Randomized double-blinded placebo-controlled trial of hydroxychloroquine with or without azithromycin for virologic cure of non-severe Covid-19
Ali S Omrani, Sameer A Pathan, Sarah A Thomas, Tim R E Harris, Peter V Coyle, Caroline E Thomas, Isma Qureshi, Zain A Bhutta, Naema Al Mawlawi, Reham Al Kahlout, Ashraf Elmalik, Aftab M Azad, Joanne Daghfal, Mulham Mustafa, Andrew Jeremijenko, Hussam Al Soub, Mohammed Abu Khattab, Muna Al Maslamani, Stephen H Thomas
EClinicalMedicine, doi:10.1016/j.eclinm.2020.100645
Background: Hydroxychloroquine (HC) § azithromycin (AZ) is widely used for Covid-19. The Qatar Prospective RCT of Expediting Coronavirus Tapering (Q-PROTECT) aimed to assess virologic cure rates of HC §AZ in cases of low-acuity Covid-19. Methods: Q-PROTECT employed a prospective, placebo-controlled design with blinded randomization to three parallel arms: placebo, oral HC (600 mg daily for one week), or oral HC plus oral AZ (500 mg day one, 250 mg daily on days two through five). At enrollment, non-hospitalized participants had mild or no symptoms and were within a day of Covid-19 positivity by polymerase chain reaction (PCR). After six days, intentto-treat (ITT) analysis of the primary endpoint of virologic cure was assessed using binomial exact 95% confidence intervals (CIs) and x 2 testing. (ClinicalTrials.gov NCT04349592, trial status closed to new participants.) Findings: The study enrolled 456 participants (152 in each of three groups: HC+AZ, HC, placebo) between 13 April and 1 August 2020. HC+AZ, HC, and placebo groups had 6 (3¢9%), 7 (4¢6%), and 9 (5¢9%) participants go off study medications before completing the medication course (p = 0¢716). Day six PCR results were available for all 152 HC+AZ participants, 149/152 (98¢0%) HC participants, and 147/152 (96¢7%) placebo participants. Day six ITT analysis found no difference (p = 0¢821) in groups' proportions achieving virologic cure: HC +AZ 16/152 (10¢5%), HC 19/149 (12¢8%), placebo 18/147 (12¢2%). Day 14 assessment also showed no association (p = 0¢072) between study group and viral cure: HC+AZ 30/149 (20¢1%,), HC 42/146 (28¢8%), placebo 45/ 143 (31¢5%). There were no serious adverse events. Interpretation: HC §AZ does not facilitate virologic cure in patients with mild or asymptomatic Covid-19.
Author contributions Authors have made the following contributions consistent with ICJME recommendations for authorship: All authors made meaningful contributions to manuscript preparation, review, and editing. In addition, the authors made contributions as follows: -Stephen H. Thomas conceived the study, co-wrote the draft manuscript, and maintains overall responsibility for Q-PROTECT conduct and reporting. -Ali S. Omrani made critical contributions/modifications to the study design and execution plans, and co-wrote the initial manuscript draft. -Sameer A. Pathan led the execution stage of the study. -Sarah A. Thomas planned the randomization and allocation concealment approaches, performed the literature search and initialdraft manuscript writing relevant to cell biology of putative drug action mechanisms, executed data-sharing processes, and assisted with revision of the manuscript during the editorial review process. -Peter V. Coyle led the virology testing planning and execution and made key manuscript contributions in the arena of laboratory medicine. -Naema Al Mawlawi and Reham Al Kahlout managed the lab specimens, executed all PCR analysis, and arranged virologic reporting data -Tim R. E. Harris provided substantial manuscript editing, and coordinated physician resourcing for study participant accrual and data processing. -Caroline E. Thomas led planning of, and manuscript writing describing, data entry spreadsheet/source-table preparing of participants' data entry..
