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Hydroxychloroquine in the treatment of outpatients with mildly symptomatic COVID-19: a multi-center observational study
BACKGROUND: Hydroxychloroquine has not been associated with improved survival among hospitalized COVID-19 patients in the majority of observational studies and similarly was not identified as an effective prophylaxis following exposure in a prospective randomized trial. We aimed to explore the role...
Autores principales: | , , , , , , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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BioMed Central
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7807228/ https://www.ncbi.nlm.nih.gov/pubmed/33446136 http://dx.doi.org/10.1186/s12879-021-05773-w |
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author | Ip, Andrew Ahn, Jaeil Zhou, Yizhao Goy, Andre H. Hansen, Eric Pecora, Andrew L. Sinclaire, Brittany A. Bednarz, Urszula Marafelias, Michael Sawczuk, Ihor S. Underwood, Joseph P. Walker, David M. Prasad, Rajiv Sweeney, Robert L. Ponce, Marie G. La Capra, Samuel Cunningham, Frank J. Calise, Arthur G. Pulver, Bradley L. Ruocco, Dominic Mojares, Greggory E. Eagan, Michael P. Ziontz, Kristy L. Mastrokyriakos, Paul Goldberg, Stuart L. |
author_facet | Ip, Andrew Ahn, Jaeil Zhou, Yizhao Goy, Andre H. Hansen, Eric Pecora, Andrew L. Sinclaire, Brittany A. Bednarz, Urszula Marafelias, Michael Sawczuk, Ihor S. Underwood, Joseph P. Walker, David M. Prasad, Rajiv Sweeney, Robert L. Ponce, Marie G. La Capra, Samuel Cunningham, Frank J. Calise, Arthur G. Pulver, Bradley L. Ruocco, Dominic Mojares, Greggory E. Eagan, Michael P. Ziontz, Kristy L. Mastrokyriakos, Paul Goldberg, Stuart L. |
author_sort | Ip, Andrew |
collection | PubMed |
description | BACKGROUND: Hydroxychloroquine has not been associated with improved survival among hospitalized COVID-19 patients in the majority of observational studies and similarly was not identified as an effective prophylaxis following exposure in a prospective randomized trial. We aimed to explore the role of hydroxychloroquine therapy in mildly symptomatic patients diagnosed in the outpatient setting. METHODS: We examined the association between outpatient hydroxychloroquine exposure and the subsequent progression of disease among mildly symptomatic non-hospitalized patients with documented SARS-CoV-2 infection. The primary outcome assessed was requirement of hospitalization. Data was obtained from a retrospective review of electronic health records within a New Jersey USA multi-hospital network. We compared outcomes in patients who received hydroxychloroquine with those who did not applying a multivariable logistic model with propensity matching. RESULTS: Among 1274 outpatients with documented SARS-CoV-2 infection 7.6% were prescribed hydroxychloroquine. In a 1067 patient propensity matched cohort, 21.6% with outpatient exposure to hydroxychloroquine were hospitalized, and 31.4% without exposure were hospitalized. In the primary multivariable logistic regression analysis with propensity matching there was an association between exposure to hydroxychloroquine and a decreased rate of hospitalization from COVID-19 (OR 0.53; 95% CI, 0.29, 0.95). Sensitivity analyses revealed similar associations. QTc prolongation events occurred in 2% of patients prescribed hydroxychloroquine with no reported arrhythmia events among those with data available. CONCLUSIONS: In this retrospective observational study of SARS-CoV-2 infected non-hospitalized patients hydroxychloroquine exposure was associated with a decreased rate of subsequent hospitalization. Additional exploration of hydroxychloroquine in this mildly symptomatic outpatient population is warranted. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12879-021-05773-w. |
format | Online Article Text |
