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Low-dose hydroxychloroquine therapy and mortality in hospitalised patients with COVID-19: a nationwide observational study of 8075 participants

Hydroxychloroquine (HCQ) has been largely used and investigated as therapy for COVID-19 across various settings at a total dose usually ranging from 2400 mg to 9600 mg. In Belgium, off-label use of low-dose HCQ (total 2400 mg over 5 days) was recommended for hospitalised patients with COVID-19. We c...

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Autores principales: Catteau, Lucy, Dauby, Nicolas, Montourcy, Marion, Bottieau, Emmanuel, Hautekiet, Joris, Goetghebeur, Els, van Ierssel, Sabrina, Duysburgh, Els, Van Oyen, Herman, Wyndham-Thomas, Chloé, Van Beckhoven, Dominique
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier Ltd and International Society of Antimicrobial Chemotherapy. 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7444610/
https://www.ncbi.nlm.nih.gov/pubmed/32853673
http://dx.doi.org/10.1016/j.ijantimicag.2020.106144
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author Catteau, Lucy
Dauby, Nicolas
Montourcy, Marion
Bottieau, Emmanuel
Hautekiet, Joris
Goetghebeur, Els
van Ierssel, Sabrina
Duysburgh, Els
Van Oyen, Herman
Wyndham-Thomas, Chloé
Van Beckhoven, Dominique
author_facet Catteau, Lucy
Dauby, Nicolas
Montourcy, Marion
Bottieau, Emmanuel
Hautekiet, Joris
Goetghebeur, Els
van Ierssel, Sabrina
Duysburgh, Els
Van Oyen, Herman
Wyndham-Thomas, Chloé
Van Beckhoven, Dominique
author_sort Catteau, Lucy
collection PubMed
description Hydroxychloroquine (HCQ) has been largely used and investigated as therapy for COVID-19 across various settings at a total dose usually ranging from 2400 mg to 9600 mg. In Belgium, off-label use of low-dose HCQ (total 2400 mg over 5 days) was recommended for hospitalised patients with COVID-19. We conducted a retrospective analysis of in-hospital mortality in the Belgian national COVID-19 hospital surveillance data. Patients treated either with HCQ monotherapy and supportive care (HCQ group) were compared with patients treated with supportive care only (no-HCQ group) using a competing risks proportional hazards regression with discharge alive as competing risk, adjusted for demographic and clinical features with robust standard errors. Of 8075 patients with complete discharge data on 24 May 2020 and diagnosed before 1 May 2020, 4542 received HCQ in monotherapy and 3533 were in the no-HCQ group. Death was reported in 804/4542 (17.7%) and 957/3533 (27.1%), respectively. In the multivariable analysis, mortality was lower in the HCQ group compared with the no-HCQ group [adjusted hazard ratio (aHR) = 0.684, 95% confidence interval (CI) 0.617–0.758]. Compared with the no-HCQ group, mortality in the HCQ group was reduced both in patients diagnosed ≤5 days (n = 3975) and >5 days (n = 3487) after symptom onset [aHR = 0.701 (95% CI 0.617–0.796) and aHR = 0.647 (95% CI 0.525–0.797), respectively]. Compared with supportive care only, low-dose HCQ monotherapy was independently associated with lower mortality in hospitalised patients with COVID-19 diagnosed and treated early or later after symptom onset.
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spelling pubmed-74446102020-08-26 Low-dose hydroxychloroquine therapy and mortality in hospitalised patients with COVID-19: a nationwide observational study of 8075 participants Catteau, Lucy Dauby, Nicolas Montourcy, Marion Bottieau, Emmanuel Hautekiet, Joris Goetghebeur, Els van Ierssel, Sabrina Duysburgh, Els Van Oyen, Herman Wyndham-Thomas, Chloé Van Beckhoven, Dominique Int J Antimicrob Agents Article Hydroxychloroquine (HCQ) has been largely used and investigated as therapy for COVID-19 across various settings at a total dose usually ranging from 2400 mg to 9600 mg. In Belgium, off-label use of low-dose HCQ (total 2400 mg over 5 days) was recommended for hospitalised patients with COVID-19. We conducted a retrospective analysis of in-hospital mortality in the Belgian national COVID-19 hospital surveillance data. Patients treated either with HCQ monotherapy and supportive care (HCQ group) were compared with patients treated with supportive care only (no-HCQ group) using a competing risks proportional hazards regression with discharge alive as competing risk, adjusted for demographic and clinical features with robust standard errors. Of 8075 patients with complete discharge data on 24 May 2020 and diagnosed before 1 May 2020, 4542 received HCQ in monotherapy and 3533 were in the no-HCQ group. Death was reported in 804/4542 (17.7%) and 957/3533 (27.1%), respectively. In the multivariable analysis, mortality was lower in the HCQ group compared with the no-HCQ group [adjusted hazard ratio (aHR) = 0.684, 95% confidence interval (CI) 0.617–0.758]. Compared with the no-HCQ group, mortality in the HCQ group was reduced both in patients diagnosed ≤5 days (n = 3975) and >5 days (n = 3487) after symptom onset [aHR = 0.701 (95% CI 0.617–0.796) and aHR = 0.647 (95% CI 0.525–0.797), respectively]. Compared with supportive care only, low-dose HCQ monotherapy was independently associated with lower mortality in hospitalised patients with COVID-19 diagnosed and treated early or later after symptom onset. Elsevier Ltd and International Society of Antimicrobial Chemotherapy. 2020-10 2020-08-24 /pmc/articles/PMC7444610/ /pubmed/32853673 http://dx.doi.org/10.1016/j.ijantimicag.2020.106144 Text en © 2020 Elsevier Ltd and International Society of Antimicrobial Chemotherapy. All rights reserved. Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.
spellingShingle Article
Catteau, Lucy
Dauby, Nicolas
Montourcy, Marion
Bottieau, Emmanuel
Hautekiet, Joris
Goetghebeur, Els
van Ierssel, Sabrina
Duysburgh, Els
Van Oyen, Herman
Wyndham-Thomas, Chloé
Van Beckhoven, Dominique
Low-dose hydroxychloroquine therapy and mortality in hospitalised patients with COVID-19: a nationwide observational study of 8075 participants
title Low-dose hydroxychloroquine therapy and mortality in hospitalised patients with COVID-19: a nationwide observational study of 8075 participants
title_full Low-dose hydroxychloroquine therapy and mortality in hospitalised patients with COVID-19: a nationwide observational study of 8075 participants
title_fullStr Low-dose hydroxychloroquine therapy and mortality in hospitalised patients with COVID-19: a nationwide observational study of 8075 participants
title_full_unstemmed Low-dose hydroxychloroquine therapy and mortality in hospitalised patients with COVID-19: a nationwide observational study of 8075 participants
title_short Low-dose hydroxychloroquine therapy and mortality in hospitalised patients with COVID-19: a nationwide observational study of 8075 participants
title_sort low-dose hydroxychloroquine therapy and mortality in hospitalised patients with covid-19: a nationwide observational study of 8075 participants
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7444610/
https://www.ncbi.nlm.nih.gov/pubmed/32853673
http://dx.doi.org/10.1016/j.ijantimicag.2020.106144
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