References
Alexander, Debono, Mammen, COVID-19 coronavirus research has overall low methodological quality thus far: case in point for chloroquine/hydroxychloroquine, J Clin Epidemiol
Arshad, Kilgore, Chaudhry, Treatment with hydroxychloroquine, azithromycin, and combination in patients hospitalized with COVID-19, Int J Infect Dis
Bessiere, Roccia, Deliniere, Assessment of QT intervals in a case series of patients with coronavirus disease 2019 (COVID-19) infection treated with hydroxychloroquine alone or in combination with azithromycin in an intensive care unit, JAMA Cardiol
Bonow, Hernandez, Turakhia, Hydroxychloroquine, coronavirus disease 2019, and QT prolongation, JAMA Cardiol
Boulware, Pullen, Bangdiwala, A randomized trial of hydroxychloroquine as postexposure prophylaxis for covid-19, N Engl J Med
Cavalcanti, Zampieri, Rosa, Hydroxychloroquine with or without azithromycin in mild-to-moderate covid-19, N Engl J Med
Chen, Fu, Yang, Low transmission risk of 9 asymptomatic carriers tested positive for both SARS-CoV-2 nucleic acid and serum IgG, J Infect
Chen, Liu, Liu, A pilot study of hydroxychloroquine in treatment of patients with moderate COVID-19, Zhejiang Da Xue Xue Bao Yi Xue Ban
Cohen, Hydroxychloroquine for the prevention of Covid-19 À searching for evidence, N Engl J Med
Ferner, Aronson, Hydroxychloroquine for Covid-19: what do the clinical trials tell us?
Gautret, Lagier, Parola, Clinical and microbiological effect of a combination of hydroxychloroquine and azithromycin in 80 COVID-19 patients with at least a six-day follow up: a pilot observational study, Travel Med Infect Dis
Gautret, Lagier, Parola, Hydroxychloroquine and azithromycin as a treatment of COVID-19: results of an open-label non-randomized clinical trial, Int J Antimicrob Agents
Geleris, Sun, Platt, Observational study of hydroxychloroquine in hospitalized patients with covid-19, N Engl J Med
He, Lau, Wu, Temporal dynamics in viral shedding and transmissibility of COVID-19, Nat Med
Horby, Landray, No clinical benefit from use of hydroxychloroquine in hospitalised patients with Covid-19
Lagier, Million, Gautret, Outcomes of 3,737 COVID-19 patients treated with hydroxychloroquine/azithromycin and other regimens in Marseille, France: a retrospective analysis, Travel Med Infect Dis
Mahevas, Tran, Roumier, Clinical efficacy of hydroxychloroquine in patients with covid-19 pneumonia who require oxygen: observational comparative study using routine care data, BMJ
Mehra, Desai, Ruschitzka, Patel, Hydroxychloroquine or chloroquine with or without a macrolide for treatment of COVID-19: a multinational registry analysis, Lancet
Million, Lagier, Gautret, Early treatment of COVID-19 patients with hydroxychloroquine and azithromycin: a retrospective analysis of 1061 cases in Marseille, France, Travel Med Infect Dis
Mitja, Corbacho-Monne, Ubals, Hydroxychloroquine for early treatment of adults with mild covid-19: a randomized-controlled trial, Clin Infect Dis
Molina, Delaugerre, Goff, None, Med Mal Infect
Pastick, Okafor, Wang, Review: hydroxychloroquine and chloroquine for treatment of SARS-CoV-2 (COVID-19), Open Forum Infect Dis
Postema, Wilde, The measurement of the QT interval, Curr Cardiol Rev
