New French Study on Hydroxychloroquine and Azithromycin: What It Tells Us

The Abstract and brief summary of a New French Study on Hydroxychloroquine and Azithromycin has been published. It has been discussed on YouTube at CardioGauge and Dr. Oz. The study was large enough for statistically significant results. Here are the main points.

1. “Mortality was significantly lower in patients who had received” the drug combination (Hydroxychloroquine and Azithromycin) for greater than or equal to 3 days, as compared to other patients in the same hospital and other hospitals.

2. “A good clinical outcome and virological cure was obtained in 973 patients within 10 days (91.7%).” So the combination of the two drugs works. Over 90% of patients were essentially “cured” within 10 days or less. The cure, of course, is from the patient’s immune system working with the drugs, not the drugs alone.

3. “A poor outcome was observed for 46 patients (4.3%); 10 were transferred to intensive care units, 5 patients died (0.47%) (74-95 years old).” So the odds of a poor outcome were worse for older persons; the only patients who died were over 73 years of age. But the overall mortality rate was quite low.

4. “Poor clinical outcome was significantly associated to older age (OR 1.11), initial higher severity (OR 10.05) and low hydroxychloroquine serum concentration.” There was an 11% greater chance of a poor outcome for the elderly, and a TEN TIMES greater change of a poor outcome with “initial higher severity”, meaning the patients who presented with severe symptoms already in place had much greater odds of a poor result to their treatment. Also, if the hydroxychloroquine was not well absorbed by the patient’s system, they had a greater chance of a poor outcome — because the hydroxychloroquine works.

Important: The study strongly implies that it is a very poor clinical decision for hospitals to turn away all but the most sick patients. Treatment with Hydroxychloroquine/Azithromycin is very effective at AVOIDING disease progression to severity. This also means that if you are sick, you need treatment right away. Waiting until you are very sick is a very poor decision; it greatly increases your risk of a poor outcome.

5. “poor clinical and virological outcomes were associated to the use of selective beta-blocking agents and angiotensin II receptor blockers”. If you are taking a beta-blocker or an ACE2 receptor blocker, consult with your physician about changing your medication, but do NOT stop taking your meds. That might be worse.

* ACE2 receptor blockers explained by the Mayo Clinic
* Beta Blockers explained by Medicinenet.com

Comments

Hydroxychloroquine and Azithromycin as a combination therapy works. The study size was good at 1061 patients. The study answers questions formerly unknown, such as whether hydroxychloroquine/azithromycin reduces mortality — it does — and whether it reduces risk of disease progression — another yes, it does. The study also tells doctors to consider whether patients at risk of mortality from COVID-19 should be switched to different meds.

Most importantly, the study implies that is it a dangerous public policy to reserve treatment with hydroxychloroquine/azithromycin to only those who are severe or critical. Treatment prevents progression to severity, and that is much better than waiting until the population becomes very sick.

This is not stated in the study, but it is suggested by the results: Treatment with hydroxychloroquine/azithromycin combination therapy may reduce the need for ventilation, IF the patient is treated with the drug combination EARLY.

Other Studies

A paper from a different group of researchers suggested that Hydroxychloroquine might work better, with fewer side effects, if it is administered as an Aerosol [2]. This puts the medicine where it is needed most, and by-passes the problem of poor absorption in some patients.

A third paper concluded that early treatment is crucial: “In order to reduce peak viral load by more than 2 logs, drug efficacy needs to be greater than 80% if treatment is administered after symptom onset; an efficacy of 50% could be sufficient if treatment is initiated before symptom onset.” [3]

Ronald L. Conte Jr.

[1] Abstract, Raoult, IUH;

Click to access Abstract_Raoult_EarlyTrtCovid19_09042020_vD1v.pdf

[2] Klimke, Ansgar, et al. “Hydroxychloroquine as an Aerosol Might Markedly Reduce and Even Prevent Severe Clinical Symptoms after SARS-CoV-2 Infection.” (2020). PDF

[3] Gonçalves, Antonio, et al. “Timing of antiviral treatment initiation is critical to reduce SARS-Cov-2 viral load.” medRxiv (2020).

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1 Response to New French Study on Hydroxychloroquine and Azithromycin: What It Tells Us

  1. Michael says:

    It’s just very unfortunate that this has been politicized to the point that many news outlets won’t support its use simply because it’s been touted as helpful by certain elected officials. I think doctors and many in the public are starting to see that bias and prescribe it but imagine how much more helpful it would be with broader media support.

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