Hydroxychloroquine and Tocilizumab Therapy in COVID-19 Patients - An Observational Study
Retrospective study of late stage use on 2,512 hospitalized patients showing no significant differences in associated mortality for patients receiving any HCQ during the hospitalization (HR, 0.99 [95% CI, 0.80-1.22]), HCQ alone (HR, 1.02 [95% CI, 0.83-1.27]), or HCQ+AZ (HR, 0.98 [95% CI, 0.75-1.28]). Misclassification is possible due to manual abstraction of EHR data. They observed a change in the prescribing patterns of HCQ during the study timeframe.
Confounding by indication.
risk of death, 1.0% lower, HR 0.99, p = 0.93, treatment 432 of 1,914 (22.6%), control 115 of 598 (19.2%), adjusted per study.
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Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
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Ip et al., 25 May 2020, retrospective, database analysis, USA, peer-reviewed, 32 authors, average treatment delay 5.0 days.
Abstract: PLOS ONE
RESEARCH ARTICLE
Hydroxychloroquine and tocilizumab therapy
in COVID-19 patients—An observational study
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Andrew Ip ID1, Donald A. Berry2,3, Eric Hansen4, Andre H. Goy5, Andrew L. Pecora5,
Brittany A. Sinclaire5, Urszula Bednarz5, Michael Marafelias5, Scott M. Berry2, Nicholas
S. Berry2, Shivam Mathura4, Ihor S. Sawczuk6, Noa Biran5, Ronaldo C. Go ID6,
Steven Sperber6, Julia A. Piwoz6, Bindu Balani6, Cristina Cicogna6, Rani Sebti6,
Jerry Zuckerman6, Keith M. Rose6, Lisa Tank6, Laurie G. Jacobs6, Jason Korcak6, Sarah
L. Timmapuri6, Joseph P. Underwood6, Gregory Sugalski6, Carol Barsky6, Daniel
W. Varga6, Arif Asif6, Joseph C. Landolfi6, Stuart L. Goldberg ID1*
1 Division of Outcomes and Value Research, John Theurer Cancer Center at Hackensack University Medical
Center, Hackensack, New Jersey, United States of America, 2 Berry Consultants LLC, Austin, Texas, United
States of America, 3 M.D. Anderson Cancer Center of the University of Texas, Houston, Texas, United
States of America, 4 COTA, Boston, Massachusetts, United States of America, 5 John Theurer Cancer
Center at Hackensack University Medical Center, Hackensack, New Jersey, United States of America,
6 Hackensack Meridian Health, Hackensack New Jersey and Hackensack Meridian School of Medicine,
Nutley, New Jersey, United States of America
* Stuart.Goldberg@hackensackmeridian.org
OPEN ACCESS
Citation: Ip A, Berry DA, Hansen E, Goy AH, Pecora
AL, Sinclaire BA, et al. (2020) Hydroxychloroquine
and tocilizumab therapy in COVID-19 patients—An
observational study. PLoS ONE 15(8): e0237693.
https://doi.org/10.1371/journal.pone.0237693
Editor: Chiara Lazzeri, Azienda Ospedaliero
Universitaria Careggi, ITALY
Received: May 21, 2020
Accepted: August 1, 2020
Published: August 13, 2020
Copyright: © 2020 Ip et al. This is an open access
article distributed under the terms of the Creative
Commons Attribution License, which permits
unrestricted use, distribution, and reproduction in
any medium, provided the original author and
source are credited.
Data Availability Statement: The study involves a
review of the electronic medical records of
patients infected with SARSCoV- 2. The research
data set has removed most, but not all protected
health information (for example: actual dates of
infection were included as needed for analysis,
but would be considered PHI). The dataset is
also considered property of Hackensack
Meridian Health and not owned by the
investigators. Therefore, for both reasons, the
dataset cannot be made openly available.
However, upon request we are willing to share
portions of the data for appropriate review.
Abstract
Hydroxychloroquine has been touted as a potential COVID-19 treatment. Tocilizumab, an
inhibitor of IL-6, has also been proposed as a treatment of critically ill patients. In this retrospective observational cohort study drawn from electronic health records we sought to
describe the association between mortality and hydroxychloroquine or tocilizumab therapy
among hospitalized COVID-19 patients. Patients were hospitalized at a 13-hospital network
spanning New Jersey USA between March 1, 2020 and April 22, 2020 with positive polymerase chain reaction results for SARS-CoV-2. Follow up was through May 5, 2020. Among
2512 hospitalized patients with COVID-19 there have been 547 deaths (22%), 1539 (61%)
discharges and 426 (17%) remain hospitalized. 1914 (76%) received at least one dose of
hydroxychloroquine..
Late treatment
is less effective
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