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..