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

{ 'indexed': {'date-parts': [[2023, 9, 7]], 'date-time': '2023-09-07T20:45:59Z', 'timestamp': 1694119559422}, 'reference-count': 39, 'publisher': 'Wiley', 'issue': '11', 'license': [ { 'start': { 'date-parts': [[2020, 11, 20]], 'date-time': '2020-11-20T00:00:00Z', 'timestamp': 1605830400000}, 'content-version': 'vor', 'delay-in-days': 19, 'URL': 'http://onlinelibrary.wiley.com/termsAndConditions#vor'}], 'funder': [ { 'DOI': '10.13039/100000057', 'name': 'National Institute of General Medical Sciences', 'doi-asserted-by': 'publisher', 'award': ['2U54GM104942‐02']}], 'content-domain': {'domain': ['accpjournals.onlinelibrary.wiley.com'], 'crossmark-restriction': True}, 'published-print': {'date-parts': [[2020, 11]]}, '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\xa0days 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\xa0hours 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\xa0±\xa0SD were 62.3\xa0±\xa015.9\xa0years (53.7% male) and 61.9\xa0' '±\xa016.0\xa0years (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>', 'DOI': '10.1002/phar.2467', 'type': 'journal-article', 'created': { 'date-parts': [[2020, 10, 12]], 'date-time': '2020-10-12T12:46:34Z', 'timestamp': 1602506794000}, 'page': '1072-1081', 'update-policy': 'http://dx.doi.org/10.1002/crossmark_policy', 'source': 'Crossref', 'is-referenced-by-count': 10, 'title': 'Hydroxychloroquine in Hospitalized Patients with COVID‐19: Real‐World Experience Assessing ' 'Mortality', 'prefix': '10.1002', 'volume': '40', 'author': [ { 'ORCID': 'http://orcid.org/0000-0001-8423-4119', 'authenticated-orcid': False, 'given': 'Frank H.', 'family': 'Annie', 'sequence': 'first', 'affiliation': [ { 'name': 'Charleston Area Medical Center Health Education and Research ' 'Institute Charleston West Virginia USA'}]}, { 'ORCID': 'http://orcid.org/0000-0002-8848-1560', 'authenticated-orcid': False, 'given': 'Cristian', 'family': 'Sirbu', 'sequence': 'additional', 'affiliation': [ { 'name': 'Charleston Area Medical Center Health Education and Research ' 'Institute Charleston West Virginia USA'}]}, { 'given': 'Keely R.', 'family': 'Frazier', 'sequence': 'additional', 'affiliation': [ { 'name': 'Charleston Area Medical Center Health Education and Research ' 'Institute Charleston West Virginia USA'}]}, { 'ORCID': 'http://orcid.org/0000-0001-9943-1908', 'authenticated-orcid': False, 'given': 'Mike', 'family': 'Broce', 'sequence': 'additional', 'affiliation': [ { 'name': 'Charleston Area Medical Center Health Education and Research ' 'Institute Charleston West Virginia USA'}]}, { 'ORCID': 'http://orcid.org/0000-0002-0551-3564', 'authenticated-orcid': False, 'suffix': 'Jr.', 'given': 'B. Daniel', 'family': 'Lucas', 'sequence': 'additional', 'affiliation': [ { 'name': 'Charleston Area Medical Center Health Education and Research ' 'Institute Charleston West Virginia USA'}]}], 'member': '311', 'published-online': {'date-parts': [[2020, 11, 20]]}, 'reference': [ { 'key': 'e_1_2_7_2_1', 'article-title': 'Cardiovascular disease novel coronavirus and the search for ' 'investigational therapies', 'author': 'Mousa AY', 'year': '2020', 'journal-title': 'J Vasc Surg'}, { '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. Available ' 'fromhttps://www.accessdata.fda.gov/drugsatfda_docs/nda/2020/OSE%20Review_Hydroxychloroquine‐Cholorquine%20‐%2019May2020_Redacted.pdf. ' 'Accessed November 2 2020.'