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Hydroxychloroquine use in hospitalised patients with COVID-19: An observational matched cohort study.
J Glob Antimicrob Resist. 2020 09; 22:842-844.JG

Abstract

AIM

To assess the efficacy and safety of hydroxychloroquine with or without azithromycin) in hospitalized adult patients with COVID-19.

METHODS

We utilized a hospital based prospective data registry. The primary end point was to assess the impact of hydroxychloroquine with or without azithromycin, on outcome, length of hospitalization, and time to clinical improvement. We utilized treatment effects with inverse-probability-weighting and Cox proportional hazards models. All analyses accounted for age, gender, race, severity on admission, days from symptoms onset and chronic comorbidities.

RESULTS

36 patients received hydroxychloroquine and were age- and sex-matched to 72 patients with COVID-19 who received supportive care. Compared to supportive care, the use of HCQ did not shorten the time to clinical improvement (+0.23 days; 95% CI: -1.8-2.3 days) nor did it shorten the duration of hospital stay (+0.91 days; 95% CI: -1.1-2.9 days). Additionally, HCQ did not decrease the risk of COVID-19 in-hospital death (aHR 1.67; 95% CI: 0.29-9.36). Finally, we observed a slight QTc prolongation from a baseline of 444 ± 26 ms to 464 ± 32 ms (mean±SD) among patients receiving hydroxychloroquine with or without azithromycin.

CONCLUSION

This study did not yield benefits from hydroxychloroquine use in patients with COVID-19 and monitoring for adverse events is warranted. Nevertheless, the treatment was safely studied under the guidance of an antimicrobial stewardship program.

Authors+Show Affiliations

Infectious Diseases Division, Warren Alpert Medical School of Brown University, Providence, RI, USA.Infectious Diseases Division, Warren Alpert Medical School of Brown University, Providence, RI, USA.Infectious Diseases Division, Warren Alpert Medical School of Brown University, Providence, RI, USA.Infectious Diseases Division, Warren Alpert Medical School of Brown University, Providence, RI, USA.Infectious Diseases Division, Warren Alpert Medical School of Brown University, Providence, RI, USA.Infectious Diseases Division, Warren Alpert Medical School of Brown University, Providence, RI, USA.Infectious Diseases Division, Warren Alpert Medical School of Brown University, Providence, RI, USA.Infectious Diseases Division, Warren Alpert Medical School of Brown University, Providence, RI, USA.Infectious Diseases Division, Warren Alpert Medical School of Brown University, Providence, RI, USA.Clinical Pharmacy, Lifespan, Providence, RI, USA.Clinical Pharmacy, Lifespan, Providence, RI, USA.Infectious Diseases Division, Warren Alpert Medical School of Brown University, Providence, RI, USA. Electronic address: ccunha@Lifespan.org.Infectious Diseases Division, Warren Alpert Medical School of Brown University, Providence, RI, USA. Electronic address: emylonakis@lifespan.org.

Pub Type(s)

Journal Article
Observational Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

32763357

Citation

Kalligeros, Markos, et al. "Hydroxychloroquine Use in Hospitalised Patients With COVID-19: an Observational Matched Cohort Study." Journal of Global Antimicrobial Resistance, vol. 22, 2020, pp. 842-844.
Kalligeros M, Shehadeh F, Atalla E, et al. Hydroxychloroquine use in hospitalised patients with COVID-19: An observational matched cohort study. J Glob Antimicrob Resist. 2020;22:842-844.
Kalligeros, M., Shehadeh, F., Atalla, E., Mylona, E. K., Aung, S., Pandita, A., Larkin, J., Sanchez, M., Touzard-Romo, F., Brotherton, A., Shah, R., Cunha, C. B., & Mylonakis, E. (2020). Hydroxychloroquine use in hospitalised patients with COVID-19: An observational matched cohort study. Journal of Global Antimicrobial Resistance, 22, 842-844. https://doi.org/10.1016/j.jgar.2020.07.018
Kalligeros M, et al. Hydroxychloroquine Use in Hospitalised Patients With COVID-19: an Observational Matched Cohort Study. J Glob Antimicrob Resist. 2020;22:842-844. PubMed PMID: 32763357.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Hydroxychloroquine use in hospitalised patients with COVID-19: An observational matched cohort study. AU - Kalligeros,Markos, AU - Shehadeh,Fadi, AU - Atalla,Eleftheria, AU - Mylona,Evangelia K, AU - Aung,Su, AU - Pandita,Aakriti, AU - Larkin,Jerry, AU - Sanchez,Martha, AU - Touzard-Romo,Francine, AU - Brotherton,Amy, AU - Shah,Rajeev, AU - Cunha,Cheston B, AU - Mylonakis,Eleftherios, Y1 - 2020/08/05/ PY - 2020/06/24/received PY - 2020/07/13/revised PY - 2020/07/27/accepted PY - 2020/8/9/pubmed PY - 2020/10/21/medline PY - 2020/8/9/entrez KW - COVID-19 KW - Efficacy KW - Hydroxychloroquine KW - QTc KW - SARS-CoV-2 KW - Safety SP - 842 EP - 844 JF - Journal of global antimicrobial resistance JO - J Glob Antimicrob Resist VL - 22 N2 - AIM: To assess the efficacy and safety of hydroxychloroquine with or without azithromycin) in hospitalized adult patients with COVID-19. METHODS: We utilized a hospital based prospective data registry. The primary end point was to assess the impact of hydroxychloroquine with or without azithromycin, on outcome, length of hospitalization, and time to clinical improvement. We utilized treatment effects with inverse-probability-weighting and Cox proportional hazards models. All analyses accounted for age, gender, race, severity on admission, days from symptoms onset and chronic comorbidities. RESULTS: 36 patients received hydroxychloroquine and were age- and sex-matched to 72 patients with COVID-19 who received supportive care. Compared to supportive care, the use of HCQ did not shorten the time to clinical improvement (+0.23 days; 95% CI: -1.8-2.3 days) nor did it shorten the duration of hospital stay (+0.91 days; 95% CI: -1.1-2.9 days). Additionally, HCQ did not decrease the risk of COVID-19 in-hospital death (aHR 1.67; 95% CI: 0.29-9.36). Finally, we observed a slight QTc prolongation from a baseline of 444 ± 26 ms to 464 ± 32 ms (mean±SD) among patients receiving hydroxychloroquine with or without azithromycin. CONCLUSION: This study did not yield benefits from hydroxychloroquine use in patients with COVID-19 and monitoring for adverse events is warranted. Nevertheless, the treatment was safely studied under the guidance of an antimicrobial stewardship program. SN - 2213-7173 UR - https://www.unboundmedicine.com/medline/citation/32763357/Hydroxychloroquine_use_in_hospitalised_patients_with_COVID_19:_An_observational_matched_cohort_study_ DB - PRIME DP - Unbound Medicine ER -