Does treatment with hydroxychloroquine either alone or in combination with azithromycin improve symptoms in patients with mild to moderate COVID-19?

Bottom Line:

The study found no significant difference in clinical status in patients that were given hydroxychloroquine alone or in combination with azithromycin.

Reference:

Cavalcanti, A.B. et al. Hydroxychloroquine with or without Azithromycin in Mild-to-Moderate Covid-19. New England Journal of Medicine (2020). https://doi.org/10.1056/NEJMoa2019014

Date Published:

23 July 2020

Synopsis:

In a previous study with a small sample size, hydroxychloroquine and azithromycin treatment was suggested to decrease the viral load of COVID-19. Thus, practitioners have been using hydroxychloroquine reinforced by azithromycin to treat patients with COVID-19. However, an observational study involving patients admitted to hospital with COVID-19 found no decrease in risk of death. Given the limited evidence, this multicenter study aims to assess whether hydroxychloroquine alone or with azithromycin would improve clinical status within 15 days of hospital admission in patients with mild to moderate COVID-19. Across 55 hospitals in Brazil, 667 patients were randomized to receive the standard of care (control), standard of care plus a 7-day treatment of hydroxychloroquine, or standard of care plus a 7-day treatment of both hydroxychloroquine and azithromycin. The primary outcome recorded was clinical status measured on a seven-point scale. The study concluded that among patients that received hydroxychloroquine alone or in combination with azithromycin, there were no significant differences in clinical status at 15 days of hospital admission.

Summary by: Eugenia Yeung