Rosenberg, Dufort, Udo, Association of treatment with hydroxychloroquine or azithromycin with in-hospital mortality in patients with COVID-19 in New York State, JAMA
Simpson, Kovacs, Stecker, Ventricular arrhythmia risk due to hydroxychloroquine-azithromycin treatment for Covid-19
Skipper, Pastick, Engen, Hydroxychloroquine in nonhospitalized adults with early COVID-19: a randomized trial, Ann Intern Med
Tang, Cao, Han, Hydroxychloroquine in patients with mainly mild to moderate coronavirus disease 2019: open label, randomised controlled trial, BMJ
Who, Solidarity" clinical trial for Covid-19 treatments
Yao, Ye, Zhang, In vitro antiviral activity and projection of optimized dosing design of hydroxychloroquine for the treatment of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), Clin Infect Dis
Yu, Li, Chen, Low dose of hydroxychloroquine reduces fatality of critically ill patients with COVID-19, Sci China Life Sci
Zou, Ruan, Huang, SARS-CoV-2 viral load in upper respiratory specimens of infected patients, N Engl J Med
{ 'indexed': {'date-parts': [[2024, 1, 25]], 'date-time': '2024-01-25T15:46:37Z', 'timestamp': 1706197597142},
'reference-count': 33,
'publisher': 'Elsevier BV',
'license': [ { 'start': { 'date-parts': [[2020, 12, 1]],
'date-time': '2020-12-01T00:00:00Z',
'timestamp': 1606780800000},
'content-version': 'tdm',
'delay-in-days': 0,
'URL': 'https://www.elsevier.com/tdm/userlicense/1.0/'},
{ 'start': { 'date-parts': [[2020, 11, 6]],
'date-time': '2020-11-06T00:00:00Z',
'timestamp': 1604620800000},
'content-version': 'vor',
'delay-in-days': 0,
'URL': 'http://creativecommons.org/licenses/by-nc-nd/4.0/'}],
'funder': [ { 'DOI': '10.13039/100007833',
'name': 'Hamad Medical Corporation',
'doi-asserted-by': 'publisher'}],
'content-domain': {'domain': [], 'crossmark-restriction': False},
'published-print': {'date-parts': [[2020, 12]]},
'DOI': '10.1016/j.eclinm.2020.100645',
'type': 'journal-article',
'created': { 'date-parts': [[2020, 11, 20]],
'date-time': '2020-11-20T22:24:37Z',
'timestamp': 1605911077000},
'page': '100645',
'source': 'Crossref',
'is-referenced-by-count': 42,
'title': 'Randomized double-blinded placebo-controlled trial of hydroxychloroquine with or without '
'azithromycin for virologic cure of non-severe Covid-19',
'prefix': '10.1016',
'volume': '29-30',
'author': [ {'given': 'Ali S.', 'family': 'Omrani', 'sequence': 'first', 'affiliation': []},
{'given': 'Sameer A.', 'family': 'Pathan', 'sequence': 'additional', 'affiliation': []},
{'given': 'Sarah A.', 'family': 'Thomas', 'sequence': 'additional', 'affiliation': []},
{'given': 'Tim R.E.', 'family': 'Harris', 'sequence': 'additional', 'affiliation': []},
{'given': 'Peter V.', 'family': 'Coyle', 'sequence': 'additional', 'affiliation': []},
{'given': 'Caroline E.', 'family': 'Thomas', 'sequence': 'additional', 'affiliation': []},
{'given': 'Isma', 'family': 'Qureshi', 'sequence': 'additional', 'affiliation': []},
{'given': 'Zain A.', 'family': 'Bhutta', 'sequence': 'additional', 'affiliation': []},
{'given': 'Naema Al', 'family': 'Mawlawi', 'sequence': 'additional', 'affiliation': []},