}, { 'key': 'e_1_2_7_5_1', 'article-title': 'Outcomes of hydroxychloroquine usage in United States veterans ' 'hospitalized with Covid‐19', 'author': 'Magagnoli J', 'year': '2020', 'journal-title': 'medRxiv'}, { 'key': 'e_1_2_7_6_1', 'doi-asserted-by': 'publisher', 'DOI': '10.1016/S2665-9913(20)30276-9'}, { 'key': 'e_1_2_7_7_1', 'unstructured': '@realDonaldTrump.HYDROXYCHLOROQUINE & AZITHROMYCIN taken together have a ' 'real chance to be one of the biggest game changers in the history of ' 'medicine. the FDA has moved mountains – Thank You! Hopefully they will ' 'BOTH (H works better with A International Journal of Antimicrobial ' 'Agents) 2020.'}, { 'key': 'e_1_2_7_8_1', 'doi-asserted-by': 'publisher', 'DOI': '10.1016/j.ijantimicag.2020.105949'}, {'key': 'e_1_2_7_9_1', 'doi-asserted-by': 'publisher', 'DOI': '10.5582/bst.2020.01047'}, { 'key': 'e_1_2_7_10_1', 'article-title': 'Effect of Hydroxychloroquine in Hospitalized Patients with COVID‐19: ' 'Preliminary results from a multi‐centre, randomized, controlled trial', 'author': 'Horby P', 'year': '2020', 'journal-title': 'medRxiv'}, { 'key': 'e_1_2_7_11_1', 'article-title': 'The RECOVERY platform', 'author': 'Normand S‐LT', 'year': '2020', 'journal-title': 'N Engl J Med'}, {'key': 'e_1_2_7_12_1', 'doi-asserted-by': 'publisher', 'DOI': '10.1038/nrrheum.2015.30'}, { 'key': 'e_1_2_7_13_1', 'doi-asserted-by': 'crossref', 'volume-title': 'Casual Inference for Statistics, Social, and Biomedical Sciences: An ' 'Introduction', 'author': 'Imbens GW', 'year': '2015', 'DOI': '10.1017/CBO9781139025751'}, { 'issue': '2', 'key': 'e_1_2_7_14_1', 'first-page': '204', 'article-title': 'Use of electronic health data in clinical development', 'volume': '79', 'author': 'Stapff M', 'year': '2017', 'journal-title': 'Pharm Ind'}, { 'key': 'e_1_2_7_15_1', 'doi-asserted-by': 'crossref', 'first-page': '1613', 'DOI': '10.1016/j.mayocp.2020.05.014', 'article-title': 'Sex differences in COVID‐19 case fatality rate: insights from a ' 'multinational registry', 'volume': '95', 'author': 'Mohamad Alkhouli AN', 'year': '2020', 'journal-title': 'Mayo Clin Proc'}, {'key': 'e_1_2_7_16_1', 'doi-asserted-by': 'publisher', 'DOI': '10.1186/1743-422X-2-69'}, { 'key': 'e_1_2_7_17_1', 'doi-asserted-by': 'publisher', 'DOI': '10.1016/S1473-3099(03)00806-5'}, { 'key': 'e_1_2_7_18_1', 'doi-asserted-by': 'publisher', 'DOI': '10.1016/S0140-6736(20)30858-8'}, { 'key': 'e_1_2_7_19_1', 'doi-asserted-by': 'publisher', 'DOI': '10.1016/j.antiviral.2020.104762'}, {'key': 'e_1_2_7_20_1', 'doi-asserted-by': 'publisher', 'DOI': '10.1113/JP270526'}, { 'key': 'e_1_2_7_21_1', 'doi-asserted-by': 'publisher', 'DOI': '10.1161/CIRCULATIONAHA.108.797035'}, { 'key': 'e_1_2_7_22_1', 'unstructured': 'The cardiotoxicity of antimalarials World Health Organization Malaria ' 'Policy Advisory Committee Meeting 2017. Available ' 'fromhttps://www.who.int/malaria/mpac/mpac‐mar2017‐erg‐cardiotoxicity‐report‐session2.pdf?ua=1. ' 'Accessed November 2 2020.'