Clinical efficacy of hydroxychloroquine in patients with covid-19 pneumonia who require oxygen: observational comparative study using routine care data
Mahévas et al., BMJ 2020, 369, doi: https://doi.org/10.1136/bmj.m1844
Mahévas et al., Clinical efficacy of hydroxychloroquine in patients with covid-19 pneumonia who require oxygen: observational.., BMJ 2020, 369, doi: https://doi.org/10.1136/bmj.m1844
Observational study of 181 patients with advanced disease requiring oxygen showing no benefit for HCQ. Power of study appears too low to support conclusions [bmj.com].None of the 15 patients receiving HCQ+AZ were transferred to intensive care or died compared to 23% overall.
Abstract: RESEARCH
Matthieu Mahévas,1 Viet-Thi Tran,2 Mathilde Roumier,3 Amélie Chabrol,4 Romain Paule,3
Constance Guillaud,1 Elena Fois,1 Raphael Lepeule,5 Tali-Anne Szwebel,6
François-Xavier Lescure,7 Frédéric Schlemmer,8 Marie Matignon,9 Mehdi Khellaf,1
Etienne Crickx,1 Benjamin Terrier,6 Caroline Morbieu,6 Paul Legendre,6 Julien Dang,2
Yoland Schoindre,3 Jean-Michel Pawlotsky,10 Marc Michel,1 Elodie Perrodeau,2 Nicolas Carlier,11
Nicolas Roche,11 Victoire de Lastours,12 Clément Ourghanlian,13 Solen Kerneis,14
Philippe Ménager,15 Luc Mouthon,6 Etienne Audureau,16 Philippe Ravaud,2 Bertrand Godeau,1
Sébastien Gallien,17 Nathalie Costedoat-Chalumeau2,6
For numbered affiliations see
end of the article
Correspondence to: M Mahévas
matthieu.mahevas@gmail.com
(ORCID 0000-0001-9182-1434)
Additional material is published
online only. To view please visit
the journal online.
Cite this as: BMJ 2020;369:m1844
http://dx.doi.org/10.1136/bmj.m1844
Accepted: 5 May 2020
ABSTRACT
OBJECTIVE
To assess the effectiveness of hydroxychloroquine in
patients admitted to hospital with coronavirus disease
2019 (covid-19) pneumonia who require oxygen.
DESIGN
Comparative observational study using data collected
from routine care.
SETTING
Four French tertiary care centres providing care to
patients with covid-19 pneumonia between 12 March
and 31 March 2020.
PARTICIPANTS
181 patients aged 18-80 years with documented severe
acute respiratory syndrome coronavirus 2 (SARS-CoV-2)
pneumonia who required oxygen but not intensive care.
INTERVENTIONS
Hydroxychloroquine at a dose of 600 mg/day within
48 hours of admission to hospital (treatment group)
versus standard care without hydroxychloroquine
(control group).
MAIN OUTCOME MEASURES
The primary outcome was survival without transfer
to the intensive care unit at day 21. Secondary
WHAT IS ALREADY KNOWN ON THIS TOPIC
Treatments are urgently needed to prevent respiratory failure and deaths from
coronavirus disease 2019 (covid-19)
An in vitro study has reported potential activity by hydroxychloroquine against
severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) responsible for
covid-19
Small studies of hydroxychloroquine treatment in patients with covid-19 have
reported promising results
WHAT THIS STUDY ADDS
In patients admitted to hospital with covid-19 pneumonia who require oxygen,
hydroxychloroquine seemed to have no effect on reducing admissions to
intensive care or deaths at day 21 after hospital admission
Hydroxychloroquine treatment did not have any effect on survival without acute
respiratory distress syndrome at day 21 after hospital admission
The results of this study do not support the use of hydroxychloroquine in these
patients
the bmj | BMJ 2020;369:m1844 | doi: 10.1136/bmj.m1844
outcomes were overall survival, survival without
acute respiratory distress syndrome, weaning from
oxygen, and discharge from hospital to home or
rehabilitation (all at day 21). Analyses were adjusted
for confounding factors by inverse probability of
treatment weighting.
RESULTS
In the main analysis, 84 patients who received
hydroxychloroquine within 48 hours of admission
to hospital (treatment group) were compared with
89 patients who did not receive hydroxychloroquine
(control group). Eight additional patients received
hydroxychloroquine more than 48 hours after
admission. In the weighted analyses, the survival
rate without transfer to the intensive care unit at
day 21 was 76% in the treatment group and 75% in
the control group..
Late treatment is less effective
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