{'given': 'Reham Al', 'family': 'Kahlout', 'sequence': 'additional', 'affiliation': []},
{'given': 'Ashraf', 'family': 'Elmalik', 'sequence': 'additional', 'affiliation': []},
{'given': 'Aftab M.', 'family': 'Azad', 'sequence': 'additional', 'affiliation': []},
{'given': 'Joanne', 'family': 'Daghfal', 'sequence': 'additional', 'affiliation': []},
{'given': 'Mulham', 'family': 'Mustafa', 'sequence': 'additional', 'affiliation': []},
{'given': 'Andrew', 'family': 'Jeremijenko', 'sequence': 'additional', 'affiliation': []},
{'given': 'Hussam Al', 'family': 'Soub', 'sequence': 'additional', 'affiliation': []},
{'given': 'Mohammed Abu', 'family': 'Khattab', 'sequence': 'additional', 'affiliation': []},
{'given': 'Muna Al', 'family': 'Maslamani', 'sequence': 'additional', 'affiliation': []},
{'given': 'Stephen H.', 'family': 'Thomas', 'sequence': 'additional', 'affiliation': []}],
'member': '78',
'reference': [ { 'key': '10.1016/j.eclinm.2020.100645_bib0001',
'doi-asserted-by': 'crossref',
'DOI': '10.1016/j.ijantimicag.2020.105949',
'article-title': 'Hydroxychloroquine and azithromycin as a treatment of COVID-19: results '
'of an open-label non-randomized clinical trial',
'author': 'Gautret',
'year': '2020',
'journal-title': 'Int J Antimicrob Agents'},
{ 'key': '10.1016/j.eclinm.2020.100645_bib0002',
'doi-asserted-by': 'crossref',
'DOI': '10.1016/j.tmaid.2020.101663',
'article-title': 'Clinical and microbiological effect of a combination of '
'hydroxychloroquine and azithromycin in 80 COVID-19 patients with at '
'least a six-day follow up: a pilot observational study',
'volume': '34',
'author': 'Gautret',
'year': '2020',
'journal-title': 'Travel Med Infect Dis'},
{ 'key': '10.1016/j.eclinm.2020.100645_bib0003',
'author': 'Molina',
'year': '2020',
'journal-title': 'Med Mal Infect'},
{ 'key': '10.1016/j.eclinm.2020.100645_bib0004',
'unstructured': 'Ferner R.E., Aronson J.K... Hydroxychloroquine for Covid-19: what do the '
'clinical trials tell us? 2020. '
'https://www.cebm.net/covid-19/hydroxychloroquine-for-covid-19-what-do-the-clinical-trials-tell-us/ '
'(accessed 20 April 2020).'},
{ 'key': '10.1016/j.eclinm.2020.100645_bib0005',
'unstructured': 'Q-PROTECT Research Protocol. 2020. '
'https://www.hamad.qa/EN/Hospitals-and-services/Communicable-Disease-Center/Research-and-Education/Pages/Q-Protect.aspx '
'(accessed 1 August 2020).'},
{ 'key': '10.1016/j.eclinm.2020.100645_bib0006',
'unstructured': 'Simpson T.F., Kovacs R.J., Stecker E.C.. Ventricular arrhythmia risk due '
'to hydroxychloroquine-azithromycin treatment for Covid-19. 2020. '
'https://www.acc.org/latest-in-cardiology/articles/2020/03/27/14/00/ventricular-arrhythmia-risk-due-to-hydroxychloroquine-azithromycin-treatment-for-covid-19 '
'(accessed 1 April 2020).'},
{ 'issue': '12',
'key': '10.1016/j.eclinm.2020.100645_bib0007',
'doi-asserted-by': 'crossref',
'first-page': '1177',
'DOI': '10.1056/NEJMc2001737',
'article-title': 'SARS-CoV-2 viral load in upper respiratory specimens of infected '
'patients',
'volume': '382',
'author': 'Zou',
'year': '2020',
'journal-title': 'N Engl J Med'},
{ 'key': '10.1016/j.eclinm.2020.100645_bib0008',
'doi-asserted-by': 'crossref',
'first-page': '120',
'DOI': '10.1016/j.jclinepi.2020.04.016',
