SARS-CoV-2 persistent viral shedding in the context of hydroxychloroquine-azithromycin treatment Drancourt, M. /Cortaredona, Sébastien Melenotte, C. Amrane, S. Eldin, C. La Scola, B. Parola, P. Million, M. Lagier, J. C. Raoult, D. Colson, P. SARS-CoV-2 COVID-19 viral persistence culture qRT-PCR hydroxychloroquine azithromycin SARS-CoV-2 nasopharyngeal shedding contributes to the spread of the COVID-19 epidemic. Among 3271 COVID-19 patients treated at the Hospital University Institute Mediterranee Infection, Marseille, France from 3 March to 27 April 2020, tested at least twice by qRT-PCR, the median SARS-CoV-2 nasopharyngeal shedding duration was 6 days (range 2-54 days). Compared with short shedders (qRT-PCR positivity < 10 days), 34 (1.04%) persistent shedders (qRT-PCR positivity >= 17 days; mean +/- SD: 23.3 +/- 3.8 days) were significantly older, with associated comorbidities, exhibiting lymphopenia, eosinopenia, increased D-dimer and increased troponin (p < 0.05), and were hospitalized in intensive care unit in 17.7% vs. 1.1% of cases (p < 0.0001). Viral culture was positive in six persistent shedders after day 10, including in one patient after day 17, and no viral co-pathogen was detected in 33 tested patients. Persistent shedders received azithromycin plus hydroxychloroquine >= 3 days in 26/34 (76.5%) patients, a figure significantly lower than in short shedders (86.6%) (p = 0.042). Accordingly, mortality was 14.7% vs. 0.5% (p < 0.0001). Persistent shedding was significantly associated with persistent dyspnea and anosmia/ageusia (p < 0.05). In the context of COVID-19 treatment, including treatment with azithromycin plus hydroxychloroquine, the persistence of SARS-CoV-2 nasopharyngeal shedding was a rare event, most frequently encountered in elderly patients with comorbidities and lacking azithromycin plus hydroxychloroquine treatment. 2021 text https://www.documentation.ird.fr/hor/fdi:010081532 fdi:010081532 Drancourt M., Cortaredona Sébastien, Melenotte C., Amrane S., Eldin C., La Scola B., Parola P., Million M., Lagier J. C., Raoult D., Colson P.. SARS-CoV-2 persistent viral shedding in the context of hydroxychloroquine-azithromycin treatment. 2021, 13 (5), 890 [12 ] EN