Abstract: Travel Medicine and Infectious Disease 34 (2020) 101663 Contents lists available at ScienceDirect Travel Medicine and Infectious Disease journal homepage: www.elsevier.com/locate/tmaid Original article Clinical and microbiological effect of a combination of hydroxychloroquine and azithromycin in 80 COVID-19 patients with at least a six-day follow up: A pilot observational study T Philippe Gautreta,b,1, Jean-Christophe Lagiera,c,1, Philippe Parolaa,b, Van Thuan Hoanga,b,d, Line Meddeba, Jacques Sevestrea, Morgane Mailhea, Barbara Doudiera, Camille Aubrya, Sophie Amranea, Piseth Senga, Marie Hocquarta, Carole Eldina,b, Julie Financee, Vera Esteves Vieiraa, Hervé Tissot Tissot-Duponta,c, Stéphane Honoréf,g, Andreas Steina,c, Matthieu Milliona,c, Philippe Colsona,c, Bernard La Scolaa,c, Véronique Veith, Alexis Jacquieri, Jean-Claude Deharoj, Michel Drancourta,c, Pierre Edouard Fourniera,b, Jean-Marc Rolaina,c, Philippe Brouquia,c, Didier Raoulta,c,∗ a IHU-Méditerranée Infection, Marseille, France Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, Marseille, France Aix Marseille Univ, IRD, APHM, MEPHI, Marseille, France d Thai Binh University of Medicine and Pharmacy, Thai Binh, Viet Nam e Assistance Publique de Marseille, Hôpital Nord, Explorations Fonctionnelles Respiratories, Aix Marseille Université, France f Service de Pharmacie, Hôpital Timone, AP-HM, Marseille, France g Laboratoire de Pharmacie Clinique, Aix Marseille Université, Marseille, France h Assistance Publique de Marseille, Médecine Interne, Unité de Médecine Aigue Polyvalente (UMAP), France i Department of Radiology and Cardiovascular Imaging, Aix-Marseille Université, UMR 7339, CNRS, CRMBM-CEMEREM (Centre de Résonance Magnétique Biologique et Médicale-Centre d'Exploration Métaboliques par Résonance Magnétique), France j Assistance Publique de Marseille, Hôpital Timone, Cardiologie, Rythomologie, Aix Marseille Université, France b c ARTICLE INFO ABSTRACT Keywords: COVID-19 SARS-CoV-2 Hydroxychloroquine Azithromycin PCR Culture Background: We need an effective treatment to cure COVID-19 patients and to decrease virus carriage duration. Methods: We conducted an uncontrolled, non-comparative, observational study in a cohort of 80 relatively mildly infected inpatients treated with a combination of hydroxychloroquine and azithromycin over a period of at least three days, with three main measurements: clinical outcome, contagiousness as assessed by PCR and culture, and length of stay in infectious disease unit (IDU). Results: All patients improved clinically except one 86 year-old patient who died, and one 74 year-old patient still in intensive care. A rapid fall of nasopharyngeal viral load was noted, with 83% negative at Day7, and 93% at Day8. Virus cultures from patient respiratory samples were negative in 97.5% of patients at Day5. Consequently patients were able to be rapidly discharged from IDU with a mean length of stay of five days. Conclusion: We believe there is urgency to evaluate the effectiveness of this potentially-life saving therapeutic strategy at a larger scale, both to treat and cure patients at an early stage before irreversible severe respiratory complications take hold and to decrease duration of carriage and avoid the spread of the disease. Furthermore, the cost of treatment is negligible.