The efficacy and safety of hydroxychloroquine in COVID19 patients : a multicenter national retrospective cohort
Abdulrahman et al.,
The efficacy and safety of hydroxychloroquine in COVID19 patients : a multicenter national retrospective..,
medRxiv, doi:10.1101/2020.11.25.20234914 (Preprint)
Retrospective analysis of acute care patients in Bahrain not showing a significant effect of HCQ.
Confounding by indication is likely. Matching appears not to have matched for baseline severity. 17.5% of HCQ patients required oxygen while only 12.6% of control patients did.
Although the 17% lower mortality is not statistically significant, it is consistent with the significant 22% lower mortality
[18‑27%] from meta analysis of the
232 mortality results to date.
risk of death, 16.7% lower, RR 0.83, p = 1.00, treatment 5 of 223 (2.2%), control 6 of 223 (2.7%), NNT 223, PSM.
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risk of death/intubation, 75.0% higher, RR 1.75, p = 0.24, treatment 12 of 223 (5.4%), control 7 of 223 (3.1%), adjusted per study, PSM.
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Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
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Abdulrahman et al., 30 Nov 2020, retrospective, propensity score matching, Bahrain, preprint, 9 authors.
Abstract: medRxiv preprint doi: https://doi.org/10.1101/2020.11.25.20234914; this version posted November 30, 2020. The copyright holder for this
preprint (which was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in
perpetuity.
It is made available under a CC-BY-NC-ND 4.0 International license .
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The efficacy and safety of hydroxychloroquine in COVID19 patients
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: a multicenter national retrospective cohort
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Abdulkarim Abdulrahman1,2, Islam AlSayed3, Marwa AlMadhi4 , Jumana
AlArayed5, Sara Jaafar Mohammed3, Aesha Khalid Sharif5, Khadija
Alansari 3, Abdulla I AlAwadhi 1,6 , Manaf AlQahtani 1,6,7*
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National Taskforce for Combating the Coronavirus (COVID-19),
Bahrain
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Mohammed Bin Khalifa Cardiac Centre, Bahrain
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King Hamad University Hospital, Bahrain
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School of Medical Sciences, Faculty of Biology, Medicine and Health,
University of Manchester, Manchester, United Kingdom
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Ministry of Health, Bahrain
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Bahrain Defence Force hospital, Bahrain
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Royal College of Surgeons in Ireland, Bahrain
*Corresponding author: Manaf AlQahtani.
Email: mqahtani@rcsi-mub.com
Phone: +973 39766000
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NOTE: This preprint reports new research that has not been certified by peer review and should not be used to guide clinical practice.
medRxiv preprint doi: https://doi.org/10.1101/2020.11.25.20234914; this version posted November 30, 2020. The copyright holder for this
preprint (which was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in
perpetuity.
It is made available under a CC-BY-NC-ND 4.0 International license .
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ABSTRACT
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Background
Hydroxychloroquine is an antimalarial drug that received worldwide news and media
attention in the treatment of COVID-19 patients. This drug was used based on its
antimicrobial and antiviral properties despite lack of definite evidence of clinical
efficacy. In this study, we aim to assess the efficacy and safety of using
Hydroxychloroquine in treatment of COVID-19 patients who are admitted in acute
care hospitals in Bahrain.
Methodology
We conducted retrospective cohort study on a random sample of admitted COVID19
patients between 24 February and 31 July 2020. The study was conducted in four
acute care COVID19 hospitals in Bahrain. Data was extracted from the medical
records. The primary endpoint was the requirement of non-invasive ventilation,
intubation or death. Secondary endpoint was length of hospitalization for survivors.
Three methods of analysis were used to control for confounding factors: logistic
multivariate regression, propensity score adjusted regression and matched
propensity score analysis.
Results
A random sample of 1571 patients were included, 440 of which received HCQ
(treatment group) and 1131 did not receive it (control group). Our results showed
that HCQ did not have a significant effect on primary outcomes due to COVID-19
infection when compared to controls after adjusting for confounders (OR 1.43 95%
CI 0.85 to 2.37, P value=0.17). Co-administration of azithromycin had no effect on
primary outcomes (OR 2.7 95% CI 0.82 to 8.85 P value =0.10). HCQ was found to
be associated with increased risk of hypoglycemia (OR 10.9 95% CI 1.72 - 69.49, P
value =0.011) and diarrhea(OR 2.8, 95% CI 1.4-5.5, P value..
Late treatment
is less effective
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