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0 0.5 1 1.5 2+ Mortality 36% Improvement Relative Risk HCQ for COVID-19  Meeus et al.  LATE TREATMENT Is late treatment with HCQ + AZ beneficial for COVID-19? Retrospective 3,885 patients in Belgium (March - May 2020) Lower mortality with HCQ + AZ (p=0.005) Meeus et al., New Microbes and New Inf.., Sep 2023 Favors HCQ Favors control

Efficacy and safety of in-hospital treatment of Covid-19 infection with low-dose hydroxychloroquine and azithromycin in hospitalized patients: A retrospective controlled cohort study

Meeus et al., New Microbes and New Infections, doi:10.1016/j.nmni.2023.101172
Sep 2023  
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Retrospective 352 hospitalized COVID-19 patients in Belgium and 3,533 control patients from the contemporaneous Belgian Collaborative Group, showing significantly lower mortality with HCQ treatment. The survival benefit was consistent in all age groups. No torsade de pointes or ventricular arrhythmias were observed. Mean time from onset is not provided, but 43% of patients with known onset were admitted within 5 days, making the efficacy consistent with expectations based on the treatment delay
HCQ 800mg day one, 200mg bid for five days, according to national guidelines. Authors note that the poor results in SOLIDARITY/RECOVERY may be related to the excessively high doses used. Most patients also received AZ. Adjusted results are only provided for all HCQ patients.
Publication was delayed over 3 years. Authors reported in 2001 that the paper had been rejected by the editors of four different journals, without peer review
risk of death, 36.5% lower, RR 0.64, p = 0.005, treatment 59 of 352 (16.8%), control 916 of 3,533 (25.9%), NNT 11, adjusted per study, MI model.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Meeus et al., 30 Sep 2023, retrospective, Belgium, peer-reviewed, 10 authors, study period 16 March, 2020 - 20 May, 2020, this trial uses multiple treatments in the treatment arm (combined with AZ) - results of individual treatments may vary.
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Efficacy and safety of in-hospital treatment of Covid-19 infection with low-dose hydroxychloroquine and azithromycin in hospitalized patients: A retrospective controlled cohort study
M.D Gert Meeus, Frauke Van Coile, Ph.D Hans Pottel, M.D Ann-Sophie Michel, M.D Ortwin Vergauwen, Katy Verhelle, M.D Stoffel Lamote, M.D Mathias Leys, M.D Michaël Boudewijns, M.D Pieter Samaey
New Microbes and New Infections, doi:10.1016/j.nmni.2023.101172
Objectives: In this study we evaluate the efficacy and safety of a treatment protocol with standard dose of hydroxychloroquine plus azithromycin in patients hospitalized with COVID-19 infection. Methods: We conducted a retrospective analysis to compare the 28-day mortality rate in 352 patients treated with hydroxychloroquine with or without azithromycin (HCQ-group) in our hospital with a contemporary control group of 3533 patients receiving standard of care from the Belgian Collaborative Group on COVID-19 Hospital Surveillance. Results: All patients who received at least one dose of treatment were included in the analysis. A statistically significant reduction in crude mortality rate at 28 days was observed in the HCQ-group compared to standard of care (16.8% vs 25.9%,p=0.001). Patients in the treatment group were on average younger (69,7 vs73,1 years, p=0,0002), were less likely to smoke or to have malignancy and more likely to be male. Patients in the treatment group were more likely to be obese, immunocompromised or to have arterial hypertension, liver disease and lung disease.. After adjustment for these variables the OR for mortality was 0.635 (95%CI 0.464-0.875). Patients who did not receive HCQ had a 57% higher risk of mortality. A survival benefit in the treatment group was consistent across all age groups. 13 patients discontinued treatment due to side effects (4 with QTc-prolongation>60msec (1.1%) and 9 because of gastro-intestinal symptoms (2.55%)). No episodes of ventricular arrhythmia or torsade de pointes were recorded during treatment. Conclusion: Treatment of COVID-19 using a combination of hydroxychloroquine plus azithromycin was safe and was associated with a statistically significant mortality benefit in the treatment of COVID-19 infection in hospitalized patients. Our findings do not support the current negative recommendations regarding this treatment.
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J O U R N A L P R E, None
J O U R N A L P R E, None
J O U R N A L P R E, None
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Late treatment
is less effective
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