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Table 2b. Chloroquine or Hydroxychloroquine and/or Azithromycin: Selected Clinical Data

Last Updated: July 8, 2021

The information in this table may include data from preprints or articles that have not been peer reviewed. This section will be updated as new information becomes available. Please see ClinicalTrials.gov for more information on clinical trials that are evaluating CQ, HCQ, and/or AZM.

The Panel has reviewed other clinical studies of HCQ with or without AZM, CQ, and AZM for the treatment of COVID-19.1-19 These studies have limitations that make them less definitive and informative than the studies discussed here. The Panel’s summaries and interpretations of some of those studies are available in the archived versions of the COVID-19 Treatment Guidelines.

Table 2b. Chloroquine or Hydroxychloroquine With or Without Azithromycin: Selected Clinical Data
Table 2b. Chloroquine or Hydroxychloroquine With or Without Azithromycin: Selected Clinical Data
  1. Chorin E, Dai M, Shulman E, et al. The QT interval in patients with COVID-19 treated with hydroxychloroquine and azithromycin. Nat Med. 2020;26(6):808-809. Available at: https://www.ncbi.nlm.nih.gov/pubmed/32488217.
  2. Gautret P, Lagier JC, Parola P, et al. Clinical and microbiological effect of a combination of hydroxychloroquine and azithromycin in 80 COVID-19 patients with at least a six-day follow up: A pilot observational study. Travel Med Infect Dis. 2020:101663. Available at: https://www.ncbi.nlm.nih.gov/pubmed/32289548.
  3. Gautret P, Lagier JC, Parola P, et al. Hydroxychloroquine and azithromycin as a treatment of COVID-19: results of an open-label non-randomized clinical trial. Int J Antimicrob Agents. 2020:105949. Available at: https://www.ncbi.nlm.nih.gov/pubmed/32205204.
  4. Huang M, Tang T, Pang P, et al. Treating COVID-19 with chloroquine. J Mol Cell Biol. 2020;12(4):322-325. Available at: https://www.ncbi.nlm.nih.gov/pubmed/32236562.
  5. Magagnoli J, Narendran S, Pereira F, et al. Outcomes of hydroxychloroquine usage in United States veterans hospitalized with COVID-19. Med (N Y). 2020;1(1):114-127.e3. Available at: https://www.ncbi.nlm.nih.gov/pubmed/32838355.
  6. Molina JM, Delaugerre C, Le Goff J, et al. No evidence of rapid antiviral clearance or clinical benefit with the combination of hydroxychloroquine and azithromycin in patients with severe COVID-19 infection. Med Mal Infect. 2020;50(4):384. Available at: https://www.ncbi.nlm.nih.gov/pubmed/32240719.
  7. Satlin MJ, Goyal P, Magleby R, et al. Safety, tolerability, and clinical outcomes of hydroxychloroquine for hospitalized patients with coronavirus 2019 disease. PLoS One. 2020;15(7):e0236778. Available at: https://www.ncbi.nlm.nih.gov/pubmed/32701969.
  8. Mikami T, Miyashita H, Yamada T, et al. Risk factors for mortality in patients with COVID-19 in New York City. J Gen Intern Med. 2021;36(1):17-26.. Available at: https://www.ncbi.nlm.nih.gov/pubmed/32607928.
  9. Catteau L, Dauby N, Montourcy M, et al. Low-dose hydroxychloroquine therapy and mortality in hospitalised patients with COVID-19: a nationwide observational study of 8075 participants. Int J Antimicrob Agents. 2020:106144. Available at: https://www.ncbi.nlm.nih.gov/pubmed/32853673.
  10. COVID-19 RISK and Treatments (CORIST) Collaboration. Use of hydroxychloroquine in hospitalised COVID-19 patients is associated with reduced mortality: findings from the observational multicentre Italian CORIST study. Eur J Intern Med. 2020;82:38-47.. Available at: https://www.ncbi.nlm.nih.gov/pubmed/32859477.
  11. Furtado RHM, Berwanger O, Fonseca HA, et al. Azithromycin in addition to standard of care versus standard of care alone in the treatment of patients admitted to the hospital with severe COVID-19 in Brazil (COALITION II): a randomised clinical trial. Lancet. 2020;396(10256):959-967. Available at: https://www.ncbi.nlm.nih.gov/pubmed/32896292.
