Early Treatment of COVID-19 Patients With Hydroxychloroquine and Azithromycin: A Retrospective Analysis of 1061 Cases in Marseille, France
Million et al.,
Early Treatment of COVID-19 Patients With Hydroxychloroquine and Azithromycin: A Retrospective Analysis of..,
Travel Med Infect Dis., 2020 May 5, doi:10.1016/j.tmaid.2020.101738
Retrospective 1061 patients. HCQ+AZ safe and results in a low fatality rate.
Million et al., 5 May 2020, peer-reviewed, 37 authors.
Abstract: Travel Medicine and Infectious Disease 35 (2020) 101738
Contents lists available at ScienceDirect
Travel Medicine and Infectious Disease
journal homepage: www.elsevier.com/locate/tmaid
Early treatment of COVID-19 patients with hydroxychloroquine and
azithromycin: A retrospective analysis of 1061 cases in Marseille, France
T
Matthieu Milliona,b,1, Jean-Christophe Lagiera,b,1, Philippe Gautreta,c,1, Philippe Colsona,b,
Pierre-Edouard Fourniera,c, Sophie Amranea,b, Marie Hocquarta, Morgane Mailhea,
Vera Esteves-Vieiraa, Barbara Doudiera, Camille Aubrya, Florian Correardd,e,
Audrey Giraud-Gatineaua,c,f,g, Yanis Roussela,b, Cyril Berengera,c, Nadim Cassira,b, Piseth Senga,b,
Christine Zandottia, Catherine Dhivera, Isabelle Ravauxa, Christelle Tomeia, Carole Eldina,c,
Hervé Tissot-Duponta, Stéphane Honoréd,e, Andreas Steina,b, Alexis Jacquierh,
Jean-Claude Deharoi, Eric Chabrièrea,b, Anthony Levasseura,b, Florence Fenollara,c,
Jean-Marc Rolaina,b, Yolande Obadiaa, Philippe Brouquia,b, Michel Drancourta,b,
Bernard La Scolaa,b, Philippe Parolaa,c, Didier Raoulta,b,∗
a
IHU-Méditerranée Infection, Marseille, France
Aix Marseille Univ., IRD, AP-HM, MEPHI, Marseille, France
Aix Marseille Univ., IRD, AP-HM, SSA, VITROME, Marseille, France
d
Aix Marseille Univ., Laboratoire de Pharmacie Clinique, Marseille, France
e
AP-HM, hôpital Timone, service Pharmacie, Marseille, France
f
Centre d'Epidémiologie et de Santé Publique des Armées (CESPA), Marseille, France
g
AP-HM, Marseille, France
h
Department of Radiology and Cardiovascular Imaging, Aix-Marseille Univ., UMR 7339, CNRS, CRMBM-CEMEREM (Centre de Résonance Magnétique Biologique et
Médicale-Centre d'Exploration Métaboliques par Résonance Magnétique), Marseille, France
i
AP-HM, Aix Marseille Univ., hôpital Timone, Cardiologie, Rythmologie, Marseille, France
b
c
A R T I C LE I N FO
A B S T R A C T
Keywords:
SARS-CoV-2
COVID-19
Hydroxychloroquine
Azithromycin
Background: In France, the combination hydroxychloroquine (HCQ) and azithromycin (AZ) is used in the
treatment of COVID-19.
Methods: We retrospectively report on 1061 SARS-CoV-2 positive tested patients treated for at least three days
with the following regimen: HCQ (200 mg three times daily for ten days) + AZ (500 mg on day 1 followed by
250 mg daily for the next four days). Outcomes were death, clinical worsening (transfer to ICU, and > 10 day
hospitalization) and viral shedding persistence (> 10 days).
Results: A total of 1061 patients were included in this analysis (46.4% male, mean age 43.6 years – range 14–95
years). Good clinical outcome and virological cure were obtained in 973 patients within 10 days (91.7%).
Prolonged viral carriage was observed in 47 patients (4.4%) and was associated to a higher viral load at diagnosis (p < .001) but viral culture was negative at day 10. All but one, were PCR-cleared at day 15. A poor
clinical outcome (PClinO) was observed for 46 patients (4.3%) and 8 died (0.75%) (74–95 years old). All deaths
resulted from respiratory failure and not from cardiac toxicity. Five patients are still hospitalized (98.7% of
patients cured so far). PClinO was associated with older age (OR 1.11), severity of illness at admission (OR
10.05) and low HCQ serum concentration. PClinO was independently associated with the use of selective betablocking agents and angiotensin II receptor blockers (p < .05). A total of 2.3% of patients reported mild adverse
events (gastrointestinal or skin symptoms, headache, insomnia and..
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