Led by IHU-Méditerranée Infection in Marseille, a group of French research centers initiated early and massive screening for SARS-CoV-2 (COVID-19) in a hospitalized patient demographic. The study team analyzed the treatment of hydroxychloroquine and azithromycin (HCQ-AZ) for those patients screened positive for SARS-CoV-2. Out of 3,737 patients screened positive for COVID-19, 3,119 were treated with HCQ-AZ. The French team found that treatment with HCQ-AZ decreased the risk of the COVID-19 patient needing transfer to the ICU or death. Overall, the use of HCQ-AZ was associated with a decreased risk of hospitalization. The retrospective study revealed that an early diagnosis as well as early isolation and early treatment of COVID-19 patients, with at least 3 days of HCQ-AZ, leads to a significantly better clinical outcome and an expedited viral load reduction than other treatments.
This retrospective study, recently reported in Travel Medicine and Infectious Disease, was led by doctors at IHU-Méditerranée Infection, Marseille as well as Aix Marseille University, and AP-HM, Marseille, France. As the pandemic emanated out of Wuhan the French team studied data originating from Chinese doctors on the ground during the pandemic. They utilized some of that knowledge to design a strategy that included early massive screening using PCR, LDCT of the chest for positive patients, and early treatment with hydroxychloroquine (HCQ) coupled with azithromycin (AZ) once they discovered the positive effects the two had in vitro and in vivo against SARS-CoV-2. The workload at the medical facility in Marseille greatly increased however the team could produce real-world data enabling a heretofore not available opportunity to describe the disease and management at the institute despite well-known limitations involved with observational studies.
Some Sizeable Real-World Numbers
The numbers were significant at IHU-Méditerranée Infection, Marseille including a total of 31,003 patients tested for SARS-CoV-2 (including 1,277 health care workers);3,525 hospitalized patients, 705 patients hospitalized in infectious disease units; 6,000 samples tested including 643 samples from health care workers; 4,786 samples inoculated and 1,908 SARS-CoV-2 strains isolated; 466 genomes sequenced and analyzed; 2,218 low-dose CT scans performed; 7,800 electrocardiograms performed and a total of 1,939 hydroxychloroquine dosages.
The team retrospectively reported that out of 3,737 screened COVID-19 patients, 3,119 (83.5%) were treated with HCQ-AZ (200 mg of oral HCQ, three times daily for ten days and 500 mg of oral AZ on day 1 followed by 250 mg daily during the next four days, respectively) ongoing for at least three days and 618 (16.5%) patients treated with other medications (“others”). The French team studied outcomes including 1) death rate 2) transfer to the intensive care unit (ICU), ≥10 days of hospitalization and viral shedding.
The French team reported that overall the treatment regimen of HCQ-AZ led to a decreased risk of transfer to the intensive care unit (ICU) as well as death (Hazard ratio 0.18 0.11-0.27), a decreased risk of hospitalization ≥ 10 days (odds rations 95% CI 0.38 0.27-0.54 (and shorted duration of viral shedding (time to negative PCR: HR 1.29 1.17-1.42). They did observe OTc prolongation (>60 ms ) in 25 patients (0.67%) which led to a halting of that treatment in 12 cases including 3 cases with QTc> 500 ms. The team observed absolutely no cases of sudden death.
The team can make the claim based on the observations, or retrospective analysis that It would appear that if patients diagnosed with SARS-CoV-2 are diagnosed, isolated and treated early and administered at least 3 days of HCQ-AZ that this led to significantly improved clinical outcomes as well as expedited viral load reduction when compared to other treatments.
Didier Raoult, IHU-Méditerranée Infection, Marseille, France (corresponding author)
Note, there are dozens of participating study authors; for a list, see the source.
Call to Action: The Henry Ford Health System study plus this study are not hard evidence that Hydroxychloroquine is safe and effective for COVID-19, but they certainly contribute to a growing body of favorable research knowledge. More studies are ongoing and TrialSite News will be reporting on them. Sign up for the daily newsletter.