Abstract: Travel Medicine and Infectious Disease 36 (2020) 101791 Contents lists available at ScienceDirect Travel Medicine and Infectious Disease journal homepage: www.elsevier.com/locate/tmaid Outcomes of 3,737 COVID-19 patients treated with hydroxychloroquine/ azithromycin and other regimens in Marseille, France: A retrospective analysis Jean-Christophe Lagier a, b, 1, Matthieu Million a, b, 1, Philippe Gautret a, c, Philippe Colson a, b, S�ebastien Cortaredona a, c, Audrey Giraud-Gatineau a, c, d, e, St�ephane Honor�e f, g, Jean-Yves Gaubert h, Pierre-Edouard Fournier a, c, Herv�e Tissot-Dupont a, b, Eric Chabri�ere a, b, Andreas Stein a, b, Jean-Claude Deharo i, Florence Fenollar a, c, Jean-Marc Rolain a, b, Yolande Obadia a, Alexis Jacquier j, Bernard La Scola a, b, Philippe Brouqui a, b, Michel Drancourt a, b, Philippe Parola a, c, Didier Raoult a, b, *, IHU COVID-19 Task force a IHU-M�editerran�ee Infection, Marseille, France Aix Marseille University, IRD, AP-HM, MEPHI, Marseille, France Aix Marseille University, IRD, AP-HM, SSA, VITROME, Marseille, France d Centre d’Epid�emiologie et de Sant�e Publique des Arm�ees (CESPA), Marseille, France e AP-HM, Marseille, France f Aix Marseille University, Laboratoire de Pharmacie Clinique, Marseille, France g AP-HM, H^ opital Timone, Service Pharmacie, Marseille, France h Department of Radiology and Cardiovascular Imaging, Aix Marseille Univ, LIIE, Marseille, France i AP-HM, Aix Marseille University, H^ opital Timone, Cardiologie, Rythmologie, Marseille, France j Department of Radiology and Cardiovascular Imaging, Aix-Marseille Univ., UMR 7339, CNRS, CRMBM-CEMEREM (Centre de R�esonance Magn�etique Biologique et M�edicale-Centre d’Exploration M�etaboliques Par R�esonance Magn�etique), Marseille, France b c A R T I C L E I N F O A B S T R A C T Keywords: SARS-CoV-2 COVID-19 Hydroxychloroquine Azithromycin Background: In our institute in Marseille, France, we initiated early and massive screening for coronavirus disease 2019 (COVID-19). Hospitalization and early treatment with hydroxychloroquine and azithromycin (HCQ-AZ) was proposed for the positive cases. Methods: We retrospectively report the clinical management of 3,737 screened patients, including 3,119 (83.5%) treated with HCQ-AZ (200 mg of oral HCQ, three times daily for ten days and 500 mg of oral AZ on day 1 fol­ lowed by 250 mg daily for the next four days, respectively) for at least three days and 618 (16.5%) patients treated with other regimen (“others”). Outcomes were death, transfer to the intensive care unit (ICU), �10 days of hospitalization and viral shedding. Results: The patients’ mean age was 45 (sd 17) years, 45% were male, and the case fatality rate was 0.9%. We performed 2,065 low-dose computed tomography (CT) scans highlighting lung lesions in 592 of the 991 (59.7%) patients with minimal clinical symptoms (NEWS score ¼ 0). A discrepancy between spontaneous dyspnoea, hypoxemia and lung lesions was observed. Clinical factors (age, comorbidities, NEWS-2 score), biological factors (lymphocytopenia; eosinopenia; decrease in blood zinc; and increase in D-dimers, lactate dehydrogenase, creatinine phosphokinase, troponin and C-reactive protein) and moderate and severe lesions detected in low-dose CT scans were associated with poor clinical outcome. Treatment with HCQ-AZ was associated with a decreased risk of transfer to ICU or death (Hazard ratio (HR) 0.18 0.11–0.27), decreased risk of hospitalization �10 days (odds ratios 95%..