Fig. 2 Effect of hydroxychloroquine and azithromycin association on SARS-CoV 2 replication. 2A. Delta Ct between 0 and 60 h post infection. Ordered axis represents the variation of delta cycle-thresholds obtained by RT-PCR between H0 and H60 for each condition. Each point represents data obtained for one well. Number of replicates was indicated for each conditions are A10H5 n = 16, A10H2 n = 5, A10H1 n = 5, A5H5 n = 15, A5H2 n = 5, A5H1 n = 3, A2H5 n = 3, A2H2 n = 3, A2H1 n = 3 and n = 13 for the positive control. Median and interquartile range were indicated for each condition. *** represent significant results under p < 0,0005. Others are not significant compared to the control. 2B. Percentage of inhibition as compared to control by the combinations of 5 μM of hydroxychloroquine associated with 5 or 10 μM for azithromycin. Data represent the mean ± SD, representing three independent experiments conducted at least in triplicate. Source: Andreani et al., 2020.

Combined hydroxychloroquine and azithromycin show synergistic effect on SARS-CoV-2 in monkey Vero E6 cells in vitro but may not be effective in human alveoli, pneumocytes and other cells.

The cell types in which hydroxychloroquine is apparently ineffective include epithelial cells lining the nose, trachea, and distal airways, including alveoli and type II pneumocytes. However, it is useful to know that hydroxychloroquine and azithromycin have a synergistic effect in the cell types where SARS-CoV-2 infection and replication is dependent on endosomal pH.

Raoult et Gautret on resistance aux antibiotics.

HCQ+AZ, the pre-therapy workup and the follow-up: electrolytes, electrocardiogram with corrected QT (Bazett’s formula) and more.

There are some contra-indications for the HCQ+AZ treatment. Also, patients need to be screened for potential prolongation of QT time on electrocardiogram and for electrolyte balance. Given that the IHU hospital in Marseille, France, is a pole of excellence, we recommend using their pre-therapy workup and the follow-up recommendations.

People are queuing to be tested for SARS-CoV-2 in the IHU Marseille of Didier Raoult. There is a high risk of getting infected in this situation. Staying in the cold also reduces innate immunity.

A test: Calculate the in-hospital mortality in the patients that did not receive either hydroxychloroquine or azithromycin in Marseille, France.

To find out if hydroxychloroquine plus azithromycin (HCQ+AZ), the preferred treatment at the IHU hospital in Marseille, France, is effective, we need to calculate the in-hospital mortality in patients who did receive HCQ+AZ and in patients who didn’t.

A study from China found hydroxychloroquine was ineffective for mild to moderate COVID-19 despite a high dose and long administration.

A study from China found that hydroxychloroquine was ineffective in the treatment of mild to moderate COVID-19. Despite a high dose and long administration.

Of the 75 patients on hydroxychloroquine plus the standard of care protocol, 22 remained positive for SARS-CoV-2 on a PCR-test by day 28 from the start of hydroxychloroquine administration.

You are unlikely to get the most appropriate treatment for COVID-19 in this hospital (May 2020). New York–Presbyterian Hospital (NYP)–Columbia University Irving Medical Center (CUIMC), a quaternary, acute care hospital in northern Manhattan.

Chaotic treatment of COVID-19 patients in New York State.

“Overall in-hospital mortality was 20.3%.” In hydroxychloroquine+azithromycin group, in-hospital mortality was 25.7%.
The use of hydroxychloroquine alone or in combination with azithromycin in hospitals of the New York State can be described as chaotic.

Mediterrannee Infections is a large infectious disease hospital network in the area of the city of Marseille.

Treatment of COVID-19 in Marseille, France.

No corticosteroids. Anticoagulants only for severe cases.
In a cohort of relatively young patients (mean age 43,6 years, standard deviation 15.6 years), the use of antihypertensive drugs was the only independent strong predictor of poor outcomes. The age was a weak independent predictor of poor outcomes .

Hydroxychloroquine has a half-life of 2963 hours (123.5 days). Hydroxychloroquine toxicity.

Chronic administration of hydroxychloroquine in systemic lupus erythematosus (SLE): it is not known yet if it is protective against COVID-19 (April 30, 2020).

As of the end of April 2020, we do not know yet if chronically administered hydroxychloroquine is protective against COVID-19 in systemic lupus erythematosus (SLE) patients.

Novartis stated they have 50,000,000 doses on hand with another 80,000,000 doses to be ready by May.

Where are the millions of doses of hydroxychloroquine that Novartis, a “Big Pharma” company, committed to contribute to the global COVID-19 pandemic response?

Ian Lipkin considered using blood plasma (or serum) from Chinese patients who recovered from COVID-19 that his beloved friends, Chinese scientists, wanted to send him from China, but later decides against using it. That is, someone smart apparently advised Ian Lipkin against using plasma (or serum) from recovered Chinese patients.

Ian Lipkin, a New York professor of medicine, director of infection and immunity, used a wrong dosage of hydroxychloroquine to treat his COVID-19.

The wrong dosage of hydroxychloroquine and the wrong protocol used by Ian Lipkin is an embarrassing episode that shows a low professional level of New York professors of medicine and medical doctors.

FDA authorized hydroxychloroquine and chloroquine for treatment of COVID-19.

Hydroxychloroquine has a half-life of 2963 hours (123.5 days). Hydroxychloroquine toxicity, dosage.

The FDA issued an authorization for the use of chloroquine and hydroxychloroquine for patients hospitalized with COVID-19. The dosage of hydroxychloroquine used in different recent trials is high. Hydroxychloroquine is toxic and has a very long half-life.