  12. Tang W, Cao Z, Han M, et al. Hydroxychloroquine in patients with mainly mild to moderate coronavirus disease 2019: open label, randomised controlled trial. BMJ. 2020;369:m1849. Available at: https://www.ncbi.nlm.nih.gov/pubmed/32409561.
  13. Borba MGS, Val FFA, Sampaio VS, et al. Effect of high vs low doses of chloroquine diphosphate as adjunctive therapy for patients hospitalized with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection: a randomized clinical trial. JAMA Netw Open. 2020;3(4):e208857. Available at: https://www.ncbi.nlm.nih.gov/pubmed/32339248.
  14. Mahevas M, Tran VT, Roumier M, et al. Clinical efficacy of hydroxychloroquine in patients with COVID-19 pneumonia who require oxygen: observational comparative study using routine care data. BMJ. 2020;369:m1844. Available at: https://www.ncbi.nlm.nih.gov/pubmed/32409486.
  15. Arshad S, Kilgore P, Chaudhry ZS, et al. Treatment with hydroxychloroquine, azithromycin, and combination in patients hospitalized with COVID-19. Int J Infect Dis. 2020;97:396-403. Available at: https://www.ncbi.nlm.nih.gov/pubmed/32623082.
  16. Recovery Collaborative Group. Azithromycin in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial. Lancet. 2021;397(10274):605-612. Available at: https://www.ncbi.nlm.nih.gov/pubmed/33545096.
  17. Omrani AS, Pathan SA, Thomas SA, et al. Randomized double-blinded placebo-controlled trial of hydroxychloroquine with or without azithromycin for virologic cure of non-severe COVID-19. EClinicalMedicine. 2020;29:100645. Available at: https://www.ncbi.nlm.nih.gov/pubmed/33251500.
  18. Principle Trial Collaborative Group. Azithromycin for community treatment of suspected COVID-19 in people at increased risk of an adverse clinical course in the UK (PRINCIPLE): a randomised, controlled, open-label, adaptive platform trial. Lancet. 2021;397(10279):1063-1074. Available at: https://www.ncbi.nlm.nih.gov/pubmed/33676597.
  19. Hinks TSC, Cureton L, Knight R, et al. A randomised clinical trial of azithromycin versus standard care in ambulatory COVID-19–the ATOMIC2 trial. medRxiv. 2021;Preprint. Available at: https://www.medrxiv.org/content/10.1101/2021.04.21.21255807v1.
  20. WHO Solidarity Trial Consortium, Pan H, Peto R, et al. Repurposed antiviral drugs for COVID-19—interim WHO Solidarity Trial results. N Engl J Med. 2021;384(6):497-511. Available at: https://www.ncbi.nlm.nih.gov/pubmed/33264556.
  21. Self WH, Semler MW, Leither LM, et al. Effect of hydroxychloroquine on clinical status at 14 days in hospitalized patients with COVID-19: a randomized clinical trial. JAMA. 2020;324(21):2165-2176. Available at: https://www.ncbi.nlm.nih.gov/pubmed/33165621.
  22. Recovery Collaborative Group, Horby P, Mafham M, et al. Effect of hydroxychloroquine in hospitalized patients with COVID-19. N Engl J Med. 2020;383(21):2030-2040. Available at: https://www.ncbi.nlm.nih.gov/pubmed/33031652.
  23. Cavalcanti AB, Zampieri FG, Rosa RG, et al. Hydroxychloroquine with or without azithromycin in mild-to-moderate COVID-19. N Engl J Med. 2020;383(21):2041-2052. Available at: https://www.ncbi.nlm.nih.gov/pubmed/32706953.
  24. Skipper CP, Pastick KA, Engen NW, et al. Hydroxychloroquine in nonhospitalized adults with early COVID-19: a randomized trial. Ann Intern Med. 2020;173(8):623-631.. Available at: https://www.ncbi.nlm.nih.gov/pubmed/32673060.
  25. Mitja O, Corbacho-Monne M, Ubals M, et al. Hydroxychloroquine for early treatment of adults with mild COVID-19: a randomized-controlled trial. Clin Infect Dis. 2020;Published online ahead of print. Available at: https://www.ncbi.nlm.nih.gov/pubmed/32674126.
  26. Rosenberg ES, Dufort EM, Udo T, et al. Association of treatment with hydroxychloroquine or azithromycin with in-hospital mortality in patients with COVID-19 in New York state. JAMA. 2020;323(24):2493-2502.. Available at: https://www.ncbi.nlm.nih.gov/pubmed/32392282.
  27. Geleris J, Sun Y, Platt J, et al. Observational study of hydroxychloroquine in hospitalized patients with COVID-19. N Engl J Med. 2020;382(25):2411-2418.. Available at: https://www.ncbi.nlm.nih.gov/pubmed/32379955.