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Early combination therapy with hydroxychloroquine and azithromycin reduces mortality in 10,429 COVID-19 outpatients

Article scientifique 2021 Anglais

Résumé

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.

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Million, M., Lagier, J., Tissot‐Dupont, H., Ravaux, I., Dhiver, C., Tomei, C., Cassir, N., Delorme, L., Cortaredona, S., Amrane, S., Aubry, C., Bendamardji, K., Bérenger, C., Doudier, B., Edouard, S., Hocquart, M., Mailhe, M., Porcheto, C., Seng, P., Triquet, C., Gentile, S., Jouve, É., Giraud‐Gatineau, A., Chaudet, H., Camoin‐Jau, L., Colson, P., Gautret, P., Fournier, P., Maille, B., Deharo, J., Habert, P., Gaubert, J., Jacquier, A., Honoré, S., Guillon-Lorvellec, K., Obadia, Y., Parola, P., Brouqui, P., Raoult, D. (2021). Early combination therapy with hydroxychloroquine and azithromycin reduces mortality in 10,429 COVID-19 outpatients. https://doi.org/10.31083/j.rcm2203116

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Auteur(s)

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 Bérenger Barbara Doudier Sophie Edouard Marie Hocquart Morgane Mailhe Coralie Porcheto Piseth Seng Catherine Triquet Stéphanie Gentile Élisabeth Jouve Audrey Giraud‐Gatineau Hervé Chaudet Laurence Camoin‐Jau Philippe Colson Philippe Gautret Pierre‐Edouard Fournier Baptiste Maille Jean‐Claude Deharo Paul Habert Jean‐Yves Gaubert Alexis Jacquier Stéphane Honoré Katell Guillon-Lorvellec Yolande Obadia Philippe Parola Philippe Brouqui Didier Raoult

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