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Beneficial effect of Hydroxychloroquine-Azithromycin combination in the treatment of elderly patients with Covid-19: results of an observational study

Pirnay et al., Hosp. Pharm. and Clinician, doi:10.1016/j.phclin.2020.06.001
Jun 2020  
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HCQ for COVID-19
1st treatment shown to reduce risk in March 2020, now with p < 0.00000000001 from 423 studies, used in 59 countries.
No treatment is 100% effective. Protocols combine treatments.
5,500+ studies for 119 treatments. c19hcq.org
68 very high risk nursing home residents, median age 86, HCQ+AZ early treatment within 2.5 days onset, 2 stopped due to QTc. Only 7 died, significantly less than other nursing homes in France and the same as the median death for the same period in 2019/2018.
Pirnay et al., 9 Jun 2020, peer-reviewed, 13 authors.
This PaperHCQAll
Effet bénéfique de l’association hydroxychloroquine/azithromycine dans le traitement des patients âgés atteints de la COVID-19 : résultats d’une étude observationnelle
G Pirnay, B Dantier, W Tourid, A Terkemani, F Bachot, L Hadim, N Abdous, W Amara, Z Abrous, A Bozel, M-L Gaubert-Dahan, R Aikpa, F Fauvelle
Le Pharmacien Hospitalier et Clinicien, doi:10.1016/j.phclin.2020.06.001
Soixante-huit patients tous âgés de plus de 65 ans et diagnostiqués PCR-positif pour la COVID-19 ont reçu l'association hydroxychloroquine/azithromycine entre le 27 mars et le 1 er mai 2020. Les posologies de l'hydroxychloroquine et d'azithromycine étaient conformes au protocole de l'Institut hospitalo-universitaire de Marseille. La moyenne d'âge était de 86,4 AE 8,2 ans, l'IMC moyen était de 22,8 AE 5,2 kg/m 2 . Dix neuf patients présentaient un surpoids (IMC supérieur à 25 kg/m 2 ) dont quatre une obésité (IMC supérieur à 30 kg/m 2 ). Sept patients présentaient une insuffisance rénale inférieure à 30 mL/min. Le relevé des pathologies associées indiquait que près de 51,5 % des patients présentaient de l'hypertension artérielle tandis que 28 % étaient atteints de cardiopathies. Parmi eux, 16,2 % présentaient un diabète. Un seul patient présentait de l'asthme et un autre de la BPCO. Deux patients ont dû arrêter leur traitement après respectivement 3 et 9 jours de bithérapie à cause d'un allongement du QTc. L'objectif de notre étude était d'évaluer l'efficacité de l'association hydroxychloroquine/azithromycine chez des sujets âgés atteints de la COVID-19. Durant la période de l'étude, 7 patients sont décédés parmi les 68 patients étudiés. Tous les décès sont survenus par des complications respiratoires graves de la maladie. Les autres patients ont été considérés guéris après disparition des signes cliniques 21 jours après le test PCR+.
References
Ansm, None
Devaux, Rolain, Colson, New insights on the antiviral effects of chloroquine against coronavirus: what do expect for COVID-19?, Int J Antimicrob Agents
Gautret, Lagier, Parola, Hydroxychloroquine and azithromycine as a treatment of COVID-19: results of an open-label non-randomized clinical trial, Int J Antimicrob Agents
Geleris, Sun, Platt, Observational study of hydroxychloroquine in hospitalized patients with COVID-19, N Engl J Med, doi:10.1056/NEJMoa2012410
Mahevas, Tran, Roumier, No evidence of clinical efficacy of hydroxychloroquine in patients hospitalized for COVID-19 infection with oxygen requirement: results of a study using routinely collected data to emulate a target trial, MedRxiv, doi:10.1101/2020.04.10.20060699
Mehra, Desai, Ruschitzka, Hydroxychloroquine or chloroquine with or without macrolide for treatment of COVID-19: a multinational registry analysis, Lancet
Million, Lagier, Gautret, Early treatment of 1061 COVID-19 patients with hydroxychloroquine and azithromycin, Marseille
Yu, Wen, Li, Hydroxychloroquine application is associated with a decreased mortality in critically ill patients with COVID-19, BMJ
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