Outcomes of 3,737 COVID-19 patients treated with hydroxychloroquine/azithromycin and other regimens in Marseille, France: A retrospective analysis
Lagier et al.
, Outcomes of 3,737 COVID-19 patients treated with hydroxychloroquine/azithromycin and other regimens in..
, Travel Med. Infect. Dis. 101791, Jun 25, 2020, doi:10.1016/j.tmaid.2020.101791
Early treatment leads to significantly better clinical outcome and faster viral load reduction. Matched sample mortality HR 0.41 p-value 0.048. Retrospective 3,737 patients. This study includes both outpatients and hospitalized patients.
risk of death, 59.0% lower, HR 0.41, p = 0.048, treatment 35 of 3,119 (1.1%), control 58 of 618 (9.4%), adjusted per study.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Lagier et al., 25 Jun 2020, retrospective, France, peer-reviewed, 22 authors, dosage 200mg tid days 1-10.
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
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
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
Centre d’Epid�emiologie et de Sant�e Publique des Arm�ees (CESPA), Marseille, France
AP-HM, Marseille, France
Aix Marseille University, Laboratoire de Pharmacie Clinique, Marseille, France
opital Timone, Service Pharmacie, Marseille, France
Department of Radiology and Cardiovascular Imaging, Aix Marseille Univ, LIIE, Marseille, France
AP-HM, Aix Marseille University, H^
opital Timone, Cardiologie, Rythmologie, Marseille, France
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
A R T I C L E I N F O
A B S T R A C T
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%..
is less effective
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