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

Running title: Hydroxychloroquine-Azithromycin and COVID-19

Philippe Gautret1,2,£ 1,3,$ 1,2 1,2,4, Jean-Christophe Lagier , Philippe Parola , Van Thuan Hoang ,11111Line Meddeb , Jacques Sevestre , Morgane Mailhe , Barbara Doudier, Camille Aubry ,11151Sophie Amrane , Piseth Seng , Marie Hocquart , Julie Finance , Vera Esteves Vieira , Hervé Tissot Dupont1,3 6,7 1,3 1,3, Stéphane Honoré , Andreas Stein , Matthieu Million , Philippe1,3 1,3 8 9 10Colson , Bernard La Scola , Véronique Veit , Alexis Jacquier , Jean-Claude DeharoMichel Drancourt1,3*Didier Raoult .


We need an effective treatment to cure COVID-19 patients and to decrease the virus carriage duration. 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 Day7, and 93% at Day8. Virus cultures from patient respiratory samples were negative in 97.5% patients at Day5. This allowed patients to rapidly de discharge from highly contagious wards with a mean length of stay of five days. 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.



The study shows a quick reduction of the viral load. 57.5% presented with at least one risk factor for complication of COVID-19 (Hypertension, diabetes, respiratory disease…) The treatment given was Hydroxychloroquine Sulfate 200 mg PO three times a day for 10 days with Azithromycin 500mg day 1 then 250 mg for the 4 following days. Patients with pneumonia received in addition Ceftriaxone. 79 out of the 80 patients received their treatment on average 4.9 days after the onset of the illness. The results show that 81.3% of patients (65/80) got a clinical improvement that enabled them to be discharged from the hospital.Only 15% required oxygen therapy. 3 patients were admitted in ICU. Only one out of these 3 patients (74 years old) is still in ICU. One death happened in a 86 year old patient. A quick drop of the nasopharyngeal viral load was observed with 83% of negative test at day 7 and 93% of negative tests at day 8. After 10 days, only 2 patients presented with a positive viral test. 97.5% of the viral cultures performed on respiratory samples were negative at day 5.

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