WSJ: 'Hydroxychloroquine and Azithromycin Continue to Show Results' for Coronavirus Patients

In the fight against Covid-19 though we might look forward in doom, one day we will look backward in awe. In an article last week, I discussed a promising drug combination to treat the disease. There is now new data supporting this treatment. Since then, Kansas City area physicians, including Joe Brewer, Dan Hinthorn and me, continue to treat many patients, and some have shown improvement. Major medical centers including the University of Washington and Mass General have added hydroxychloroquine to treatment options. [...]

Physicians are using two drugs in combination—hydroxychloroquine and azithromycin, which I’ll abbreviate HC and AZ—to treat patients with advanced Covid-19 symptoms. We use a regimen reported in a recent open-label trial in Marseille, France, which was updated March 26, and which doctors may modify in any given case.

[...] Clinical information has also emerged from Covid treatment. During the initial Chinese outbreak, Wuhan doctors observed that patients with lupus—a disease for which HC is a common treatment—did not seem to develop Covid-19. Of 178 hospital patients who tested positive, none had lupus and none were on HC. None of this Wuhan hospital’s dermatology department’s 80 lupus patients were infected with the novel coronavirus. The Wuhan doctors hypothesized that this may be due to long-term use of HC. They treated 20 Covid-19 patients with HC. Their result: “Clinical symptoms improve significantly in 1 to 2 days. After five days of chest CT examination, 19 cases showed significant absorption improvement.”

Second, consider AZ—the antibiotic marketed as Z-Pak—combined with HC. The French study showed that 57% of 14 Covid-19 patients receiving HC without AZ tested negative for the virus on a nasal swab on day six. But 100% of the six patients who received both HC and AZ tested negative on day six. Compare that with 16 infected patients at another hospital who didn’t receive either treatment: only 12% tested negative on day six. These are small samples, but significant.

The authors of the French study last week published the results of an additional 80 hospitalized patients receiving a combination of HC and AZ. By day eight of treatment, 93% showed a negative nasopharyngeal swab for the virus. “This allowed patients to rapidly be discharged from highly contagious wards with a mean length of stay of five days,” the authors write. “Other teams should urgently evaluate this cost-effective therapeutic strategy, to both avoid the spread of the disease and treat patients as soon as possible before severe respiratory irreversible complications take hold.” I agree.

In 80 in-patients receiving a combination of hydroxychloroquine and azithromycin we noted a clinical improvement in all but one 86 year-old patient who died, and one 74 year- old patient still in intensive care unit.

A rapid fall of nasopharyngeal viral load tested by qPCR was noted, with 83% negative at Day7, and 93% at Day8. Virus cultures from patient respiratory samples were negative in 97.5% patients at Day5.

This allowed patients to rapidly de discharge from highly contagious wards with a mean length of stay of five days.

We believe other teams should urgently evaluate this cost-effective therapeutic strategy, to both avoid the spread of the disease and treat patients as soon as possible before severe respiratory irreversible complications take hold.

Two Chinese studies have shown that "10 days after the start of symptoms, 90 percent of people who have a moderate form (of the disease) have a controlled viral load," epidemiologist Dominique Costagliola, of the French health research institute Inserm, told AFP.

The fact that they got these results using hydroxychloroquine "does not make the case for its effect," she said.