Early Treatment with Hydroxychloroquine and Azithromycin in 10,429 COVID-19 Outpatients: A Monocentric Retrospective Cohort Study
Million et al.,
Early Treatment with Hydroxychloroquine and Azithromycin in 10,429 COVID-19 Outpatients: A Monocentric..,
Reviews in Cardiovascular Medicine, doi:10.31083/j.rcm2203116 (date from earlier preprint)
Retrospective 10,429 outpatients in France, 8,315 treated with HCQ+AZ a median of 4 days from symptom onset, showing significantly lower mortality with treatment.
risk of death, 83.0% lower, HR 0.17, p < 0.001, treatment 5 of 8,315 (0.1%), control 11 of 2,114 (0.5%), NNT 217, adjusted per study.
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risk of ICU admission, 44.0% lower, HR 0.56, p = 0.18, treatment 17 of 8,315 (0.2%), control 7 of 2,114 (0.3%), NNT 789, adjusted per study.
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risk of hospitalization, 4.0% lower, HR 0.96, p = 0.77, treatment 214 of 8,315 (2.6%), control 64 of 2,114 (3.0%), adjusted per study.
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Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
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Million et al., 27 May 2021, retrospective, France, peer-reviewed, 28 authors, average treatment delay 4.0 days, dosage 200mg tid days 1-10, this trial uses multiple treatments in the treatment arm (combined with AZ) - results of individual treatments may vary.
Abstract: Medicine
Original Research
Early combination therapy with hydroxychloroquine and
azithromycin reduces mortality in 10,429 COVID-19
outpatients
Matthieu MILLION1, *, Jean-Christophe LAGIER1 , Hervé TISSOT-DUPONT1 , Isabelle RAVAUX1 , Catherine DHIVER1 ,
Christelle TOMEI1 , Nadim CASSIR1 , Léa DELORME2 , Sébastien CORTAREDONA2 , Sophie AMRANE2 , Camille AUBRY2 ,
Karim BENDAMARDJI1 , Cyril BERENGER2 , Barbara DOUDIER1 , Sophie EDOUARD1 , Marie HOCQUART2 , Morgane MAILHE1 ,
Coralie PORCHETO1 , Piseth SENG1 , Catherine TRIQUET1 , Stéphanie GENTILE3 , Elisabeth JOUVE3 ,
Audrey GIRAUD-GATINEAU2 , Herve CHAUDET2 , Laurence CAMOIN-JAU4 , Philippe COLSON1 , Philippe GAUTRET2 ,
Pierre-Edouard FOURNIER2 , Baptiste MAILLE5 , Jean-Claude DEHARO5 , Paul HABERT6 , Jean-Yves GAUBERT6 ,
Alexis JACQUIER6 , Stéphane HONORE7 , Katell GUILLON-LORVELLEC1 , Yolande OBADIA2 ,
Philippe PAROLA2 , Philippe BROUQUI1 , Didier RAOULT1
1
IHU-Méditerranée Infection, Aix Marseille Univ, Assistance Publique Hôpitaux de Marseille (AP-HM), Institut de recherche pour le développement (IRD),
Reviews
in
Cardiovascular
Unité Microbes Evolution Phylogénie et Infections (MEPHI),13005 Marseille, France
2
IHU-Méditerranée Infection, Aix Marseille Univ, Assistance Publique Hôpitaux de Marseille (AP-HM), Institut de recherche pour le développement (IRD),
Unité Vecteurs – Infections Tropicales et Méditerranéennes (VITROME), Service de santé des armées (SSA), 13005 Marseille, France
3
EA 3279: CEReSS - Health Service Research and Quality of Life Center, Service d'Evaluation Médicale, Aix Marseille Univ, Assistance Publique Hôpitaux de
Marseille, 13005 Marseille, France
4
Laboratoire D'Hématologie, Hôpital de La Timone, Assistance Publique Hôpitaux de Marseille, 13005 Marseille, France
5
Service de Cardiologie, Centre Hospitalier Universitaire La Timone, Assistance Publique Hôpitaux de Marseille, Aix Marseille Univ, C2VN, 13005 Marseille,
France
6
Radiology Department, La Timone Hospital, Assistance Publique Des Hôpitaux de Marseille, Aix Marseille Univ, LIIE, CERIMED, 13005 Marseille, France
7
Service de Pharmacie, Hôpital Timone, Laboratoire de Pharmacie Clinique, Aix Marseille Université AP-HM, 13005 Marseille, France
*Correspondence: matthieu.million@gmail.com (Matthieu MILLION)
DOI:10.31083/j.rcm2203116
This is an open access article under the CC BY 4.0 license (https://creativecommons.org/licenses/by/4.0/).
Submitted: 10 August 2021 Revised: 27 August 2021 Accepted: 30 August 2021 Published: 24 September 2021
We evaluated the age-specific mortality of unselected adult outpatients infected with SARS-CoV-2 treated early in a dedicated COVID19 day hospital and we assessed whether the use of hydroxychloroquine (HCQ) + azithromycin (AZ) was associated with improved survival in this cohort. A retrospective monocentric cohort study was
conducted in the day hospital of our center from March to December 2020 in adults with PCR-proven infection who were treated as
outpatients with a standardized protocol. The primary endpoint was
6-week mortality, and secondary endpoints were transfer to the intensive care unit and hospitalization rate. Among 10,429 patients
(median age, 45 [IQR 32–57] years; 5597 [53.7%] women), 16 died
(0.15%). The infection fatality rate was 0.06% among the 8315 patients treated with HCQ+AZ. No deaths occurred among the 8414 patients younger than 60 years. Older age and male sex were associated
with a higher risk of death, ICU transfer, and..
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