Use of hydroxychloroquine in hospitalised COVID-19 patients is associated with reduced mortality: Findings from the observational multicentre Italian CORIST study
Di Castelnuovo et al.
, Use of hydroxychloroquine in hospitalised COVID-19 patients is associated with reduced mortality: Findings..
, European J. Internal Medicine, doi:10.1016/j.ejim.2020.08.019
Retrospective 3,451 hospitalized patients, 30% reduction in mortality with HCQ after propensity adjustment, HR 0.70 [0.59 - 0.84].
risk of death, 30.0% lower, HR 0.70, p < 0.001, treatment 386 of 2,634 (14.7%), control 90 of 817 (11.0%), adjusted per study.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Di Castelnuovo et al., 25 Aug 2020, retrospective, Italy, peer-reviewed, 110 authors.
Abstract: European Journal of Internal Medicine 000 (2020) 1–10
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European Journal of Internal Medicine
journal homepage: www.elsevier.com/locate/ejinme
Use of hydroxychloroquine in hospitalised COVID-19 patients is associated
with reduced mortality: Findings from the observational multicentre Italian
The COVID-19 RISK and Treatments (CORIST) Collaboration1,∗
a r t i c l e
i n f o
a b s t r a c t
Background: Hydroxychloroquine (HCQ) was proposed as potential treatment for COVID-19.
Objective: We set-up a multicenter Italian collaboration to investigate the relationship between HCQ therapy and
COVID-19 in-hospital mortality.
Methods: In a retrospective observational study, 3,451 unselected patients hospitalized in 33 clinical centers
in Italy, from February 19, 2020 to May 23, 2020, with laboratory-conﬁrmed SARS-CoV-2 infection, were analyzed. The primary end-point in a time-to event analysis was in-hospital death, comparing patients who received
HCQ with patients who did not. We used multivariable Cox proportional-hazards regression models with inverse
probability for treatment weighting by propensity scores, with the addition of subgroup analyses.
Results: Out of 3,451 COVID-19 patients, 76.3% received HCQ. Death rates (per 1,000 person-days) for patients
receiving or not HCQ were 8.9 and 15.7, respectively. After adjustment for propensity scores, we found 30%
lower risk of death in patients receiving HCQ (HR=0.70; 95%CI: 0.59 to 0.84; E-value=1.67). Secondary analyses yielded similar results. The inverse association of HCQ with inpatient mortality was particularly evident in
patients having elevated C-reactive protein at entry.
Conclusions: HCQ use was associated with a 30% lower risk of death in COVID-19 hospitalized patients. Within
the limits of an observational study and awaiting results from randomized controlled trials, these data do not
discourage the use of HCQ in inpatients with COVID-19.
is less effective
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