The association of treatment with hydroxychloroquine and hospital mortality in COVID-19 patients

DOI record: { "DOI": "10.1007/s11739-020-02505-x", "ISSN": [ "1828-0447", "1970-9366" ], "URL": "http://dx.doi.org/10.1007/s11739-020-02505-x", "abstract": "<jats:title>Abstract</jats:title><jats:p>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 &lt; 90% and temperature &gt; 37 °C were added to de model with OR 0.45 (0.30–0.68)<jats:italic>p</jats:italic> &lt; 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.</jats:p>", "alternative-id": [ "2505" ], "assertion": [ { "group": { "label": "Article History", "name": "ArticleHistory" }, "label": "Received", "name": "received", "order": 1, "value": "8 July 2020" }, { "group": { "label": "Article History", "name": "ArticleHistory" }, "label": "Accepted", "name": "accepted", "order": 2, "value": "12 September 2020" }, { "group": { "label": "Article History", "name": "ArticleHistory" }, "label": "First Online", "name": "first_online", "order": 3, "value": "30 September 2020" }, { "group": { "label": "Compliance with ethical standards", "name": "EthicsHeading" }, "name": "Ethics", "order": 1 }, { "group": { "label": "Conflict of interests", "name": "EthicsHeading" }, "name": "Ethics", "order": 2, "value": "The author(s) declare that they have no conflict of interest." }, { "group": { "label": "Ethical approval", "name": "EthicsHeading" }, "name": "Ethics", "order": 3, "value": "The ethics committee of HM Hospitales approved this study. Data were anonymized before the authors could access it. No results that may make patients identifiable are reported." }, { "group": { "label": "Statements on human and animal rights", "name": "EthicsHeading" }, "name": "Ethics", "order": 4, "value": "The study was conducted in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki and its later amendments." }, { "group": { "label": "Informed consent", "name": "EthicsHeading" }, "name": "Ethics", "order": 5, "value": "This study was conducted on already available clincal data and informed consent was not required." } ], "author": [ { "ORCID": "http://orcid.org/0000-0001-7177-0262", "affiliation": [], "authenticated-orcid": false, "family": "Ayerbe", "given": "Luis", "sequence": "first" }, { "ORCID": "http://orcid.org/0000-0001-6408-9823", "affiliation": [], "authenticated-orcid": false, "family": "Risco-Risco", "given": "Carlos", "sequence": "additional" }, { "ORCID": "http://orcid.org/0000-0002-0449-869X", "affiliation": [], "authenticated-orcid": false, "family": "Ayis", "given": "Salma", "sequence": "additional" } ], "container-title": "Internal and Emergency Medicine", "container-title-short": "Intern Emerg Med", "content-domain": { "crossmark-restriction": false, "domain": [ "link.springer.com" ] }, "created": { "date-parts": [ [ 2020, 9, 30 ] ], "date-time": "2020-09-30T14:03:41Z", "timestamp": 1601474621000 }, "deposited": { "date-parts": [ [ 2022, 11, 21 ] ], "date-time": "2022-11-21T10:50:16Z", "timestamp": 1669027816000 }, "funder": [ { "DOI": "10.13039/501100000272", "doi-asserted-by": "publisher", "name": "National Institute for Health Research" }, { "DOI": "10.13039/100009148", "doi-asserted-by": "crossref", "name": "Queen Mary University of London" } ], "indexed": { "date-parts": [ [ 2024, 5, 11 ] ], "date-time": "2024-05-11T15:13:03Z", "timestamp": 1715440383677 }, "is-referenced-by-count": 23, "issue": "8", "issued": { "date-parts": [ [ 2020, 9, 30 ] ] }, "journal-issue": { "issue": "8", "published-print": { "date-parts": [ [ 2020, 11 ] ] } }, "language": "en", "license": [ { "URL": "https://creativecommons.org/licenses/by/4.0", "content-version": "tdm", "delay-in-days": 0, "start": { "date-parts": [ [ 2020, 9, 30 ] ], "date-time": "2020-09-30T00:00:00Z", "timestamp": 1601424000000 } }, { "URL": "https://creativecommons.org/licenses/by/4.0", "content-version": "vor", "delay-in-days": 0, "start": { "date-parts": [ [ 2020, 9, 30 ] ], "date-time": "2020-09-30T00:00:00Z", "timestamp": 1601424000000 } } ], "link": [ { "URL": "https://link.springer.com/content/pdf/10.1007/s11739-020-02505-x.pdf", "content-type": "application/pdf", "content-version": "vor", "intended-application": "text-mining" }, { "URL": "https://link.springer.com/article/10.1007/s11739-020-02505-x/fulltext.html", "content-type": "text/html", "content-version": "vor", "intended-application": "text-mining" }, { "URL": "https://link.springer.com/content/pdf/10.1007/s11739-020-02505-x.pdf", "content-type": "application/pdf", "content-version": "vor", "intended-application": "similarity-checking" } ], "member": "297", "original-title": [], "page": "1501-1506", "prefix": "10.1007", "published": { "date-parts": [ [ 2020, 9, 30 ] ] }, "published-online": { "date-parts": [ [ 2020, 9, 30 ] ] }, "published-print": { "date-parts": [ [ 2020, 11 ] ] }, "publisher": "Springer Science and Business Media LLC", "reference": [ { "key": "2505_CR1", "unstructured": "WHO (2020) Naming the coronavirus disease (COVID-19) and the virus that causes it. https://www.who.int/emergencies/diseases/novel-coronavirus-2019/technical-guidance/naming-the-coronavirus-disease-(covid-2019)-and-the-virus-that-causes-it. 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