Outcomes of 2111 COVID-19 Hospitalized Patients Treated with Hydroxychloroquine/Azithromycin and Other Regimens in Marseille, France, 2020: A Monocentric Retrospective Analysis

Jean-Christophe Lagier; Matthieu Million; Sébastien Cortaredona; Léa Delorme; Philippe Colson; Pierre-Edouard Fournier; Philippe Brouqui; Didier Raoult; Philippe Parola; IHU Task Force

doi:10.2147/TCRM.S364022

Outcomes of 2111 COVID-19 Hospitalized Patients Treated with Hydroxychloroquine/Azithromycin and Other Regimens in Marseille, France, 2020: A Monocentric Retrospective Analysis

Ther Clin Risk Manag. 2022 May 31:18:603-617. doi: 10.2147/TCRM.S364022. eCollection 2022.

Authors

Jean-Christophe Lagier^{1

2}, Matthieu Million^{1

2}, Sébastien Cortaredona^{1

3}, Léa Delorme¹, Philippe Colson^{1

2}, Pierre-Edouard Fournier^{1

3}, Philippe Brouqui^{1

2}, Didier Raoult^{1

2}, Philippe Parola^{1

3}; IHU Task Force

Affiliations

¹ IHU-Méditerranée Infection, Marseille, France.
² MEPHI, Aix Marseille Université, Institut de Recherche pour le Développement, Assistance Publique Hôpitaux de Marseille, Marseille, France.
³ VITROME, Aix Marseille Université, Institut de Recherche pour le Développement, Assistance Publique Hôpitaux de Marseille, Service de Santé des Armées, Marseille, France.

Abstract

Objectives: We evaluated the 6-week mortality of SARS-CoV-2 hospitalized patients treated using a standardized protocol in 2020 in Marseille, France.

Methods: A retrospective monocentric cohort study was conducted in the standard hospital wards at the Institut Hospitalo-Universitaire Méditerranée Infection, between March and December 2020 in adults with SARS-CoV-2 PCR-proven infection.

Results: Of the 2111 hospitalized patients (median age, 67 [IQR 55-79] years; 1154 [54.7%] men), 271 were transferred to the intensive care unit (12.8%) and 239 died (11.3%; the mean age of patients who died was 81.2 (±9.9)). Treatment with hydroxychloroquine plus azithromycin (HCQ-AZ), used in 1270 patients, was an independent protective factor against death (0.68 [0.52 - 0.88]). This effect was consistent for all subgroups of age, comorbidities, severity of the disease and comedications with zinc or corticosteroids. Zinc was independently protective against death (0.39 [0.23 - 0.67]), in a subgroup analysis of patients treated with HCQ-AZ without dexamethasone. The use of high-flow oxygen therapy in elderly patients who were not eligible for intensive care unit transfer saved 19 patients (33.9%).

Conclusions: In our 2020 cohort, treating COVID-19 with HCQ-AZ was associated with lower mortality. These results need to be analyzed in the context of academic discussions about observational studies versus randomized clinical trials. More data will deserve to be analyzed in the SARS-Cov 2 variants, vaccination and post-vaccination era.

Keywords: COVID-19; SARS-CoV-2; azithromycin; hydroxychloroquine.

Grants and funding

This work was funded by ANR “Investissements d’avenir”, Méditerranée infection 10-IAHU-03, and was also supported by Région Provence-Alpes-Côte d’Azur. This work had received financial support from the Fondation Méditerranée Infection.