0000-0002-2402-4467', 'affiliation': [], 'authenticated-orcid': False, 'family': 'Rolain', 'given': 'Jean-Marc', 'sequence': 'additional'}, { 'ORCID': 'http://orcid.org/0000-0002-8368-2670', 'affiliation': [], 'authenticated-orcid': False, 'family': 'Azar', 'given': 'Eid', 'sequence': 'additional'}], 'container-title': [], 'content-domain': {'crossmark-restriction': False, 'domain': []}, 'created': {'date-parts': [[2020, 6, 2]], 'date-time': '2020-06-02T21:45:16Z', 'timestamp': 1591134316000}, 'deposited': { 'date-parts': [[2022, 10, 26]], 'date-time': '2022-10-26T04:53:48Z', 'timestamp': 1666760028000}, 'group-title': 'Infectious Diseases (except HIV/AIDS)', 'indexed': { 'date-parts': [[2022, 10, 27]], 'date-time': '2022-10-27T04:21:35Z', 'timestamp': 1666844495915}, 'institution': [{'name': 'medRxiv'}], 'is-referenced-by-count': 0, 'issued': {'date-parts': [[2020, 6, 2]]}, 'link': [ { 'URL': 'https://syndication.highwire.org/content/doi/10.1101/2020.05.28.20114835', 'content-type': 'unspecified', 'content-version': 'vor', 'intended-application': 'similarity-checking'}], 'member': '246', 'original-title': [], 'posted': {'date-parts': [[2020, 6, 2]]}, 'prefix': '10.1101', 'published': {'date-parts': [[2020, 6, 2]]}, 'publisher': 'Cold Spring Harbor Laboratory', 'reference': [ { 'key': '2020122908400627000_2020.05.28.20114835v1.1', 'unstructured': 'Coronavirus disease 2019 [Internet]. 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Late treatment
is less effective
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