The association of treatment with hydroxychloroquine and hospital mortality in COVID-19 patients
Ayerbe et al.
, The association of treatment with hydroxychloroquine and hospital mortality in COVID-19 patients
, Internal and Emergency Medicine, doi:0.1007/s11739-020-02505-x
2075 hospital patients in Spain showing HCQ reduces mortality 52%, odds ratio OR 0.39, p<0.001, after adjustment for age, gender, temperature > 37 °C, and saturation of oxygen < 90% treatment with azithromycin, steroids, heparin, tocilizumab, a combination of lopinavir with ritonavir, and oseltamivir, and date of admission (model 4).
risk of death, 52.2% lower, RR 0.48, p < 0.001, treatment 237 of 1,857 (12.8%), control 49 of 162 (30.2%), NNT 5.7, adjusted per study, odds ratio converted to relative risk.
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Ayerbe et al., 30 Sep 2020, retrospective, database analysis, Spain, peer-reviewed, 3 authors.
Abstract: Internal and Emergency Medicine (2020) 15:1501–1506
IM - ORIGINAL
The association of treatment with hydroxychloroquine and hospital
mortality in COVID‑19 patients
· Carlos Risco‑Risco3
· Salma Ayis4,5
Received: 8 July 2020 / Accepted: 12 September 2020 / Published online: 30 September 2020
© The Author(s) 2020
This study investigates the association between the treatment with hydroxychloroquine and mortality in patients admitted with
COVID-19. Routinely recorded, clinical data, up to the 24th of April 2020, from the 2075 patients with COVID-19, admitted in 17 hospitals in Spain between the 1st of March and the 20th of April 2020 were used. The following variables were
extracted for this study: age, gender, temperature, and saturation of oxygen on admission, treatment with hydroxychloroquine,
azithromycin, heparin, steroids, tocilizumab, a combination of lopinavir with ritonavir, and oseltamivir, together with data
on mortality. Multivariable logistic regression models were used to investigate the associations. At the time of collecting
the data, 301 patients had died, 1449 had been discharged home from the hospitals, 240 were still admitted, and 85 had been
transferred to hospitals not included in the study. Median follow-up time was 8 (IQR 5–12) days. Hydroxychloroquine had
been used in 1857 patients. Hydroxychloroquine was associated with lower mortality when the model was adjusted for age
and gender, with OR (95% CI): 0.44 (0.29–0.67). This association remained significant when saturation of oxygen < 90%
and temperature > 37 °C were added to de model with OR 0.45 (0.30–0.68) p < 0.001, and also when all the other drugs, and
time of admission, were included as covariates. The association between hydroxychloroquine and lower mortality observed
in this study can be acknowledged by clinicians in hospitals and in the community. Randomized-controlled trials to assess
the causal effects of hydroxychloroquine in different therapeutic regimes are required.
Keywords Coronavirus infections · COVID-19 · Hydroxychloroquine · Mortality
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