Hydroxychloroquine and Zinc With Either Azithromycin or Doxycycline for Treatment of COVID-19 in Outpatient Setting

Inclusion Criteria:

• Able to read and understand informed consent.
• High initial clinical suspicion by physician based on signs and symptoms (fever,cough, myalgias, fatigue, shortness of breath) followed by RT-PCR for confirmation ofCOVID-19 diagnosis
• Any gender
• Age 60 years and older
• Age 30-59 years with one or more of the following:
• abnormal lung exam
• abnormal oxygen staturation <95%
• abnormal chest x-ray or chest CT
• persistent fever >100.4 degrees Fahrenheit upon arrival to Emergency department (ED)
• one of the following co-morbidities: hypertension, diabetes mellitus, history ofcoronary artery disease, chronic kidney disease (CKD), asthma, chronicobstructive pulmonary disease, current or former smoker, or morbid obesity (BodyMass Index ≥35)

Exclusion Criteria:

• Pregnant or breastfeeding female
• Severe COVID-19 requiring admission for inpatient treatment
• Need for any oxygen supplementation
• Need for mechanical ventilatory support
• History of oxygen supplementation dependency
• History of cancer with ongoing chemotherapy or radiation therapy
• Concurrent antimicrobial therapy
• Known hypersensitivity to hydroxychloroquine or other 4-aminoquinoline compounds
• Already taking hydroxychloroquine or chloroquine within 1 month
• Known G6-PD deficiency
• History of retinopathy
• History of current cardiac diseases (heart failure, ventricular arrhythmias, Leftbundle branch block and/or Right bundle branch block, QTc prolongation >480ms), orfamily history of sudden cardiac death
• Ongoing use of drugs that prolong the QTc interval (antipsychotics, antidepressants,class I and III antiarrhythmics, triptans)
• Severe renal disease: glomerular filtration rate (GFR) <30ml/min
• Severe hepatic impairment (elevated total bilirubin >2 mg/dL, decreased albumin <2.8g/dL, signs of jaundice and ascites.)
• Active alcohol abuse (>5 drinks per day or >20 drinks per week.)
• Seizure disorder, currently on medications
• Known hypersensitivity to any tetracyclines.