}, { 'key': 'e_1_2_7_23_1', 'doi-asserted-by': 'publisher', 'DOI': '10.1001/jamacardio.2020.1834'}, { 'key': 'e_1_2_7_24_1', 'doi-asserted-by': 'publisher', 'DOI': '10.1001/jamacardio.2020.1787'}, {'key': 'e_1_2_7_25_1', 'doi-asserted-by': 'publisher', 'DOI': '10.5582/bst.2020.03072'}, {'key': 'e_1_2_7_26_1', 'doi-asserted-by': 'publisher', 'DOI': '10.1056/NEJMoa2012410'}, {'key': 'e_1_2_7_27_1', 'doi-asserted-by': 'publisher', 'DOI': '10.1001/jama.2020.8630'}, {'key': 'e_1_2_7_28_1', 'doi-asserted-by': 'publisher', 'DOI': '10.1016/j.ijid.2020.06.099'}, { 'key': 'e_1_2_7_29_1', 'doi-asserted-by': 'publisher', 'DOI': '10.1016/j.ijantimicag.2020.106144'}, { 'key': 'e_1_2_7_30_1', 'first-page': '1', 'article-title': 'Risk factors for mortality in patients with COVID‐19 in New York City', 'author': 'Mikami T', 'year': '2020', 'journal-title': 'J Gen Intern Med'}, {'key': 'e_1_2_7_31_1', 'doi-asserted-by': 'publisher', 'DOI': '10.1056/NEJMoa2019014'}, {'key': 'e_1_2_7_32_1', 'doi-asserted-by': 'publisher', 'DOI': '10.1056/NEJMoa2016638'}, {'key': 'e_1_2_7_33_1', 'doi-asserted-by': 'publisher', 'DOI': '10.7326/M20-4207'}, { 'key': 'e_1_2_7_34_1', 'unstructured': '"Solidarity" clinical trial for COVID‐19 treatments [Internet] 2020. ' 'Available ' 'fromhttps://www.who.int/emergencies/diseases/novel‐coronavirus‐2019/global‐research‐on‐novel‐coronavirus‐2019‐ncov/solidarity‐clinical‐trial‐for‐covid‐19‐treatments. ' 'Accessed November 2 2020.'}, { 'key': 'e_1_2_7_35_1', 'unstructured': 'Outcomes Related to COVID‐19 Treated with Hydroxychloroquine Among ' 'In‐patients with Symptomatic Disease (ORCHID) 2020. Available ' 'fromhttps://clinicaltrials.gov/ct2/show/NCT04332991. Accessed November 2 ' '2020'}, { 'key': 'e_1_2_7_36_1', 'unstructured': 'HEalth Care Worker pROphylaxis Against COVID‐19: The HERO Trial 2020. ' 'Available fromhttps://clinicaltrials.gov/ct2/show/NCT04352946. Accessed ' 'November 2 2020.'}, { 'key': 'e_1_2_7_37_1', 'unstructured': 'COVID‐19 Treatment Guidelines Panel.Coronavirus Disease 2019 (COVID‐19) ' 'Treatment Guidelines. National Institutes of Health. Available ' 'fromhttps://www.covid19treatmentguidelines.nih.gov/. Accessed August 9 ' '2020.'}, { 'key': 'e_1_2_7_38_1', 'article-title': 'Ventricular arrhythmia risk due to hydroxychloroquine‐azithromycin ' 'treatment for COVID‐19', 'author': 'Simpson T', 'year': '2020', 'journal-title': 'Cardiol Mag'}, { 'key': 'e_1_2_7_39_1', 'doi-asserted-by': 'publisher', 'DOI': '10.1016/j.mayocp.2020.03.024'}, { 'issue': '11', 'key': 'e_1_2_7_40_1', 'doi-asserted-by': 'crossref', 'first-page': '1218', 'DOI': '10.1093/aje/kwaa093', 'article-title': 'Opinion: early outpatient treatment of symptomatic, high‐risk Covid‐19 ' 'patients that should be ramped‐up immediately as key to the pandemic ' 'crisis', 'volume': '189', 'author': 'Risch HA', 'year': '2020', 'journal-title': 'Am J Epidemiol'}], 'container-title': 'Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy', 'original-title': [], 'language': 'en', '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'}], 'deposited': { 'date-parts': [[2023, 9, 4]], 'date-time': '2023-09-04T04:01:57Z', 'timestamp': 1693800117000}, 'score': 1, 'resource': {'primary': {'URL': 'https://accpjournals.onlinelibrary.wiley.com/doi/10.1002/phar.2467'}}, 'subtitle': [], 'short-title': [], 'issued': {'date-parts': [[2020, 11]]}, 'references-count': 39, 'journal-issue': {'issue': '11', 'published-print': {'date-parts': [[2020, 11]]}}, 'alternative-id': ['10.1002/phar.2467'], 'URL': 'http://dx.doi.org/10.1002/phar.2467', 'relation': {}, 'ISSN': ['0277-0008', '1875-9114'], 'subject': ['Pharmacology (medical)'], 'container-title-short': 'Pharmacotherapy', 'published': {'date-parts': [[2020, 11]]}, 'assertion': [ { 'value': '2020-11-20', 'order': 2, 'name': 'published', 'label': 'Published', 'group': {'name': 'publication_history', 'label': 'Publication History'}}]}