This study proposes to evaluate clinical outcomes and viral load in COVID-19 infected patients with early moderate and severe disease admitted to the hospital and randomized to one of three arms. Patients will be randomized to supportive care, OR hydroxychloroquine alone, OR hydroxychloroquine and azithromycin.
This is a phase 3 study.
Primary Objective:
• To evaluate clinical outcomes in patients with suspected or confirmed COVID-19 with early
moderate to severe disease in a randomized controlled trial.
Secondary Objectives:
- To evaluate quantitative viral load over time
- To evaluate length of hospital stay and days in ICU
- To evaluate toxicity of the treatment options
- To evaluate rate of readmission after hospital discharge
- To evaluate duration of clinical symptoms
Arm A:
Control Arm - Supportive Care Only
Arm B:
Hydroxychloroquine 400 mg po bid on Day 1 Hydroxychloroquine 200 mg po bid Days 2 through 5
Arm C:
Hydroxychloroquine as in Arm B AND Azithromycin 500 mg po on Day 1 Azithromycin 250 mg po
days 2 through 5
Drug: Hydroxychloroquine
tablets provided as described in Arm B
Drug: Azithromycin
tablets provided as described in Arm C
Inclusion Criteria:
- Age greater than 18 years
- Positive SARS-CoV-2 testing or consistent clinical syndrome (based on clinical picture
e.g. characteristic infiltrates on chest x-ray, laboratory findings, and with
agreement by two physicians) in patients under investigation (PUIs).
- Onset of symptoms < 7 days from date of enrollment
- Oxygen saturation of >94% on room air with defined risk factors (Table 1) consistent
with moderate disease OR oxygen saturation of < 94% on room air consistent with severe
disease
- Ability and willingness to comply with study procedures
Exclusion Criteria:
- QTc greater than 450 milliseconds on screening EKG
- Pregnant or lactating women
- Inability to take oral pills or inability to use a feeding tube
- Inability to obtain informed consent either from the patient or from the next of kin
if patient is incapacitated. For the purpose of this study obtaining a verbal consent
from a family member on the phone with a witness will be considered acceptable since
there is a 'no visitor' policy in force at hospitals.
- Patients requiring ICU level care
- use of azithromycin or hydroxychloroquine within 30 days prior to admission
University Medical Center New Orleans
New Orleans, Louisiana, United States
Meredith Clement, MD, Principal Investigator
LSUHSC/UMCNO