Therapeutics and Clinical Risk Management (May 2022)

Outcomes of 2111 COVID-19 Hospitalized Patients Treated with Hydroxychloroquine/Azithromycin and Other Regimens in Marseille, France, 2020: A Monocentric Retrospective Analysis

  • Lagier JC,
  • Million M,
  • Cortaredona S,
  • Delorme L,
  • Colson P,
  • Fournier PE,
  • Brouqui P,
  • Raoult D,
  • Parola P

Journal volume & issue
Vol. Volume 18
pp. 603 – 617

Abstract

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Jean-Christophe Lagier,1,2 Matthieu Million,1,2 Sébastien Cortaredona,1,3 Léa Delorme,1 Philippe Colson,1,2 Pierre-Edouard Fournier,1,3 Philippe Brouqui,1,2 Didier Raoult,1,2 Philippe Parola1,3 On behalf of the IHU Task Force1IHU-Méditerranée Infection, Marseille, France; 2MEPHI, Aix Marseille Université, Institut de Recherche pour le Développement, Assistance Publique Hôpitaux de Marseille, Marseille, France; 3VITROME, Aix Marseille Université, Institut de Recherche pour le Développement, Assistance Publique Hôpitaux de Marseille, Service de Santé des Armées, Marseille, FranceCorrespondence: Philippe Parola, Institut Hospitalo-Universitaire Méditerranée Infection, 19-21 Boulevard Jean Moulin, Marseille, 13005, France, Tel + 33 0 4 13 73 24 01, Fax + 33 0 4 13 73 24 02, Email [email protected] Jean-Christophe Lagier, Email [email protected]: We evaluated the 6-week mortality of SARS-CoV-2 hospitalized patients treated using a standardized protocol in 2020 in Marseille, France.Methods: A retrospective monocentric cohort study was conducted in the standard hospital wards at the Institut Hospitalo-Universitaire Méditerranée Infection, between March and December 2020 in adults with SARS-CoV-2 PCR-proven infection.Results: Of the 2111 hospitalized patients (median age, 67 [IQR 55– 79] years; 1154 [54.7%] men), 271 were transferred to the intensive care unit (12.8%) and 239 died (11.3%; the mean age of patients who died was 81.2 (± 9.9)). Treatment with hydroxychloroquine plus azithromycin (HCQ-AZ), used in 1270 patients, was an independent protective factor against death (0.68 [0.52 – 0.88]). This effect was consistent for all subgroups of age, comorbidities, severity of the disease and comedications with zinc or corticosteroids. Zinc was independently protective against death (0.39 [0.23 – 0.67]), in a subgroup analysis of patients treated with HCQ-AZ without dexamethasone. The use of high-flow oxygen therapy in elderly patients who were not eligible for intensive care unit transfer saved 19 patients (33.9%).Conclusions: In our 2020 cohort, treating COVID-19 with HCQ-AZ was associated with lower mortality. These results need to be analyzed in the context of academic discussions about observational studies versus randomized clinical trials. More data will deserve to be analyzed in the SARS-Cov 2 variants, vaccination and post-vaccination era.Keywords: SARS-CoV-2, COVID-19, hydroxychloroquine, azithromycin

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