Hydroxychloroquine in the treatment of outpatients with mildly symptomatic COVID-19: A multi-center observational study

{ 'indexed': {'date-parts': [[2024, 2, 2]], 'date-time': '2024-02-02T06:44:04Z', 'timestamp': 1706856244572}, 'reference-count': 38, 'publisher': 'Springer Science and Business Media LLC', 'issue': '1', 'license': [ { 'start': { 'date-parts': [[2021, 1, 14]], 'date-time': '2021-01-14T00:00:00Z', 'timestamp': 1610582400000}, 'content-version': 'tdm', 'delay-in-days': 0, 'URL': 'http://creativecommons.org/licenses/by/4.0/'}, { 'start': { 'date-parts': [[2021, 1, 14]], 'date-time': '2021-01-14T00:00:00Z', 'timestamp': 1610582400000}, 'content-version': 'vor', 'delay-in-days': 0, 'URL': 'http://creativecommons.org/licenses/by/4.0/'}], 'content-domain': {'domain': ['link.springer.com'], 'crossmark-restriction': False}, 'published-print': {'date-parts': [[2021, 12]]}, 'abstract': '<jats:title>Abstract</jats:title><jats:sec>\n' ' <jats:title>Background</jats:title>\n' ' <jats:p>Hydroxychloroquine has not been associated with improved survival ' 'among hospitalized COVID-19 patients in the majority of observational studies and similarly ' 'was not identified as an effective prophylaxis following exposure in a prospective randomized ' 'trial. We aimed to explore the role of hydroxychloroquine therapy in mildly symptomatic ' 'patients diagnosed in the outpatient setting.</jats:p>\n' ' </jats:sec><jats:sec>\n' ' <jats:title>Methods</jats:title>\n' ' <jats:p>We examined the association between outpatient hydroxychloroquine ' 'exposure and the subsequent progression of disease among mildly symptomatic non-hospitalized ' 'patients with documented SARS-CoV-2 infection. The primary outcome assessed was requirement ' 'of hospitalization. Data was obtained from a retrospective review of electronic health ' 'records within a New Jersey USA multi-hospital network. We compared outcomes in patients who ' 'received hydroxychloroquine with those who did not applying a multivariable logistic model ' 'with propensity matching.</jats:p>\n' ' </jats:sec><jats:sec>\n' ' <jats:title>Results</jats:title>\n' ' <jats:p>Among 1274 outpatients with documented SARS-CoV-2 infection 7.6% were ' 'prescribed hydroxychloroquine. In a 1067 patient propensity matched cohort, 21.6% with ' 'outpatient exposure to hydroxychloroquine were hospitalized, and 31.4% without exposure were ' 'hospitalized. In the primary multivariable logistic regression analysis with propensity ' 'matching there was an association between exposure to hydroxychloroquine and a decreased rate ' 'of hospitalization from COVID-19 (OR 0.53; 95% CI, 0.29, 0.95). Sensitivity analyses revealed ' 'similar associations. QTc prolongation events occurred in 2% of patients prescribed ' 'hydroxychloroquine with no reported arrhythmia events among those with data ' 'available.</jats:p>\n' ' </jats:sec><jats:sec>\n' ' <jats:title>Conclusions</jats:title>\n' ' <jats:p>In this retrospective observational study of SARS-CoV-2 infected ' 'non-hospitalized patients hydroxychloroquine exposure was associated with a decreased rate of ' 'subsequent hospitalization. Additional exploration of hydroxychloroquine in this mildly ' 'symptomatic outpatient population is warranted.