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Clinical and microbiological effect of a combination of hydroxychloroquine and azithromycin in 80 COVID-19 patients with at least a six-day follow up: an observational study

https://www.mediterranee-infection.com/wp-content/uploads/2020/03/COVID-IHU-2-1.pdf

In 80 in-patients receiving a combination of hydroxychloroquine and azithromycin we noted a clinical improvement in all but one 86-year-old patient who died, and one 74-year-old patient still in intensive care unit. A rapid fall of nasopharyngeal viral load tested by qPCR was noted, with 83% negative at Day 7, and 93% at Day8. Virus cultures from patient respiratory samples were negative in 97.5% patients at Day5. This allowed patients to rapidly discharge from highly contagious wards with a mean length of stay of five days.

George Martin, MD commentary:

This 80-patient study further supports the combined use of HCQ 200 mg TID + azithromycin 500 mg day on day 1 followed by 250 mg QD x 4 days. For patients with pneumonia and NEWS score≥5, a broad-spectrum antibiotic (ceftriaxone) was added to hydroxychloroquine and azithromycin.

The key to this therapy is early intervention. The mean time between the onset of symptoms and the initiation of treatment was 4.9 days and most patients were treated on the day of admission or on the day after (93.7%).

The most important outcome measure is that the protocol allowed patients to rapidly discharge from highly contagious wards with a mean length of stay of five days.

The author said it best: “We believe other teams should urgently evaluate this cost-effective therapeutic strategy, to both avoid the spread of the disease and treat patients as soon as possible before severe respiratory irreversible complications take hold”.