Abstract: See discussions, stats, and author profiles for this publication at: https://www.researchgate.net/publication/340293105
No Evidence of Rapid Antiviral Clearance or Clinical Benefit with the
Combination of Hydroxychloroquine and Azithromycin in Patients with
Severe COVID-19 Infection
Article in Médecine et Maladies Infectieuses · March 2020
DOI: 10.1016/j.medmal.2020.03.006
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Letter to the editor
No evidence of rapid antiviral clearance or clinical benefit with the combination of hydroxychloroquine and
azithromycin in patients with severe COVID-19 infection
The COVID-19 epidemic is the worst worldwide pandemic in a
century with more than 500,000 cases and 25,000 deaths so far. In
France, more than 30,000 cases have been reported up to March 27,
and nearly 2000 have died.
Pending the availability of a vaccine, there is a critical need to
identify effective treatments and a number of clinical trials have
been implemented worldwide.
Chloroquine analogs have been shown to inhibit the acidification of endosomes and to exhibit in vitro a non-specific antiviral
activity at high micromolar concentration against a broad range of
emerging virus (HIV, dengue, hepatitis C, chikungunya, influenza,
Ebola, SARS and MERS viruses) and more recently COVID-19 [1,2].
In France, following the results of a clinical study in Marseille,
there is considerable interest for the use of hydroxychloroquine to
treat COVID-19 disease, and the French Ministry of Health recently
allowed the use of hydroxychloroquine to treat COVID-19 disease
pending the results of ongoing clinical trials [3].
In their study, Gautret et al. reported a 100% viral clearance in
nasopharyngeal swabs in 6 patients after 5 and 6 days of the combination of hydroxychloroquine and azithromycin [3]. This rate of
viral clearance was lower with hydroxychloroquine alone (57.1%)
and was only 12.5% in patients who did not receive hydroxychloroquine (P < 0.001).
Such a rapid and full viral clearance was quite unexpected and
we wished to assess in a prospective study virologic and clinical
outcomes of 11 consecutive patients hospitalised in our department who received hydroxychloroquine (600 mg/d for 10 days) and
azithromycin (500 mg day 1 and 250 mg days 2 to 5) using the same
dosing regimen reported by Gautret et al. [3].
There were 7 men and 4 women with a mean age of 58.7 years
(range: 20–77), 8 had significant comorbidities associated with
poor outcomes (obesity: 2; solid cancer: 3; hematological cancer:
2;..
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