'article-title': 'COVID-19 coronavirus research has overall low methodological quality '
'thus far: case in point for chloroquine/hydroxychloroquine',
'volume': '123',
'author': 'Alexander',
'year': '2020',
'journal-title': 'J Clin Epidemiol'},
{ 'key': '10.1016/j.eclinm.2020.100645_bib0009',
'doi-asserted-by': 'crossref',
'DOI': '10.1056/NEJMoa2016638',
'article-title': 'A randomized trial of hydroxychloroquine as postexposure prophylaxis '
'for covid-19',
'author': 'Boulware',
'year': '2020',
'journal-title': 'N Engl J Med'},
{ 'key': '10.1016/j.eclinm.2020.100645_bib0010',
'doi-asserted-by': 'crossref',
'DOI': '10.1016/j.tmaid.2020.101738',
'article-title': 'Early treatment of COVID-19 patients with hydroxychloroquine and '
'azithromycin: a retrospective analysis of 1061 cases in Marseille, '
'France',
'volume': '35',
'author': 'Million',
'year': '2020',
'journal-title': 'Travel Med Infect Dis'},
{ 'key': '10.1016/j.eclinm.2020.100645_bib0011',
'article-title': 'Hydroxychloroquine for early treatment of adults with mild covid-19: a '
'randomized-controlled trial',
'author': 'Mitja',
'year': '2020',
'journal-title': 'Clin Infect Dis'},
{ 'key': '10.1016/j.eclinm.2020.100645_bib0012',
'doi-asserted-by': 'crossref',
'DOI': '10.7326/M20-4207',
'article-title': 'Hydroxychloroquine in nonhospitalized adults with early COVID-19: a '
'randomized trial',
'author': 'Skipper',
'year': '2020',
'journal-title': 'Ann Intern Med'},
{ 'key': '10.1016/j.eclinm.2020.100645_bib0013',
'doi-asserted-by': 'crossref',
'first-page': 'm1849',
'DOI': '10.1136/bmj.m1849',
'article-title': 'Hydroxychloroquine in patients with mainly mild to moderate coronavirus '
'disease 2019: open label, randomised controlled trial',
'volume': '369',
'author': 'Tang',
'year': '2020',
'journal-title': 'BMJ'},
{ 'issue': '2',
'key': '10.1016/j.eclinm.2020.100645_bib0014',
'first-page': '215',
'article-title': 'A pilot study of hydroxychloroquine in treatment of patients with '
'moderate COVID-19',
'volume': '49',
'author': 'Chen',
'year': '2020',
'journal-title': 'Zhejiang Da Xue Xue Bao Yi Xue Ban'},
{ 'key': '10.1016/j.eclinm.2020.100645_bib0015',
'article-title': 'Low dose of hydroxychloroquine reduces fatality of critically ill '
'patients with COVID-19',
'author': 'Yu',
'year': '2020',
'journal-title': 'Sci China Life Sci'},
{ 'key': '10.1016/j.eclinm.2020.100645_bib0016',
'doi-asserted-by': 'crossref',
'DOI': '10.1056/NEJMoa2012410',
'article-title': 'Observational study of hydroxychloroquine in hospitalized patients with '
'covid-19',
'author': 'Geleris',
'year': '2020',
'journal-title': 'N Engl J Med'},
{ 'key': '10.1016/j.eclinm.2020.100645_bib0017',
'doi-asserted-by': 'crossref',
'DOI': '10.1001/jama.2020.8630',
'article-title': 'Association of treatment with hydroxychloroquine or azithromycin with '
'in-hospital mortality in patients with COVID-19 in New York State',
'author': 'Rosenberg',
'year': '2020',
'journal-title': 'JAMA'},
{ 'key': '10.1016/j.eclinm.2020.100645_bib0018',
'doi-asserted-by': 'crossref',
'first-page': 'm1844',
'DOI': '10.1136/bmj.m1844',
'article-title': 'Clinical efficacy of hydroxychloroquine in patients with covid-19 '
