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An Independent Analysis of a Retrospective Cohort of 30,423 Covid-19 Patients Treated at IHU-Mediterranean in Marseille, France: Part 1, Efficacy of early Treatment with Hydroxychloroquine and Azithromycin

Lounnas et al., Archives of Microbiology & Immunology, doi:10.26502/ami.936500153
Feb 2024  
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Death/ICU 58% Improvement Relative Risk HCQ for COVID-19  Lounnas et al.  EARLY TREATMENT Is early treatment with HCQ beneficial for COVID-19? PSM retrospective study in France (March 2020 - December 2021) Lower death/ICU with HCQ (p<0.000001) Lounnas et al., Archives of Microbiolo.., Feb 2024 FavorsHCQ Favorscontrol 0 0.5 1 1.5 2+
HCQ for COVID-19
1st treatment shown to reduce risk in March 2020
*, now with p < 0.00000000001 from 411 studies, recognized in 46 countries.
No treatment is 100% effective. Protocols combine treatments. * >10% efficacy, ≥3 studies.
4,400+ studies for 79 treatments.
Independent analysis of the IHU-Mediterranean data1 with 30,423 COVID-19 patients showing significantly lower risk of ICU admission or death with early treatment of hydroxychloroquine plus azithromycin (HCQ-AZ), and with azithromycin, both compared to no treatment.
risk of death/ICU, 58.1% lower, OR 0.42, p < 0.001, adjusted per study, propensity score matching, multivariable, RR approximated with OR.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Lounnas et al., 29 Feb 2024, retrospective, France, peer-reviewed, 6 authors, study period March 2020 - December 2021.
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An Independent Analysis of a Retrospective Cohort of 30,423 Covid-19 Patients Treated at IHU-Mediterranean in Marseille, France: Part 1, Efficacy of early Treatment with Hydroxychloroquine and Azithromycin
Valere Lounnas, Eleftherios Gkioulekas, Marc Rendell, Alexis Lacout, Xavier Azalbert, Christian Perronne
Archives of Microbiology & Immunology, doi:10.26502/ami.936500153
A cohort of 30, patients treated between March 2020 and December 2021 at the IHU-Méditerranée Infection in Marseille (France) was retrospectively analyzed in terms of treatment attempted and disease worsening factors to quantify efficacy with respect to the composite endpoint of transfer to intensive care unit or death, within a couple of months (56 days) from admission. Within limitations of the data and of the models, after adjustment for sampling biases, multivariate logistic regression analyses were performed to determine unadjusted and adjusted odds ratios (ORs) for the subset of patients having received the combined treatment hydroxychloroquine plus azithromycin (HCQ-AZ) or no specific treatment (i.e. no HCQ, no AZ and no ivermectin (IVM)) (24,943 patients). An efficacy of 58% in reducing the risk of ICU transfer and death was measured (HCQ-AZ unadjusted OR = 0.499; 95%CI = [0.343; 0.727], p < 0.001) (HCQ-AZ adjusted OR = 0.419; 95%CI = [0.327; 0.539], p < 0.001). AZ without HCQ but associated with ivermectin in 31.3% of the cases was significantly active as well with respect to no specific treatment, with a measured efficacy of 27% (unadjusted OR = 0.720, 95% CI = [0.574; 0.905] p = 0.005 and adjusted OR = 0.727, 95%CI = [0.608; 0.870] p < 0.001). Interactions between HCQ-AZ and the model covariates were systematically explored. No interaction between HCQ-AZ treatment and vaccination was detected. Statistically significant favorable interactions were detected between HCQ-AZ treatment and male sex, age categories ≥ 50 years, the UK variant and when the variant was not determined, obesity, chronic obstructive pulmonary disease (COPD), cancer, immunodeficiency, confirming the high efficacy of this early treatment. No statistically significant unfavorable interaction of HCQ-AZ with any covariate was detected. Limitations of the models and their implications for the results are discussed extensively.
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