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Reviews in Cardiovascular Medicine  2021, Vol. 22 Issue (3): 1063-1072     DOI: 10.31083/j.rcm2203116
Special Issue: Utilizing Technology in the COVID 19 era
Original Research Previous articles |
Early combination therapy with hydroxychloroquine and azithromycin reduces mortality in 10,429 COVID-19 outpatients
Matthieu MILLION1, *(), Jean-Christophe LAGIER1, Hervé TISSOT-DUPONT1, Isabelle RAVAUX1, Catherine DHIVER1, Christelle TOMEI1, Nadim CASSIR1, Léa DELORME2, Sébastien CORTAREDONA2, Sophie AMRANE2, Camille AUBRY2, Karim BENDAMARDJI1, Cyril BERENGER2, Barbara DOUDIER1, Sophie EDOUARD1, Marie HOCQUART2, Morgane MAILHE1, Coralie PORCHETO1, Piseth SENG1, Catherine TRIQUET1, Stéphanie GENTILE3, Elisabeth JOUVE3, Audrey GIRAUD-GATINEAU2, Herve CHAUDET2, Laurence CAMOIN-JAU4, Philippe COLSON1, Philippe GAUTRET2, Pierre-Edouard FOURNIER2, Baptiste MAILLE5, Jean-Claude DEHARO5, Paul HABERT6, Jean-Yves GAUBERT6, Alexis JACQUIER6, Stéphane HONORE7, Katell GUILLON-LORVELLEC1, Yolande OBADIA2, Philippe PAROLA2, Philippe BROUQUI1, Didier RAOULT1
1IHU-Méditerranée Infection, Aix Marseille Univ, Assistance Publique Hôpitaux de Marseille (AP-HM), Institut de recherche pour le développement (IRD), Unité Microbes Evolution Phylogénie et Infections (MEPHI),13005 Marseille, France
2IHU-Méditerranée Infection, Aix Marseille Univ, Assistance Publique Hôpitaux de Marseille (AP-HM), Institut de recherche pour le développement (IRD),
Unité Vecteurs – Infections Tropicales et Méditerranéennes (VITROME), Service de santé des armées (SSA), 13005 Marseille, France
3EA 3279: CEReSS - Health Service Research and Quality of Life Center, Service d'Evaluation Médicale, Aix Marseille Univ, Assistance Publique Hôpitaux de Marseille, 13005 Marseille, France
4Laboratoire D'Hématologie, Hôpital de La Timone, Assistance Publique Hôpitaux de Marseille, 13005 Marseille, France
5Service de Cardiologie, Centre Hospitalier Universitaire La Timone, Assistance Publique Hôpitaux de Marseille, Aix Marseille Univ, C2VN, 13005 Marseille, France
6Radiology Department, La Timone Hospital, Assistance Publique Des Hôpitaux de Marseille, Aix Marseille Univ, LIIE, CERIMED, 13005 Marseille, France
7Service de Pharmacie, Hôpital Timone, Laboratoire de Pharmacie Clinique, Aix Marseille Université AP-HM, 13005 Marseille, France
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Abstract:
We evaluated the age-specific mortality of unselected adult outpatients infected with SARS-CoV-2 treated early in a dedicated COVID-19 day hospital and we assessed whether the use of hydroxychloroquine (HCQ) + azithromycin (AZ) was associated with improved survival in this cohort. A retrospective monocentric cohort study was conducted in the day hospital of our center from March to December 2020 in adults with PCR-proven infection who were treated as outpatients with a standardized protocol. The primary endpoint was 6-week mortality, and secondary endpoints were transfer to the intensive care unit and hospitalization rate. Among 10,429 patients (median age, 45 [IQR 32–57] years; 5597 [53.7%] women), 16 died (0.15%). The infection fatality rate was 0.06% among the 8315 patients treated with HCQ+AZ. No deaths occurred among the 8414 patients younger than 60 years. Older age and male sex were associated with a higher risk of death, ICU transfer, and hospitalization. Treatment with HCQ+AZ (0.17 [0.06–0.48]) was associated with a lower risk of death, independently of age, sex and epidemic period. Meta-analysis evidenced consistency with 4 previous outpatient studies (32,124 patients—Odds ratio 0.31 [0.20–0.47], I2 = 0%). Early ambulatory treatment of COVID-19 with HCQ+AZ as a standard of care is associated with very low mortality, and HCQ+AZ improve COVID-19 survival compared to other regimens.
Key words:  SARS-CoV-2      COVID-19      Hydroxychloroquine      Azithromycin      Ambulatory      Outpatients      Treatment     
Submitted:  10 August 2021      Revised:  27 August 2021      Accepted:  30 August 2021      Published:  24 September 2021     
*Corresponding Author(s):  Matthieu MILLION     E-mail:  matthieu.million@gmail.com

Cite this article: 

Matthieu MILLION, Jean-Christophe LAGIER, Hervé TISSOT-DUPONT, Isabelle RAVAUX, Catherine DHIVER, Christelle TOMEI, Nadim CASSIR, Léa DELORME, Sébastien CORTAREDONA, Sophie AMRANE, Camille AUBRY, Karim BENDAMARDJI, Cyril BERENGER, Barbara DOUDIER, Sophie EDOUARD, Marie HOCQUART, Morgane MAILHE, Coralie PORCHETO, Piseth SENG, Catherine TRIQUET, Stéphanie GENTILE, Elisabeth JOUVE, Audrey GIRAUD-GATINEAU, Herve CHAUDET, Laurence CAMOIN-JAU, Philippe COLSON, Philippe GAUTRET, Pierre-Edouard FOURNIER, Baptiste MAILLE, Jean-Claude DEHARO, Paul HABERT, Jean-Yves GAUBERT, Alexis JACQUIER, Stéphane HONORE, Katell GUILLON-LORVELLEC, Yolande OBADIA, Philippe PAROLA, Philippe BROUQUI, Didier RAOULT. Early combination therapy with hydroxychloroquine and azithromycin reduces mortality in 10,429 COVID-19 outpatients. Reviews in Cardiovascular Medicine, 2021, 22(3): 1063-1072.

URL: 

https://rcm.imrpress.com/EN/10.31083/j.rcm2203116     OR     https://rcm.imrpress.com/EN/Y2021/V22/I3/1063

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