'pneumonia who require oxygen: observational comparative study using '
'routine care data',
'volume': '369',
'author': 'Mahevas',
'year': '2020',
'journal-title': 'BMJ'},
{ 'key': '10.1016/j.eclinm.2020.100645_bib0019',
'doi-asserted-by': 'crossref',
'DOI': '10.1001/jamacardio.2020.1782',
'article-title': 'Hydroxychloroquine, coronavirus disease 2019, and QT prolongation',
'author': 'Bonow',
'year': '2020',
'journal-title': 'JAMA Cardiol'},
{ 'key': '10.1016/j.eclinm.2020.100645_bib0020',
'article-title': 'Hydroxychloroquine or chloroquine with or without a macrolide for '
'treatment of COVID-19: a multinational registry analysis',
'author': 'Mehra',
'year': '2020',
'journal-title': 'Lancet'},
{ 'key': '10.1016/j.eclinm.2020.100645_bib0021',
'unstructured': 'Horby P., Landray M.J... No clinical benefit from use of '
'hydroxychloroquine in hospitalised patients with Covid-19. 2020. '
'https://www.recoverytrial.net/news/statement-from-the-chief-investigators-of-the-randomised-evaluation-of-covid-19-therapy-recovery-trial-on-hydroxychloroquine-5-june-2020-no-clinical-benefit-from-use-of-hydroxychloroquine-in-hospitalised-patients-with-covid-19 '
'(accessed 1 July 2020).'},
{ 'key': '10.1016/j.eclinm.2020.100645_bib0022',
'unstructured': 'FDA cautions against use of hydroxychloroquine or chloroquine for '
'COVID-19 outside of the hospital setting or a clinical trial due to risk '
'of heart rhythm problems. 2020. '
'https://www.fda.gov/drugs/drug-safety-and-availability/fda-cautions-against-use-hydroxychloroquine-or-chloroquine-covid-19-outside-hospital-setting-or '
'(accessed 15 July 2020).'},
{ 'key': '10.1016/j.eclinm.2020.100645_bib0023',
'unstructured': 'WHO. "Solidarity" clinical trial for Covid-19 treatments. 2020. '
'https://www.who.int/emergencies/diseases/novel-coronavirus-2019/global-research-on-novel-coronavirus-2019-ncov/solidarity-clinical-trial-for-covid-19-treatments '
'(accessed 15 July 2020).'},
{ 'key': '10.1016/j.eclinm.2020.100645_bib0024',
'doi-asserted-by': 'crossref',
'DOI': '10.1056/NEJMoa2019014',
'article-title': 'Hydroxychloroquine with or without azithromycin in mild-to-moderate '
'covid-19',
'author': 'Cavalcanti',
'year': '2020',
'journal-title': 'N Engl J Med'},
{ 'key': '10.1016/j.eclinm.2020.100645_bib0025',
'doi-asserted-by': 'crossref',
'first-page': '396',
'DOI': '10.1016/j.ijid.2020.06.099',
'article-title': 'Treatment with hydroxychloroquine, azithromycin, and combination in '
'patients hospitalized with COVID-19',
'volume': '97',
'author': 'Arshad',
'year': '2020',
'journal-title': 'Int J Infect Dis'},
{ 'key': '10.1016/j.eclinm.2020.100645_bib0026',
'doi-asserted-by': 'crossref',
'DOI': '10.1016/j.tmaid.2020.101791',
'article-title': 'Outcomes of 3,737 COVID-19 patients treated with '
'hydroxychloroquine/azithromycin and other regimens in Marseille, '
'France: a retrospective analysis',
'author': 'Lagier',
'year': '2020',
'journal-title': 'Travel Med Infect Dis'},
{ 'issue': '6',
'key': '10.1016/j.eclinm.2020.100645_bib0027',
'doi-asserted-by': 'crossref',
'first-page': '585',
'DOI': '10.1056/NEJMe2020388',
'article-title': 'Hydroxychloroquine for the prevention of Covid-19 – searching for '
'evidence',