id | pubmed-7807228 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-78072282021-01-14 Hydroxychloroquine in the treatment of outpatients with mildly symptomatic COVID-19: a multi-center observational study Ip, Andrew Ahn, Jaeil Zhou, Yizhao Goy, Andre H. Hansen, Eric Pecora, Andrew L. Sinclaire, Brittany A. Bednarz, Urszula Marafelias, Michael Sawczuk, Ihor S. Underwood, Joseph P. Walker, David M. Prasad, Rajiv Sweeney, Robert L. Ponce, Marie G. La Capra, Samuel Cunningham, Frank J. Calise, Arthur G. Pulver, Bradley L. Ruocco, Dominic Mojares, Greggory E. Eagan, Michael P. Ziontz, Kristy L. Mastrokyriakos, Paul Goldberg, Stuart L. BMC Infect Dis Research Article BACKGROUND: Hydroxychloroquine has not been associated with improved survival among hospitalized COVID-19 patients in the majority of observational studies and similarly was not identified as an effective prophylaxis following exposure in a prospective randomized trial. We aimed to explore the role of hydroxychloroquine therapy in mildly symptomatic patients diagnosed in the outpatient setting. METHODS: We examined the association between outpatient hydroxychloroquine exposure and the subsequent progression of disease among mildly symptomatic non-hospitalized patients with documented SARS-CoV-2 infection. The primary outcome assessed was requirement of hospitalization. Data was obtained from a retrospective review of electronic health records within a New Jersey USA multi-hospital network. We compared outcomes in patients who received hydroxychloroquine with those who did not applying a multivariable logistic model with propensity matching. RESULTS: Among 1274 outpatients with documented SARS-CoV-2 infection 7.6% were prescribed hydroxychloroquine. In a 1067 patient propensity matched cohort, 21.6% with outpatient exposure to hydroxychloroquine were hospitalized, and 31.4% without exposure were hospitalized. In the primary multivariable logistic regression analysis with propensity matching there was an association between exposure to hydroxychloroquine and a decreased rate of hospitalization from COVID-19 (OR 0.53; 95% CI, 0.29, 0.95). Sensitivity analyses revealed similar associations. QTc prolongation events occurred in 2% of patients prescribed hydroxychloroquine with no reported arrhythmia events among those with data available. CONCLUSIONS: In this retrospective observational study of SARS-CoV-2 infected non-hospitalized patients hydroxychloroquine exposure was associated with a decreased rate of subsequent hospitalization. Additional exploration of hydroxychloroquine in this mildly symptomatic outpatient population is warranted. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12879-021-05773-w. BioMed Central 2021-01-14 /pmc/articles/PMC7807228/ /pubmed/33446136 http://dx.doi.org/10.1186/s12879-021-05773-w Text en © The Author(s) 2021 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Article Ip, Andrew Ahn, Jaeil Zhou, Yizhao Goy, Andre H. Hansen, Eric Pecora, Andrew L. Sinclaire, Brittany A. Bednarz, Urszula Marafelias, Michael Sawczuk, Ihor S. Underwood, Joseph P. Walker, David M. Prasad, Rajiv Sweeney, Robert L. Ponce, Marie G. La Capra, Samuel Cunningham, Frank J. Calise, Arthur G. Pulver, Bradley L. Ruocco, Dominic Mojares, Greggory E. Eagan, Michael P. Ziontz, Kristy L. Mastrokyriakos, Paul Goldberg, Stuart L. Hydroxychloroquine in the treatment of outpatients with mildly symptomatic COVID-19: a multi-center observational study |
title | Hydroxychloroquine in the treatment of outpatients with mildly symptomatic COVID-19: a multi-center observational study |
title_full | Hydroxychloroquine in the treatment of outpatients with mildly symptomatic COVID-19: a multi-center observational study |
title_fullStr | Hydroxychloroquine in the treatment of outpatients with mildly symptomatic COVID-19: a multi-center observational study |
title_full_unstemmed | Hydroxychloroquine in the treatment of outpatients with mildly symptomatic COVID-19: a multi-center observational study |
title_short | Hydroxychloroquine in the treatment of outpatients with mildly symptomatic COVID-19: a multi-center observational study |
title_sort | hydroxychloroquine in the treatment of outpatients with mildly symptomatic covid-19: a multi-center observational study |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7807228/ https://www.ncbi.nlm.nih.gov/pubmed/33446136 http://dx.doi.org/10.1186/s12879-021-05773-w |
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