Source: NCBI

Citation: Gautret, P., Lagier, J. C., Honoré, S., Hoang, V. T., & Raoult, D. (2021). Clinical efficacy and safety profile of hydroxychloroquine and azithromycin against COVID-19. International journal of antimicrobial agents57(1), 106242.

We agree with colleagues that clinical outcomes are also key elements to consider when assessing the effect of hydroxychloroquine-azythromycin (HCQ-AZ) combination [1]. To this end, we reanalyzed our data on all patients enrolled in our study (n=42) and, in addition to viral clearance over time, we analyzed clinical outcomes, including the need for oxygen therapy, transfer to intensive care unit (ICU), death and length of stay at hospital. Requirement for oxygen therapy, transfer to ICU and death did not significantly differ between groups. Length of stay at hospital and viral persistence were significantly shorter in the treated patients group, compared to the control group. Length of stay was calculated in 38 of 42 patients because two patients died, one was discharged against medical advice and information was missing for one patient (Table 1 ).

Table 1

Characteristics of studied populations.

We agree that the HCQ-AZ combination may potentially lead to drug-drug interactions. We paid a rigorous attention to avoiding this combination in patients with cardiac diseases, abnormal EKG, dyskalemia or the routine use of other interacting medications. The systematic pre-therapy workup included serum electrolyte analysis, and an electrocardiogram with corrected QT measurement (Bazett’s formula).

Close serum electrolyte analysis monitoring was performed in patients with low serum potassium levels at baseline. An electrocardiogram was routinely performed 48 hours after the start of treatment. Treatment with HCQ was discontinued when the corrected QT interval (QTc, Bazett’s formula) was>500ms, and the risk-benefit ratio of HCQ+AZ treatment was estimated by the infectious disease specialist and agreed with the cardiologist to be between 460 and 500ms.

No cases of torsade de pointe or sudden death were observed. Since this paper was published, we have treated a total of 3,119 patients with HCQ-AZ for at least three days. QTc prolongation (>60 ms) was observed in 25 patients (0.67%), resulting in discontinuation of treatment in 12 cases, including three cases with QTc> 500 ms.

No cases of torsade de pointe or sudden death were observed, including in the 9.5% patients over 65 years of age [2]. Finally, we totally agree with colleagues to pay attention to magnesium levels, with supplementation, if needed, to prevent life-threatening arrhythmias.

Related: COVID-19: A realistic approach to community management – HCQ & IVM in concert with vaccination

“I treated Covid not caring about the bans: zero deaths. But they told me to shut up ”▷ Dr. Szumski

Top US medics recommend ‘sequenced multidrug therapy’ including HCQ & Ivermectin, for early high-risk COVID-19 infections

Professor Ananda Prasad at 92 years of age – putting together the pivotal antiviral role of zinc

Share on facebook
Share on twitter
Share on whatsapp
On Trend

Latest Stories

A Conversation With Dr. Brian Tyson – The Chloroquine Wars Part XLI

The data from the vaccine trials must be recalculated under the lens that some of the serious adverse events (SAEs) should be treated as COVID-19 cases.
There may not be any vaccine efficacy in the data at all if some of the post-vaccination deaths are due to vaccine-induced COVID-19. It could even be the case that the mortality efficacy goes negative. My implied lives saved calculations put this easily in the realm of possibility. The only way to know is for authorities to organize and compile the data. And while a risk analysis is certainly due after more than six months of hundreds of millions of doses delivered, there is little indication authorities have bothered with the process. That’s more than a bit unsettling.

Read More »

Dr. Brian Tyson, USA: Hydroxychloroquine – Data, Strategies and Success Treating over 6000 Covid Patients

We continue to delve extensively into the COVID-19 data with esteemed statistician, Mathew Crawford. In this episode, we take a closer look at the use of early treatment and its success. Mathew has been researching the data from Dr. Brian Tyson, who has successfully treated over 6000 patients who contracted COVID throughout the pandemic. It is my great honor to have Dr. Tyson here on this episode to not only discuss the data, but also the strategies that he has been using throughout the pandemic.

Read More »