Viral clearance in patients with COVID-19: associated factors and the
role of antiviral treatment
Abstract
The role of hydroxychloroquine (HCQ) in lowering the viral load of
patients with COVID-19 is controversial. In our Institute, we treated
more than 30,000 people with COVID-19 in 2020 and 2021, using the same
diagnostic tools and the same treatment dosages. In this retrospective
comparative study of data collected over this period, we aimed to
compare the viral clearance in the nasopharynx as determined by qPCR in
patients who were treated with HCQ and those who were not. As a new
feature, we adjusted the data according to the most significant
confounding factors (age, initial viral load, and timescale between the
onset of symptoms and treatment). Of the 1 276 patients selected from
our database, 776 were treated with HCQ and 500 were not. Viral
clearance in the treatment group was reached significantly earlier than
in the non-treatment group, at days 5, 10 and 30. These differences
remain significant after adjustments for confounding factors. In
conclusion, although age, initial viral load, and time to treatment do
influence the viral load in patients with COVID-19, hydroxychloroquine
associated with azithromycin still independently significantly lowered
viral load more rapidly than other treatments, including azithromycin
alone.