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.

Principles And Practice of Mechanical Ventilation, Third Edition (Tobin, Principles and Practice of Mechanical Ventilation) by Martin J. Tobin.

Physiological Literacy on mechanical ventilation in COVID-19: “Only a small proportion of patients—largely those in a cardiac arrest situation—“require” mechanical ventilation.”

Pulmonologist Michael J. Tobin: “Once a patient is placed on a ventilator, the key challenge is to avoid complications.
Mechanical ventilation (in and of itself) does not produce lung healing—it merely keeps patients alive until their own biological mechanisms are able to outwit the coronavirus.
The best way to minimize ventilator-associated complications is to avoid intubation unless it is absolutely necessary.
The surest way to increase Covid-19 mortality is liberal use of intubation and mechanical ventilation.