%0 Journal Article
%9 ACL : Articles dans des revues avec comité de lecture répertoriées par l'AERES
%A Million, M.
%A Lagier, J. C.
%A Tissot-Dupont, H.
%A Ravaux, I.
%A Dhiver, C.
%A Tomei, C.
%A Cassir, N.
%A Delorme, L.
%A Cortaredona, Sébastien
%A Amrane, S.
%A Aubry, C.
%A Bendamardji, K.
%A Berenger, C.
%A Doudier, B.
%A Edouard, S.
%A Hocquart, M.
%A Mailhe, M.
%A Porcheto, C.
%A Seng, P.
%A Triquet, C.
%A Gentile, S.
%A Jouve, E.
%A Giraud-Gatineau, A.
%A Chaudet, H.
%A Camoin-Jau, L.
%A Colson, P.
%A Gautret, P.
%A Fournier, P. E.
%A Maille, B.
%A Deharo, J. C.
%A Habert, P.
%A Gaubert, J. Y.
%A Jacquier, A.
%A Honore, S.
%A Guillon-Lorvellec, K.
%A Obadia, Y.
%A Parola, P.
%A Brouqui, P.
%A Raoult, D.
%T Early combination therapy with hydroxychloroquine and azithromycin reduces mortality in 10,429 COVID-19 outpatients
%D 2021
%L fdi:010083179
%G ENG
%J Reviews in Cardiovascular Medicine
%@ 1530-6550
%K SARS-CoV-2 ; COVID-19 ; Hydroxychloroquine ; Azithromycin ; Ambulatory ; Out-patients ; Treatment
%M ISI:000702099800054
%N 3
%P 1063-1072
%R 10.31083/j.rcm2203116
%U https://www.documentation.ird.fr/hor/fdi:010083179
%> https://horizon.documentation.ird.fr/exl-doc/pleins_textes/2021-11/010083179.pdf
%V 22
%W Horizon (IRD)
%X We evaluated the age-specific mortality of unselected adult outpatients infected with SARS-CoV-2 treated early in a dedicated COVID-19 day hospital and we assessed whether the use of hydroxychloroquine (HCQ) + azithromycin (AZ) was associated with improved survival in this cohort. A retrospective monocentric cohort study was conducted in the day hospital of our center from March to December 2020 in adults with PCR-proven infection who were treated as outpatients with a standardized protocol. The primary endpoint was 6-week mortality, and secondary endpoints were transfer to the intensive care unit and hospitalization rate. Among 10,429 patients (median age, 45 [IQR 32-57] years; 5597 [53.7%] women), 16 died (0.15%). The infection fatality rate was 0.06% among the 8315 patients treated with HCQ+AZ. No deaths occurred among the 8414 patients younger than 60 years. Older age and male sex were associated with a higher risk of death, ICU transfer, and hospitalization. Treatment with HCQ+AZ (0.17 [0.06-0.48]) was associated with a lower risk of death, independently of age, sex and epidemic period. Meta-analysis evidenced consistency with 4 previous outpatient studies (32,124 patients-Odds ratio 0.31 [0.20-0.47], I-2 = 0%). Early ambulatory treatment of COVID-19 with HCQ+AZ as a standard of care is associated with very low mortality, and HCQ+AZ improve COVID-19 survival compared to other regimens.
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