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Hydroxychloroquine in Hospitalized Patients with COVID-19: Real-World Experience Assessing Mortality

Frank H Annie1, Cristian Sirbu1, Keely R Frazier1

  • 1Charleston Area Medical Center Health Education and Research Institute, Charleston, West Virginia, USA.

Pharmacotherapy
|October 12, 2020
PubMed

Insights

Hydroxychloroquine (HCQ) did not increase 30-day mortality in hospitalized COVID-19 patients. This study found no significant difference in mortality or arrhythmias when using HCQ alone or with azithromycin (AZ).

Area of Science:

  • Infectious Diseases
  • Pharmacology
  • Epidemiology

Background:

  • Hydroxychloroquine (HCQ) has been investigated for treating coronavirus disease 2019 (COVID-19).
  • Its use has been off-label or within clinical trials, necessitating real-world data analysis.

Purpose of the Study:

  • To investigate the relationship between HCQ use and patient outcomes in COVID-19.
  • To determine the effect of HCQ on all-cause mortality within 30 days of follow-up in hospitalized patients.

Main Methods:

  • A retrospective cohort study utilizing a multinational database of COVID-19 patients.
  • Propensity matching was employed to compare patients receiving HCQ within 48 hours of admission with those who did not.
  • Data included medications, preexisting conditions, clinical measures, and outcomes.

Main Results:

  • No statistically significant difference in 30-day all-cause mortality was observed between the HCQ and no-HCQ groups (13.1% vs. 13.6%).
  • The combination of HCQ and azithromycin (AZ) did not show a statistically significant increase in mortality compared to no HCQ and AZ.
  • No trend in overall mortality or arrhythmogenesis was found for the HCQ-AZ group versus the no HCQ-no AZ group.

Conclusions:

  • Real-world data analysis indicates that HCQ use in hospitalized COVID-19 patients is not associated with a statistically significant increase in mortality.
  • The combination of HCQ and AZ also did not demonstrate a significant increase in mortality or arrhythmogenesis.
  • These findings contribute to understanding the safety profile of HCQ in COVID-19 treatment.
Abstract

Keywords:
Antimalarialazithromycincoronavirushydroxychloroquinemacrolidesevere acute respiratory syndrome coronavirus 2

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