The much anticipated research on 3,737 COVID-19 patients by Professor Raoult and his team was published this June 25th, as a pre-proof, in the journal Travel Medicine and Infectious Disease.
The article “Outcomes of 3,737 COVID-19 patients treated with hydroxychloroquine/azithromycin and other regimens in Marseille, France: A retrospective analysis” can be found online at:
Interestingly, in his testimony yesterday, at the French National Assembly, Prof. Raoult indicated that the article was refused by The Lancet the very same week as the venerable publication accepted the fraudulent and now retracted article by Mehra et al.
Note that this research encompasses 3,737 COVID-19 patients, yet of those, only 3,119 were treated with the hydroxychloroquine / azithromycin therapy, often referred to as the Raoult Protocol.
Note that outside Marseille, the wait and see strategy for dealing with the disease was mostly adopted in France, like in many other countries. In that respect, it’s important to note the study assertion that “staying at home (lockdown) without testing while waiting for dyspnoea was not supported by our results.” This is a criticism applicable to most countries, especially those that refrained from implementing any form of early treatment, such as the UK, Canada and others.
Overall, according to the latest update, the case fatality rate among those 3,737 patients was 1.1%, which can be contrasted with hospital-level case fatality rates of about 25%, in the research by Oxford University in the context of its RECOVERY clinical trials.
Find the full study at this link: https://www.sciencedirect.com/science/article/pii/S1477893920302817
Here are a few highlights.
“We retrospectively report the clinical management of 3,737 screened patients, including 3,119 (83.5%) treated with HCQ-AZ (200 mg of oral HCQ, three times daily for ten days and 500 mg of oral AZ on day 1 followed by 250 mg daily for the next four days, respectively) for at least three days and 618 (16.5%) patients treated with other regimen (“others”). Outcomes were death, transfer to the intensive care unit (ICU), ≥10 days of hospitalization and viral shedding.”
“Treatment with HCQ-AZ was associated with a decreased risk of transfer to ICU or death (Hazard ratio (HR) 0.18 0.11–0.27), decreased risk of hospitalization ≥10 days (odds ratios 95% CI 0.38 0.27–0.54) and shorter duration of viral shedding (time to negative PCR: HR 1.29 1.17–1.42). QTc prolongation (>60 ms) was observed in 25 patients (0.67%) leading to the cessation of treatment in 12 cases including 3 cases with QTc> 500 ms. No cases of torsade de pointe or sudden death were observed.”
“Although this is a retrospective analysis, results suggest that early diagnosis, early isolation and early treatment of COVID-19 patients, with at least 3 days of HCQ-AZ lead to a significantly better clinical outcome and a faster viral load reduction than other treatments.”
“The decision of the government of France to recommend staying at home (lockdown) without testing while waiting for dyspnoea was not supported by our results.”
“As with other clinicians, we have seen patients with hypoxia, including some with very low blood oxygen levels, who described themselves as feeling well and comfortable (“happy hypoxemia”) . Since these patients may develop severe symptoms based on our observations, the use of inexpensive pulse oximeters (around 20€) in primary-care health settings and/or by family doctors might be considered a triage tool on which to base hospitalization referral for further investigation.”
“Our approach of early diagnosis and care of as many patients as possible results in much lower mortality rates than other strategies. The test-and-treat strategy adopted in Marseille also seems capable of shortening the duration of the outbreak when compared to data from France overall by identifying infected people and reducing their viral shedding duration. In fact, more people were tested in Marseille than in most other areas, and the outbreak lasted only 9 weeks.”
“In addition, patients under HCQ-AZ treatment for at least 3 days had a better clinical outcome, based on mortality rates among patients >60 years, less transfer to ICU and shorter length of stay at the hospital, and these patients also had a shorter duration of viral shedding than patients who did not receive this drug combination. Finally, a global strategy for the management of the COVID-19 outbreak may help to limit both the number of cases and fatalities and guide countries where this pandemic has not yet peaked.”
“Since this analysis was completed, and as of the 11h June, 2020, 6 more patients died including 1 patient treated with HCQ-AZ for at least 3 days and 5 in the other group, resulting in an overall 1.1% case fatality rate for the 3,737 patients included in our study.”
Again, please refer to the full study at: https://www.sciencedirect.com/science/article/pii/S1477893920302817