</jats:p>\n' ' </jats:sec>', 'DOI': '10.1186/s12879-021-05773-w', 'type': 'journal-article', 'created': {'date-parts': [[2021, 1, 14]], 'date-time': '2021-01-14T11:03:19Z', 'timestamp': 1610622199000}, 'update-policy': 'http://dx.doi.org/10.1007/springer_crossmark_policy', 'source': 'Crossref', 'is-referenced-by-count': 36, 'title': 'Hydroxychloroquine in the treatment of outpatients with mildly symptomatic COVID-19: a ' 'multi-center observational study', 'prefix': '10.1186', 'volume': '21', 'author': [ { 'ORCID': 'http://orcid.org/0000-0003-0456-5618', 'authenticated-orcid': False, 'given': 'Andrew', 'family': 'Ip', 'sequence': 'first', 'affiliation': []}, {'given': 'Jaeil', 'family': 'Ahn', 'sequence': 'additional', 'affiliation': []}, {'given': 'Yizhao', 'family': 'Zhou', 'sequence': 'additional', 'affiliation': []}, {'given': 'Andre H.', 'family': 'Goy', 'sequence': 'additional', 'affiliation': []}, {'given': 'Eric', 'family': 'Hansen', 'sequence': 'additional', 'affiliation': []}, {'given': 'Andrew L.', 'family': 'Pecora', 'sequence': 'additional', 'affiliation': []}, {'given': 'Brittany A.', 'family': 'Sinclaire', 'sequence': 'additional', 'affiliation': []}, {'given': 'Urszula', 'family': 'Bednarz', 'sequence': 'additional', 'affiliation': []}, {'given': 'Michael', 'family': 'Marafelias', 'sequence': 'additional', 'affiliation': []}, {'given': 'Ihor S.', 'family': 'Sawczuk', 'sequence': 'additional', 'affiliation': []}, { 'suffix': 'III', 'given': 'Joseph P.', 'family': 'Underwood', 'sequence': 'additional', 'affiliation': []}, {'given': 'David M.', 'family': 'Walker', 'sequence': 'additional', 'affiliation': []}, {'given': 'Rajiv', 'family': 'Prasad', 'sequence': 'additional', 'affiliation': []}, {'given': 'Robert L.', 'family': 'Sweeney', 'sequence': 'additional', 'affiliation': []}, {'given': 'Marie G.', 'family': 'Ponce', 'sequence': 'additional', 'affiliation': []}, {'given': 'Samuel', 'family': 'La Capra', 'sequence': 'additional', 'affiliation': []}, {'given': 'Frank J.', 'family': 'Cunningham', 'sequence': 'additional', 'affiliation': []}, {'given': 'Arthur G.', 'family': 'Calise', 'sequence': 'additional', 'affiliation': []}, {'given': 'Bradley L.', 'family': 'Pulver', 'sequence': 'additional', 'affiliation': []}, {'given': 'Dominic', 'family': 'Ruocco', 'sequence': 'additional', 'affiliation': []}, {'given': 'Greggory E.', 'family': 'Mojares', 'sequence': 'additional', 'affiliation': []}, {'given': 'Michael P.', 'family': 'Eagan', 'sequence': 'additional', 'affiliation': []}, {'given': 'Kristy L.', 'family': 'Ziontz', 'sequence': 'additional', 'affiliation': []}, {'given': 'Paul', 'family': 'Mastrokyriakos', 'sequence': 'additional', 'affiliation': []}, {'given': 'Stuart L.', 'family': 'Goldberg', 'sequence': 'additional', 'affiliation': []}], 'member': '297', 'published-online': {'date-parts': [[2021, 1, 14]]}, 'reference': [ { 'key': '5773_CR1', 'volume-title': 'Infectious diseases Society of America guidelines on the treatment and ' 'management of patients with COVID-19', 'author': 'A Bhimraj', 'year': '2020', 'unstructured': 'Bhimraj A, Morgan RL, Shumaker AH, Lavergne V, Baden L, Cheng VC, et al. 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Hydroxychloroquine in the treatment of ' 'outpatients with mildly symptomatic COVID-19: a multi-center ' 'observational study dataset. 