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Triple therapy with hydroxychloroquine, azithromycin, and ciclesonide for COVID-19 pneumonia

Mori et al., Journal of Microbiology, Immunology and Infection, doi:10.1016/j.jmii.2020.09.003
Oct 2020  
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HCQ for COVID-19
1st treatment shown to reduce risk in March 2020, now with p < 0.00000000001 from 419 studies, recognized in 46 countries.
No treatment is 100% effective. Protocols combine treatments.
5,100+ studies for 112 treatments. c19hcq.org
Small case study of 5 patients in Japan showing improvement with HCQ+AZ+ciclesonide.
Mori et al., 5 Oct 2020, peer-reviewed, 3 authors.
This PaperHCQAll
Triple therapy with hydroxychloroquine, azithromycin, and ciclesonide for COVID-19 pneumonia
Nobuaki Mori, Mitsuya Katayama, Shigenari Nukaga
Journal of Microbiology, Immunology and Infection, doi:10.1016/j.jmii.2020.09.003
No specific therapy is available for COVID-19. We report the effectiveness and adverse effects of triple therapy with hydroxychloroquine, azithromycin, and ciclesonide in patients with COVID-19 pneumonia. The clinical condition of the patients improved within 5 days in response to the therapy.
Ethical approval This study was approved by the National Hospital Organization Tokyo Medical Center Ethics Committee (R20-048). Triple therapy for COVID-19 pneumonia The need for patient consent was waived owing to the retrospective nature of the study. Declaration of competing interest All authors do not have any conflicts of interest to declare.
References
Bhimraj, Morgan, Shumaker, Lavergne, Baden et al., Infectious diseases society of America guidelines on the treatment and management of patients with COVID-19, Clin Infect Dis, doi:10.1093/cid/ciaa478
Chaolin, Yeming, Xingwang, Lili, Jianping et al., Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China, Lancet, doi:10.1016/S0140-6736(20)30183-5
Gautret, Lagier, Parola, Hoang, Meddeb et al., Hydroxychloroquine and azithromycin as a treatment of COVID-19: results of an open-label clinical trial, Int J Antimicrob Agents, doi:10.1016/j.ijantimicag.2020.105949
Joshua, Yifei, Matthew, George, Observational study of hydroxychloroquine in hospitalized patients with Covid-19, N Engl J Med
Matsuyama, Kawase, Nao, Shirato, Makoto et al., The inhaled corticosteroid ciclesonide blocks coronavirus RNA replication by targeting viral NSP15, Biorxivorg, doi:10.1101/2020.03.11.987016
Sanders, Monogue, Jodlowski, Cutrell, Pharmacologic treatments for coronavirus disease 2019 (COVID-19), J Am Med Assoc, doi:10.1001/jama.2020.6019
Taccone, Gorham, Vincent, Hydroxychloroquine in the management of critically ill patients with COVID-19: the need for an evidence base Comment, The Lancet Respiratory, doi:10.1016/S2213-2600(20)30172-7
Zimmermann, Ziesenitz, Curtis, Ritz, The immunomodulatory effects of macrolidesda systematic review of the underlying mechanisms, Front Immunol
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Late treatment
is less effective
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