The efficacy and safety of hydroxychloroquine in COVID19 patients : a multicenter national retrospective cohort

{ 'institution': [{'name': 'medRxiv'}], 'indexed': {'date-parts': [[2022, 4, 4]], 'date-time': '2022-04-04T10:09:40Z', 'timestamp': 1649066980306}, 'posted': {'date-parts': [[2020, 11, 30]]}, 'group-title': 'Infectious Diseases (except HIV/AIDS)', 'reference-count': 46, 'publisher': 'Cold Spring Harbor Laboratory', 'content-domain': {'domain': [], 'crossmark-restriction': False}, 'accepted': {'date-parts': [[2020, 11, 30]]}, 'abstract': '<jats:title>ABSTRACT</jats:title><jats:sec><jats:title>Background</jats:title><jats:p>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.</jats:p></jats:sec><jats:sec><jats:title>Methodology</jats:title><jats:p>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.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>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 =0.003), but not QT ' 'prolongation(OR=1.92, 95% CI 0.95-3.9, P value =0.06) or cardiac arrhythmia.(OR=1.06, 95% CI ' '0.55-2.05, P value ' '=0.85).</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>Our results ' 'showed no significant beneficial effect of using hydroxychloroquine on the outcome of ' 'COVID-19 patients. Moreover, the risk of hypoglycemia due to hydroxychloroquine would possess ' 'a significant risk for out of hospital use.</jats:p></jats:sec>', 'DOI': '10.1101/2020.11.25.20234914', 'type': 'posted-content', 'created': { 'date-parts': [[2020, 11, 30]], 'date-time': '2020-11-30T18:02:13Z', 'timestamp': 1606759333000}, 'source': 'Crossref', 'is-referenced-by-count': 0, 'title': 'The efficacy and safety of hydroxychloroquine in COVID19 patients : a multicenter national ' 'retrospective cohort', 'prefix': '10.1101', 'author': [ { 'ORCID': 'http://orcid.org/0000-0002-7331-388X', 'authenticated-orcid': False, 'given': 'Abdulkarim', 'family': 'Abdulrahman', 'sequence': 'first', 'affiliation': []}, {'given': 'Islam', 'family': 'AlSayed', 'sequence': 'additional', 'affiliation': []}, { 'ORCID': 'http://orcid.org/0000-0002-4363-9846', 'authenticated-orcid': False, 'given': 'Marwa', 'family': 'AlMadhi', 'sequence': 'additional', 'affiliation': []}, { 'ORCID': 'http://orcid.org/0000-0002-0317-6461', 'authenticated-orcid': False, 'given': 'Jumana', 'family': 'AlArayed', 'sequence': 'additional', 'affiliation': []}, { 'ORCID': 'http://orcid.org/0000-0002-4849-7939', 'authenticated-orcid': False, 'given': 'Sara Jaafar', 'family': 'Mohammed', 'sequence': 'additional', 'affiliation': []}, {'given': 'Aesha Khalid', 'family': 'Sharif', 'sequence': 'additional', 'affiliation': []}, { 'ORCID': 'http://orcid.org/0000-0001-9601-6709', 'authenticated-orcid': False, 'given': 'Khadija', 'family': 'Alansari', 'sequence': 'additional', 'affiliation': []}, { 'ORCID': 'http://orcid.org/0000-0003-3682-3677', 'authenticated-orcid': False, 'given': 'Abdulla I', 'family': 'AlAwadhi', 'sequence': 'additional', 'affiliation': []}, { 'ORCID': 'http://orcid.org/0000-0002-1523-0429', 'authenticated-orcid': False, 'given': 'Manaf', 'family': 'AlQahtani', 'sequence': 'additional', 'affiliation': []}], 'member': '246', 'reference': [ { 'key': '2020120211101020000_2020.11.25.20234914v1.1', 'doi-asserted-by': 'publisher', 'DOI': '10.23750/abm.v91i1.9397'}, { 'key': '2020120211101020000_2020.11.25.20234914v1.2', 'unstructured': 'WHO. 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