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Comparing the impact of Hydroxychloroquine based regimens and standard treatment on COVID-19 patient outcomes: A retrospective cohort study

Almazrou et al., Saudi Pharmaceutical Journal, doi:10.1016/j.jsps.2020.09.019
Oct 2020  
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Ventilation 65% Improvement Relative Risk ICU admission 21% HCQ for COVID-19  Almazrou et al.  LATE TREATMENT Is late treatment with HCQ beneficial for COVID-19? Retrospective 161 patients in Saudi Arabia Lower ventilation with HCQ (not stat. sig., p=0.16) c19hcq.org Almazrou et al., Saudi Pharmaceutical J., Oct 2020 FavorsHCQ Favorscontrol 0 0.5 1 1.5 2+
HCQ for COVID-19
1st treatment shown to reduce risk in March 2020
 
*, now with p < 0.00000000001 from 411 studies, recognized in 46 countries.
No treatment is 100% effective. Protocols combine treatments. * >10% efficacy, ≥3 studies.
4,300+ studies for 75 treatments. c19hcq.org
Retrospective 161 hospitalized patients in Saudi Arabia showing lower ventilation and ICU admission with HCQ, but not statistically significant with the small sample sizes.
risk of mechanical ventilation, 65.0% lower, RR 0.35, p = 0.16, treatment 3 of 95 (3.2%), control 6 of 66 (9.1%), NNT 17.
risk of ICU admission, 21.0% lower, RR 0.79, p = 0.78, treatment 8 of 95 (8.4%), control 7 of 66 (10.6%), NNT 46.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Almazrou et al., 1 Oct 2020, retrospective, Saudi Arabia, peer-reviewed, 5 authors.
This PaperHCQAll
Comparing the impact of Hydroxychloroquine based regimens and standard treatment on COVID-19 patient outcomes: A retrospective cohort study
Saja H Almazrou, Ziyad S Almalki, Abdullah S Alanazi, Abdulhadi M Alqahtani, Saleh M Alghamd
Saudi Pharmaceutical Journal, doi:10.1016/j.jsps.2020.09.019
Background: Pharmacological treatments including antivirals (Lopinavir/Ritonavir), Immuno-modulatory and anti-inflammatory drugs including, Tocilizumab and Hydroxychloroquine (HCQ) has been widely investigated as a treatment for COVID-19. Despite the ongoing controversies, HCQ was recommended for managing mild to moderate cases in Saudi Arabia . However, to our knowledge, no previous studies have been conducted in Saudi Arabia to assess its effectiveness. Methods: A hospital-based retrospective cohort study involving 161 patients with COVID-19 was conducted from March 1 to May 20, 2020. The study was conducted at Prince Mohammed bin Abdul Aziz Hospital (PMAH). The population included hospitalized adults (age ! 18 years) with laboratory-confirmed COVID-19. Each eligible patient was followed from the time of admission until the time of discharge. Patients were classified into two groups according to treatment type: in the HCQ group, patients were treated with HCQ; in the SC group, patients were treated with other antiviral or antibacterial treatments according to Ministry of Health (MOH) protocols. The outcomes were hospitalization days, ICU admission, and the need for mechanical ventilation. We estimated the differences in hospital length of stay and time in the ICU between the HCQ group and the standard care (SC) group using a multivariate generalized linear regression. The differences in ICU admission and mechanical ventilation were compared via logistic regression. All models were adjusted for age and gender variables. Results: A total of 161 patients fulfilled the inclusion criteria. Approximately 59% (n = 95) received HCQbased treatment, and 41% (n = 66) received SC. Length of hospital stay and time in ICU in for patients who received HCQ based treatment was shorter than those who received SC. Similarly, there was less need for ICU admission and mechanical ventilation among patients who received HCQ based treatment compared with SC, (8.6% vs. 10.7 and 3.1% vs. 9.1%). However, the regression analysis showed no significant difference between the two groups in terms of patient outcomes. Conclusion: HCQ had a modest effect on hospital length stay and days in ICU compared with SC. However, these results need to be interpreted with caution. Larger observational studies and
Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
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Late treatment
is less effective
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