Hydroxychloroquine and azithromycin as a treatment of COVID-19: results of an open-label non-randomized clinical trial
Authors: Morgane Mailhe
Hervé Tissot Dupont
Valérie Giordanengo
Philippe Gautret
Philippe Parola
Jean-Christophe Lagier
Vera Esteves Vieira
Stéphane Honoré
Van Thuan Hoang
Jean-Marc Rolain
Philippe Colson
Barbara Doudier
Eric Chabrière
Johan Courjon
Line Meddeb
Didier Raoult
Philippe Brouqui
Bernard La Scola
Journal: International Journal of Antimicrobial Agents (2020)
Discipline: PHARMACOLOGY & TOXICOLOGY
Keywords: 2019-nCoV; Azithromycin; COVID-19; Clinical trial; Hydroxychloroquine
Affiliations: IHU-Méditerranée Infection, Marseille, France; Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, Marseille, France., IHU-Méditerranée Infection, Marseille, France; Aix Marseille Univ, IRD, APHM, MEPHI, Marseille, France., IHU-Méditerranée Infection, Marseille, France; Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, Marseille, France; Thai Binh University of Medicine and Pharmacy, Thai Binh, Viet Nam., IHU-Méditerranée Infection, Marseille, France., Infectiologie, Hôpital de l'Archet, Centre Hospitalier Universitaire de Nice, Nice, France; Université Côte d'Azur, Nice, France; U1065, Centre Méditerranéen de Médecine Moléculaire, C3M, Virulence Microbienne et Signalisation Inflammatoire, INSERM, Nice, France., Department of Virology, Biological and Pathological Center, Centre Hospitalier Universitaire de Nice, 06200 Nice, France., Service Pharmacie, Hôpital Timone, AP-HM, Marseille, France; Laboratoire de Pharmacie Clinique, Aix Marseille Université, Marseille, France., IHU-Méditerranée Infection, Marseille, France; Aix Marseille Univ, IRD, APHM, MEPHI, Marseille, France. Electronic address: .

Abstract:  Background: Chloroquine and hydroxychloroquine have been found to be efficient on SARS-CoV-2, and reported to be efficient in Chinese COV-19 patients. We evaluate the effect of hydroxychloroquine on respiratory viral loads. Patients and methods: French Confirmed COVID-19 patients were included in a single arm protocol from early March to March 16th, to receive 600mg of hydroxychloroquine daily and their viral load in nasopharyngeal swabs was tested daily in a hospital setting. Depending on their clinical presentation, azithromycin was added to the treatment. Untreated patients from another center and cases refusing the protocol were included as negative controls. Presence and absence of virus at Day6-post inclusion was considered the end point. Results: Six patients were asymptomatic, 22 had upper respiratory tract infection symptoms and eight had lower respiratory tract infection symptoms. Twenty cases were treated in this study and showed a significant reduction of the viral carriage at D6-post inclusion compared to controls, and much lower average carrying duration than reported in the litterature for untreated patients. Azithromycin added to hydroxychloroquine was significantly more efficient for virus elimination. Conclusion: Despite its small sample size, our survey shows that hydroxychloroquine treatment is significantly associated with viral load reduction/disappearance in COVID-19 patients and its effect is reinforced by azithromycin. 

Retracted: No

PubPeer comments:
 There were 24 nucleotides were deleted but not 25. The authors should re-check it. Figure 5A ![file] , 
 ![file] This is unbelievable, the mentioned KO cells include 24 nucleotides, therefore, it can not be a DDX23 KO cells. Therefore, the conclusion in the main text was unbelievable. , 
 ![file] In Figure 7, there were many DDX23 in the nucleus (Fig 7B), however, the IFA results represented in Fig 7A showed that there was no DDX23 in the nucleus. That was completely contradictory. ,