'volume': '383',
'author': 'Cohen',
'year': '2020',
'journal-title': 'N Engl J Med'},
{ 'key': '10.1016/j.eclinm.2020.100645_bib0028',
'doi-asserted-by': 'crossref',
'DOI': '10.1016/j.jinf.2020.06.034',
'article-title': 'Low transmission risk of 9 asymptomatic carriers tested positive for '
'both SARS-CoV-2 nucleic acid and serum IgG',
'author': 'Chen',
'year': '2020',
'journal-title': 'J Infect'},
{ 'key': '10.1016/j.eclinm.2020.100645_bib0029',
'article-title': 'Temporal dynamics in viral shedding and transmissibility of COVID-19',
'author': 'He',
'year': '2020',
'journal-title': 'Nat Med'},
{ 'issue': '4',
'key': '10.1016/j.eclinm.2020.100645_bib0030',
'doi-asserted-by': 'crossref',
'first-page': 'ofaa130',
'DOI': '10.1093/ofid/ofaa130',
'article-title': 'Review: hydroxychloroquine and chloroquine for treatment of SARS-CoV-2 '
'(COVID-19)',
'volume': '7',
'author': 'Pastick',
'year': '2020',
'journal-title': 'Open Forum Infect Dis'},
{ 'issue': '15',
'key': '10.1016/j.eclinm.2020.100645_bib0031',
'doi-asserted-by': 'crossref',
'first-page': '732',
'DOI': '10.1093/cid/ciaa237',
'article-title': 'In vitro antiviral activity and projection of optimized dosing design '
'of hydroxychloroquine for the treatment of Severe Acute Respiratory '
'Syndrome Coronavirus 2 (SARS-CoV-2)',
'volume': '71',
'author': 'Yao',
'year': '2020',
'journal-title': 'Clin Infect Dis'},
{ 'issue': '3',
'key': '10.1016/j.eclinm.2020.100645_bib0032',
'doi-asserted-by': 'crossref',
'first-page': '287',
'DOI': '10.2174/1573403X10666140514103612',
'article-title': 'The measurement of the QT interval',
'volume': '10',
'author': 'Postema',
'year': '2014',
'journal-title': 'Curr Cardiol Rev'},
{ 'key': '10.1016/j.eclinm.2020.100645_bib0033',
'doi-asserted-by': 'crossref',
'DOI': '10.1001/jamacardio.2020.1787',
'article-title': 'Assessment of QT intervals in a case series of patients with '
'coronavirus disease 2019 (COVID-19) infection treated with '
'hydroxychloroquine alone or in combination with azithromycin in an '
'intensive care unit',
'author': 'Bessiere',
'year': '2020',
'journal-title': 'JAMA Cardiol'}],
'container-title': 'EClinicalMedicine',
'original-title': [],
'language': 'en',
'link': [ { 'URL': 'https://api.elsevier.com/content/article/PII:S2589537020303898?httpAccept=text/xml',
'content-type': 'text/xml',
'content-version': 'vor',
'intended-application': 'text-mining'},
{ 'URL': 'https://api.elsevier.com/content/article/PII:S2589537020303898?httpAccept=text/plain',
'content-type': 'text/plain',
'content-version': 'vor',
'intended-application': 'text-mining'}],
'deposited': { 'date-parts': [[2021, 5, 13]],
'date-time': '2021-05-13T12:00:34Z',
'timestamp': 1620907234000},
'score': 1,
'resource': {'primary': {'URL': 'https://linkinghub.elsevier.com/retrieve/pii/S2589537020303898'}},
'subtitle': [],
'short-title': [],
'issued': {'date-parts': [[2020, 12]]},
'references-count': 33,
'alternative-id': ['S2589537020303898'],
'URL': 'http://dx.doi.org/10.1016/j.eclinm.2020.100645',
'relation': {},
'ISSN': ['2589-5370'],
'subject': ['General Medicine'],
'container-title-short': 'EClinicalMedicine',
'published': {'date-parts': [[2020, 12]]},
'article-number': '100645'}