Hydroxychloroquine use in hospitalised patients with COVID-19: An observational matched cohort study
Kalligeros et al.
, Hydroxychloroquine use in hospitalised patients with COVID-19: An observational matched cohort study
, Journal of Global Antimicrobial Resistance, doi:10.1016/j.jgar.2020.07.018
Small retrospective database analysis of 36 patients receiving HCQ not showing significant differences. Confounding by indication
risk of death, 67.0% higher, HR 1.67, p = 0.57, treatment 36, control 72.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Kalligeros et al., 5 Aug 2020, retrospective, USA, peer-reviewed, 13 authors, average treatment delay 6.0 days.
Abstract: Journal of Global Antimicrobial Resistance 22 (2020) 842–844
Contents lists available at ScienceDirect
Journal of Global Antimicrobial Resistance
journal homepage: www.elsevier.com/locate/jgar
Hydroxychloroquine use in hospitalised patients with COVID-19: An
observational matched cohort study
Markos Kalligerosa,1, Fadi Shehadeha,1, Eleftheria Atallaa , Evangelia K. Mylonaa ,
Su Aunga , Aakriti Panditaa , Jerry Larkina , Martha Sancheza , Francine Touzard-Romoa ,
Amy Brothertonb , Rajeev Shahb , Cheston B. Cunhaa,**, Eleftherios Mylonakisa,*
Infectious Diseases Division, Warren Alpert Medical School of Brown University, Providence, RI, USA
Clinical Pharmacy, Lifespan, Providence, RI, USA
A R T I C L E I N F O
A B S T R A C T
Received 24 June 2020
Received in revised form 13 July 2020
Accepted 27 July 2020
Available online 5 August 2020
Aim: To assess the efﬁcacy and safety of hydroxychloroquine with or without azithromycin) in
hospitalized adult patients with COVID-19.
Methods: We utilized a hospital based prospective data registry. The primary end point was to assess the
impact of hydroxychloroquine with or without azithromycin, on outcome, length of hospitalization, and
time to clinical improvement. We utilized treatment effects with inverse-probability-weighting and Cox
proportional hazards models. All analyses accounted for age, gender, race, severity on admission, days
from symptoms onset and chronic comorbidities.
Results: 36 patients received hydroxychloroquine and were age- and sex-matched to 72 patients with
COVID-19 who received supportive care. Compared to supportive care, the use of HCQ did not shorten the
time to clinical improvement (+0.23 days; 95% CI: 1.8–2.3 days) nor did it shorten the duration of
hospital stay (+0.91 days; 95% CI: 1.1–2.9 days). Additionally, HCQ did not decrease the risk of COVID-19
in-hospital death (aHR 1.67; 95% CI: 0.29–9.36). Finally, we observed a slight QTc prolongation from a
baseline of 444 26 ms to 464 32 ms (meanSD) among patients receiving hydroxychloroquine with
or without azithromycin.
Conclusion: This study did not yield beneﬁts from hydroxychloroquine use in patients with COVID-19 and
monitoring for adverse events is warranted. Nevertheless, the treatment was safely studied under the
guidance of an antimicrobial stewardship program.
© 2020 The Author(s). Published by Elsevier Ltd on behalf of International Society for Antimicrobial
Chemotherapy. This is an open access article under the CC BY-NC-ND license (http://creativecommons.
Hydroxychloroquine (HCQ) and chloroquine were among the
ﬁrst drugs that emerged as potential therapeutic options against
coronavirus disease 2019 (COVID-19). These two antimalarial
drugs, also commonly used as immunomodulators in the setting of
rheumatological diseases, showed in vitro activity against severe
acute respiratory syndrome coronavirus 2 (SARS-CoV-2) [1,2]. The
aim of this study was to assess the efﬁcacy and safety of HCQ, with
* Corresponding author. Present address: Infectious Diseases Division, Warren
Alpert Medical School of Brown University, Rhode Island Hospital, 593 Eddy Street,
POB, 3rd Floor, Suite 328/330, Providence, RI 02903, USA.
** Corresponding author. Present address: Antimicrobial Stewardship Program
(Rhode Island Hospital & Miriam Hospital), Division of Infectious Disease,..
is less effective
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