2020. https://doi.org/10.7303/syn22909530 ' 'Synapse: https://www.synapse.org/#!Synapse:syn22909530/files/.', 'DOI': '10.7303/syn22909530'}], 'container-title': 'BMC Infectious Diseases', 'original-title': [], 'language': 'en', 'link': [ { 'URL': 'http://link.springer.com/content/pdf/10.1186/s12879-021-05773-w.pdf', 'content-type': 'application/pdf', 'content-version': 'vor', 'intended-application': 'text-mining'}, { 'URL': 'http://link.springer.com/article/10.1186/s12879-021-05773-w/fulltext.html', 'content-type': 'text/html', 'content-version': 'vor', 'intended-application': 'text-mining'}, { 'URL': 'http://link.springer.com/content/pdf/10.1186/s12879-021-05773-w.pdf', 'content-type': 'application/pdf', 'content-version': 'vor', 'intended-application': 'similarity-checking'}], 'deposited': { 'date-parts': [[2021, 1, 14]], 'date-time': '2021-01-14T11:05:00Z', 'timestamp': 1610622300000}, 'score': 1, 'resource': { 'primary': { 'URL': 'https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-021-05773-w'}}, 'subtitle': [], 'short-title': [], 'issued': {'date-parts': [[2021, 1, 14]]}, 'references-count': 38, 'journal-issue': {'issue': '1', 'published-print': {'date-parts': [[2021, 12]]}}, 'alternative-id': ['5773'], 'URL': 'http://dx.doi.org/10.1186/s12879-021-05773-w', 'relation': {}, 'ISSN': ['1471-2334'], 'subject': ['Infectious Diseases'], 'container-title-short': 'BMC Infect Dis', 'published': {'date-parts': [[2021, 1, 14]]}, 'assertion': [ { 'value': '25 August 2020', 'order': 1, 'name': 'received', 'label': 'Received', 'group': {'name': 'ArticleHistory', 'label': 'Article History'}}, { 'value': '6 January 2021', 'order': 2, 'name': 'accepted', 'label': 'Accepted', 'group': {'name': 'ArticleHistory', 'label': 'Article History'}}, { 'value': '14 January 2021', 'order': 3, 'name': 'first_online', 'label': 'First Online', 'group': {'name': 'ArticleHistory', 'label': 'Article History'}}, { 'value': 'Institutional Review Board approval was obtained for access to the prospective ' 'observational database (Hackensack Meridian Health under Study# Pro2020–0342). ' 'The requirement for patient informed consent, verbal or written, and HIPAA ' 'aurthorization was waived by the IRB as this project represented a ' 'non-interventional study utilizing routinely collected data for secondary ' 'research purposes.', 'order': 1, 'name': 'Ethics', 'group': {'name': 'EthicsHeading', 'label': 'Ethics approval and consent to participate'}}, { 'value': 'Not applicable.', 'order': 2, 'name': 'Ethics', 'group': {'name': 'EthicsHeading', 'label': 'Consent for publication'}}, { 'value': '<i>Potential conflicts of interest</i>: AHG reports being a study investigator ' 'for Genentech-Hoffman La Roche, during the conduct of the study; research ' 'funding as study investigator from Acerta, AstraZeneca, Celgene, Kite Pharma, ' 'Elsevier’s PracticeUpdate Oncology, Gilead, Medscape, MJH Associates, OncLive ' 'Peer Exchange, Physicians Education Resource, and Xcenda, outside the submitted ' 'work, and research funding as a study investigator for Constellation, Infinity, ' 'Infinity Verastem, Janssen, Karyopharm, and Pharmacyclics, outside of the ' 'submitted work.<i>Potential conflicts of interest:</i> EH report consulting for ' 'Regional Cancer Care Associates and Hackensack Meridian Health, outside the ' 'submitted work.<i>Potential conflicts of interest:</i> ALP and SLG report ' 'having equity ownership in COTA, outside the submitted work.<i>No conflicts of ' 'interest:</i> AI, JA, YZ, BAS, UB, MM, ISS, JPU, DMW, RP, RLS, MGP, SLC, FJC, ' 'AGC, BLP, DR, GEM, MPE, KLZ, and PM.', 'order': 3, 'name': 'Ethics', 'group': {'name': 'EthicsHeading', 'label': 'Competing interests'}}], 'article-number': '72'}