Hydroxychloroquine in hospitalized COVID-19 patients: Real world experience assessing mortality

DOI record: { "DOI": "10.1002/phar.2467", "ISSN": [ "0277-0008", "1875-9114" ], "URL": "http://dx.doi.org/10.1002/phar.2467", "abstract": "<jats:sec><jats:title>\n<jats:sc>Introduction</jats:sc>\n</jats:title><jats:p>Hydroxychloroquine (HCQ) for coronavirus disease 2019 (COVID‐19) is presently being used off‐label or within a clinical trial.</jats:p></jats:sec><jats:sec><jats:title>\n<jats:sc>Objectives</jats:sc>\n</jats:title><jats:p>We investigated a multinational database of patients with COVID‐19 with real‐world data containing outcomes and their relationship to HCQ use. The primary outcome was all‐cause mortality within 30 days of follow‐up.</jats:p></jats:sec><jats:sec><jats:title>\n<jats:sc>Methods</jats:sc>\n</jats:title><jats:p>This was a retrospective cohort study of patients receiving HCQ within 48 hours of hospital admission. Medications, preexisting conditions, clinical measures on admission, and outcomes were recorded.</jats:p></jats:sec><jats:sec><jats:title>\n<jats:sc>Results</jats:sc>\n</jats:title><jats:p>Among patients with a diagnosis of COVID‐19 in our propensity‐matched cohort, the mean ages ± SD were 62.3 ± 15.9 years (53.7% male) and 61.9 ± 16.0 years (53.0% male) in the HCQ and no‐HCQ groups, respectively. There was no difference in overall 30‐day mortality between the HCQ and no‐HCQ groups (HCQ 13.1%, n=367; no HCQ 13.6%, n=367; odds ratio 0.95, 95% confidence interval 0.62–1.46) after propensity matching. Although statistically insignificant, the HCQ‐azithromycin (AZ) group had an overall mortality rate of 14.6% (n=199) compared with propensity‐matched no‐HCQ–AZ cohort’s rate of 12.1% (n=199, OR 1.24, 95% CI 0.70–2.22). Importantly, however, there was no trend in this cohort’s overall mortality/arrhythmogenesis outcome (HCQ‐AZ 17.1%, no HCQ–no AZ 17.1%; OR 1.0, 95% CI 0.6–1.7).</jats:p></jats:sec><jats:sec><jats:title>\n<jats:sc>Conclusions</jats:sc>\n</jats:title><jats:p>We report from a large retrospective multinational database analysis of COVID‐19 outcomes with HCQ and overall mortality in hospitalized patients. There was no statistically significant increase in mortality and mortality‐arrhythmia with HCQ or HCQ‐AZ.</jats:p></jats:sec>", "alternative-id": [ "10.1002/phar.2467" ], "assertion": [ { "group": { "label": "Publication History", "name": "publication_history" }, "label": "Published", "name": "published", "order": 2, "value": "2020-11-20" } ], "author": [ { "ORCID": "http://orcid.org/0000-0001-8423-4119", "affiliation": [ { "name": "Charleston Area Medical Center Health Education and Research Institute Charleston West Virginia USA" } ], "authenticated-orcid": false, "family": "Annie", "given": "Frank H.", "sequence": "first" }, { "ORCID": "http://orcid.org/0000-0002-8848-1560", "affiliation": [ { "name": "Charleston Area Medical Center Health Education and Research Institute Charleston West Virginia USA" } ], "authenticated-orcid": false, "family": "Sirbu", "given": "Cristian", "sequence": "additional" }, { "affiliation": [ { "name": "Charleston Area Medical Center Health Education and Research Institute Charleston West Virginia USA" } ], "family": "Frazier", "given": "Keely R.", "sequence": "additional" }, { "ORCID": "http://orcid.org/0000-0001-9943-1908", "affiliation": [ { "name": "Charleston Area Medical Center Health Education and Research Institute Charleston West Virginia USA" } ], "authenticated-orcid": false, "family": "Broce", "given": "Mike", "sequence": "additional" }, { "ORCID": "http://orcid.org/0000-0002-0551-3564", "affiliation": [ { "name": "Charleston Area Medical Center Health Education and Research Institute Charleston West Virginia USA" } ], "authenticated-orcid": false, "family": "Lucas", "given": "B. Daniel", "sequence": "additional", "suffix": "Jr." } ], "container-title": "Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy", "container-title-short": "Pharmacotherapy", "content-domain": { "crossmark-restriction": true, "domain": [ "accpjournals.onlinelibrary.wiley.com" ] }, "created": { "date-parts": [ [ 2020, 10, 12 ] ], "date-time": "2020-10-12T12:46:34Z", "timestamp": 1602506794000 }, "deposited": { "date-parts": [ [ 2023, 9, 4 ] ], "date-time": "2023-09-04T04:01:57Z", "timestamp": 1693800117000 }, "funder": [ { "DOI": "10.13039/100000057", "award": [ "2U54GM104942‐02" ], "doi-asserted-by": "publisher", "name": "National Institute of General Medical Sciences" } ], "indexed": { "date-parts": [ [ 2023, 9, 7 ] ], "date-time": "2023-09-07T20:45:59Z", "timestamp": 1694119559422 }, "is-referenced-by-count": 10, "issue": "11", "issued": { "date-parts": [ [ 2020, 11 ] ] }, "journal-issue": { "issue": "11", "published-print": { "date-parts": [ [ 2020, 11 ] ] } }, "language": "en", "license": [ { "URL": "http://onlinelibrary.wiley.com/termsAndConditions#vor", "content-version": "vor", "delay-in-days": 19, "start": { "date-parts": [ [ 2020, 11, 20 ] ], "date-time": "2020-11-20T00:00:00Z", "timestamp": 1605830400000 } } ], "link": [ { "URL": "https://onlinelibrary.wiley.com/doi/pdf/10.1002/phar.2467", "content-type": "application/pdf", "content-version": "vor", "intended-application": "text-mining" }, { "URL": "https://onlinelibrary.wiley.com/doi/full-xml/10.1002/phar.2467", "content-type": "application/xml", "content-version": "vor", "intended-application": "text-mining" }, { "URL": "https://onlinelibrary.wiley.com/doi/pdf/10.1002/phar.2467", "content-type": "unspecified", "content-version": "vor", "intended-application": "similarity-checking" } ], "member": "311", "original-title": [], "page": "1072-1081", "prefix": "10.1002", "published": { "date-parts": [ [ 2020, 11 ] ] }, "published-online": { "date-parts": [ [ 2020, 11, 20 ] ] }, "published-print": { "date-parts": [ [ 2020, 11 ] ] }, "publisher": "Wiley", "reference": [ { "article-title": "Cardiovascular disease novel coronavirus and the search for investigational therapies", "author": "Mousa AY", "journal-title": "J Vasc Surg", "key": "e_1_2_7_2_1", "year": "2020" }, { "key": "e_1_2_7_3_1", "unstructured": "Coronavirus (COVID‐19) update: FDA revokes emergency use authorization for chloroquine and hydroxychloroquine[press release] 2020." }, { "key": "e_1_2_7_4_1", "unstructured": "KapoorR.Pharmacovigilance Memorandum Department of Health and Human Services 2020. 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