EVALUATION OF THE EFFICACY OF THE HYDROXYCHLOROQUINE-AZITHROMYCIN COMBINATION IN THE IN THE PREVENTION OF COVID-19 RELATED SDRA

EVALUATION OF THE EFFICACY OF THE HYDROXYCHLOROQUINE-AZITHROMYCIN COMBINATION IN THE IN THE PREVENTION OF COVID-19 RELATED SDRA

Since end of December, a new coronavirus, close to the 2002 SARS coronavirus, cause serious pneumonias throughout world. There is currently no strong evidence of an efficient specific treatment. Hydroxychloroquine is an old chloroquine-derived drug, prescribed for auto-immune disorders. It has shown efficacy against Sars-CoV-2 in vitro. Some studies showed that Hydroxychloroquine might improve the clinical status of Sars-CoV-2 infected patients. Azithromycin is a macrolide antibiotic, with immunomodulatory properties. Adding Azithromycin to a hydroxychloroquine-based treatment showed an apparent accelerated viral clearance in infected patients. This study wants to evaluate the clinical impact of adding Azithromycin to Hydroxychloroquine in the treatment of Sars-CoV-2 pneumonia

Inclusion Criteria:

• Age > 18 years old
• Positive Sars-CoV-2 RT-PCR on nasopharyngeal swab
• CT scan suggestive of Sars-CoV-2 pneumonia

Exclusion Criteria:

• Negative Sars-CoV-2 RT-PCR on nasopharyngeal swab
• Known hypersensitivity to Hydroxychloroquine, Azithromycin or a macrolide family member
• Long term prescribed treatment contraindicated with azithromycin (colchicine, ergotamine, dihydroergotamine) and/or hydroxychloroquine (citalopram, escitalopram, hydroxyzine, domperidone, piperaquin)
• Retinopathy or maculopathy
• Porphyria
• Severe renal failure (GFR less than 30 mL/min/m²)
• Dyskaliemia, (ie less than 3,5 mmol/L or more than 5,5 mmol/L)
• Hypomagnesiemia, ie less than 0,7 mmol/L
• Severe cholestasis, cirrhosis or severe hepatic failure
• Known cardiac medical history of congestive heart failure or myocardial infarction
• Bradycardia less than 50 beats per minute
• Prolonged corrected QT interval, (ie cQT more than 440 ms in men and 450 ms in women) or medical history of ventricular cardiac rhythm disorders
• Blood disorders with history of hematopoietic stem cells allograft
• Known history of G6PD deficiency
• Pregnancy
• Breastfeeding
• Subject protected by law under guardianship of curatorship
• Inability to take oral medications