A couple of smaller studies in France and China indicate that that hydroxychloroquine is associated with viral load reduction/disappearance in COVID-19 patients, and its effect appears to be reinforced by azithromycin.
When we reviewed the Gautret et al publication, we were intrigued that the effect analysis population was conducted after six hydroxychloroquine-treated patients were excluded, including 3 patients who went to ICU and 1 that died. We also noted an imbalance in PCR testing in the supplementary material. Those not taking HCQ had many more PCRs “not recorded”.
We hope the conclusions continue to be supported, but it is important that more robust clinical evaluations occur to determine the role of either HCQ or azithromycin in managemet of COVID19, including where within the disease spectrum they are best directed eg. PEP, PrEP, early Rx, Rx moderate/severe disease, the dose selection, duration and ideal timing of Rx initiation.
Gautret et al. (2020) Hydroxychloroquine and azithromycin as a treatment of COVID‐19: results of an open‐label non‐randomized clinical trial. International Journal of Antimicrobial Agents – In Press 17 March 2020 – DOI : 10.1016/j.ijantimicag.2020.105949