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No clinical benefit in mortality associated with hydroxychloroquine treatment in patients with COVID-19

BACKGROUND: The use of hydroxychloroquine (HCQ), with or without concurrent administration of azithromycin (AZM), for treatment of COVID-19 has received considerable attention. The purpose of this study was to determine whether HCQ administration is associated with improved mortality in COVID-19 pat...

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Autores principales: Sands, Kenneth, Wenzel, Richard, McLean, Laura, Korwek, Kimberly, Roach, Jonathon, Miller, Karla, Poland, Russell E., Burgess, L. Hayley, Jackson, Edmund, Perlin, Jonathan B.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Authors. Published by Elsevier Ltd on behalf of International Society for Infectious Diseases. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7834474/
https://www.ncbi.nlm.nih.gov/pubmed/33359949
http://dx.doi.org/10.1016/j.ijid.2020.12.060
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author Sands, Kenneth
Wenzel, Richard
McLean, Laura
Korwek, Kimberly
Roach, Jonathon
Miller, Karla
Poland, Russell E.
Burgess, L. Hayley
Jackson, Edmund
Perlin, Jonathan B.
author_facet Sands, Kenneth
Wenzel, Richard
McLean, Laura
Korwek, Kimberly
Roach, Jonathon
Miller, Karla
Poland, Russell E.
Burgess, L. Hayley
Jackson, Edmund
Perlin, Jonathan B.
author_sort Sands, Kenneth
collection PubMed
description BACKGROUND: The use of hydroxychloroquine (HCQ), with or without concurrent administration of azithromycin (AZM), for treatment of COVID-19 has received considerable attention. The purpose of this study was to determine whether HCQ administration is associated with improved mortality in COVID-19 patients. METHODS: We conducted a retrospective analysis of data collected during the care process for COVID-19 positive patients discharged from facilities affiliated with a large healthcare system in the United States as of April 27, 2020. Patients were categorized by treatment with HCQ (in addition to standard supportive therapy) or receipt of supportive therapy with no HCQ. Patient outcomes were evaluated for in-hospital mortality. Patient demographics and clinical characteristics were accounted for through a multivariable regression analysis. RESULTS: A total of 1669 patients were evaluated (no HCQ, n = 696; HCQ, n = 973). When adjusting for patient characteristics, receipt of AZM, and severity of disease at admission, there was no beneficial effect of receipt of HCQ on the risk of death. In this population, there was an 81% increase in the risk of mortality among patients who received HCQ at any time during their hospital stay versus no HCQ exposure (OR: 1.81, 95% CI: 1.20–2.77, p = 0.01). CONCLUSIONS: In this retrospective analysis, we found that there was no benefit of administration of HCQ on mortality in COVID-19 patients. These results support recent changes to clinical trials that discourage the use of HCQ in COVID-19 patients.
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spelling pubmed-78344742021-01-26 No clinical benefit in mortality associated with hydroxychloroquine treatment in patients with COVID-19 Sands, Kenneth Wenzel, Richard McLean, Laura Korwek, Kimberly Roach, Jonathon Miller, Karla Poland, Russell E. Burgess, L. Hayley Jackson, Edmund Perlin, Jonathan B. Int J Infect Dis Article BACKGROUND: The use of hydroxychloroquine (HCQ), with or without concurrent administration of azithromycin (AZM), for treatment of COVID-19 has received considerable attention. The purpose of this study was to determine whether HCQ administration is associated with improved mortality in COVID-19 patients. METHODS: We conducted a retrospective analysis of data collected during the care process for COVID-19 positive patients discharged from facilities affiliated with a large healthcare system in the United States as of April 27, 2020. Patients were categorized by treatment with HCQ (in addition to standard supportive therapy) or receipt of supportive therapy with no HCQ. Patient outcomes were evaluated for in-hospital mortality. Patient demographics and clinical characteristics were accounted for through a multivariable regression analysis. RESULTS: A total of 1669 patients were evaluated (no HCQ, n = 696; HCQ, n = 973). When adjusting for patient characteristics, receipt of AZM, and severity of disease at admission, there was no beneficial effect of receipt of HCQ on the risk of death. In this population, there was an 81% increase in the risk of mortality among patients who received HCQ at any time during their hospital stay versus no HCQ exposure (OR: 1.81, 95% CI: 1.20–2.77, p = 0.01). CONCLUSIONS: In this retrospective analysis, we found that there was no benefit of administration of HCQ on mortality in COVID-19 patients. These results support recent changes to clinical trials that discourage the use of HCQ in COVID-19 patients. The Authors. Published by Elsevier Ltd on behalf of International Society for Infectious Diseases. 2021-03 2021-01-01 /pmc/articles/PMC7834474/ /pubmed/33359949 http://dx.doi.org/10.1016/j.ijid.2020.12.060 Text en © 2021 The Authors 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
Sands, Kenneth
Wenzel, Richard
McLean, Laura
Korwek, Kimberly
Roach, Jonathon
Miller, Karla
Poland, Russell E.
Burgess, L. Hayley
Jackson, Edmund
Perlin, Jonathan B.
No clinical benefit in mortality associated with hydroxychloroquine treatment in patients with COVID-19
title No clinical benefit in mortality associated with hydroxychloroquine treatment in patients with COVID-19
title_full No clinical benefit in mortality associated with hydroxychloroquine treatment in patients with COVID-19
title_fullStr No clinical benefit in mortality associated with hydroxychloroquine treatment in patients with COVID-19
title_full_unstemmed No clinical benefit in mortality associated with hydroxychloroquine treatment in patients with COVID-19
title_short No clinical benefit in mortality associated with hydroxychloroquine treatment in patients with COVID-19
title_sort no clinical benefit in mortality associated with hydroxychloroquine treatment in patients with covid-19
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7834474/
https://www.ncbi.nlm.nih.gov/pubmed/33359949
http://dx.doi.org/10.1016/j.ijid.2020.12.060
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