Compassionate Use of Hydroxychloroquine in Clinical Practice for Patients With Mild to Severe COVID-19 in a French University Hospital
Olivier Paccoud, Florence Tubach, Amandine Baptiste, Alexandre Bleibtreu, David Hajage, Gentiane Monsel, Gianpiero Tebano, David Boutolleau, Elise Klement, Nagisa Godefroy, Romain Palich, Oula Itani, Antoine Faiçal, Marc-Antoine Valantin, Roland Tubiana, Sonia Burrel, Vincent Calvez, Eric Caumes, Anne-Geneviève Marcelin, Valérie Pourcher
Clinical Infectious Diseases, doi:10.1093/cid/ciaa791
Background. Data from nonrandomized studies have suggested that hydroxychloroquine could be an effective therapeutic agent against coronavirus disease 2019 (COVID-19). Methods. We conducted an observational, retrospective cohort study involving hospitalized adult patients with confirmed, mild to severe COVID-19 in a French university hospital. Patients who received hydroxychloroquine (200 mg 3 times daily dosage for 10 days) on a compassionate basis in addition to standard of care (SOC) were compared with patients without contraindications to hydroxychloroquine who received SOC alone. A propensity score-weighted analysis was performed to control for confounders: age, sex, time between symptom onset and admission ≤ 7 days, Charlson comorbidity index, medical history of arterial hypertension, obesity, National Early Warning Score 2 (NEWS2) score at admission, and pneumonia severity. The primary endpoint was time to unfavorable outcome, defined as: death, admission to an intensive care unit, or decision to withdraw or withhold life-sustaining treatments, whichever came first. Results. Data from 89 patients with laboratory-confirmed COVID-19 were analyzed, 84 of whom were considered in the primary analysis; 38 patients treated with hydroxychloroquine and 46 patients treated with SOC alone. At admission, the mean age of patients was 66 years, the median Charlson comorbidity index was 3, and the median NEWS2 severity score was 3. After propensity score weighting, treatment with hydroxychloroquine was not associated with a significantly reduced risk of unfavorable outcome (hazard ratio, 0.90 [95% confidence interval, .38-2.1], P = .81). Overall survival was not significantly different between the 2 groups (hazard ratio, 0.89 [0.23; 3.47], P = 1).
Conclusion. In hospitalized adults with COVID-19, no significant reduction of the risk of unfavorable outcomes was observed with hydroxychloroquine in comparison to SOC. Unmeasured confounders may have persisted however, despite careful propensity-weighted analysis and the study might be underpowered. Ongoing controlled trials in patients with varying degrees of initial severity on a larger scale will help determine whether there is a place for hydroxychloroquine in the treatment of COVID-19. In hospitalized adults with COVID-19, no significant reduction of the risk of unfavorable outcomes was observed with hydroxychloroquine in comparison to SOC.
Supplementary Data Supplementary materials are available at Clinical Infectious Diseases online. Consisting of data provided by the authors to benefit the reader, the posted materials are not copyedited and are the sole responsibility of the authors, so questions or comments should be addressed to the corresponding author.
Notes
References
Austin, Stuart, Moving towards best practice when using inverse probability of treatment weighting (IPTW) using the propensity score to estimate causal treatment effects in observational studies, Stat Med
Charlson, Pompei, Ales, Mackenzie, A new method of classifying prognostic comorbidity in longitudinal studies: development and validation, J Chronic Dis
Chen, Zhou, Dong, Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study, Lancet
Corman, Landt, Kaiser, Detection of 2019 novel coronavirus (2019-nCoV) by real-time RT-PCR, Euro Surveill
Cortegiani, Ingoglia, Ippolito, Giarratano, Einav, A systematic review on the efficacy and safety of chloroquine for the treatment of COVID-19, J Crit Care
De Lamballerie, Boisson, Reynier, On chikungunya acute infection and chloroquine treatment, Vector Borne Zoonotic Dis
Gao, Tian, Yang, Breakthrough: chloroquine phosphate has shown apparent efficacy in treatment of COVID-19 associated pneumonia in clinical studies, Biosci Trends
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
Hinton, Fda, None
Huang, Wang, Li, Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China, Lancet
Keyaerts, Vijgen, Maes, Neyts, Van Ranst, In vitro inhibition of severe acute respiratory syndrome coronavirus by chloroquine, Biochem Biophys Res Commun
Kim, Sparks, Liew, A rush to judgment? Rapid reporting and dissemination of results and its consequences regarding the use of hydroxychloroquine for COVID-19, Ann Intern Med
Liu, Cao, Xu, Hydroxychloroquine, a less toxic derivative of chloroquine, is effective in inhibiting SARS-CoV-2 infection in vitro, Cell Discov
Molina, Delaugerre, Goff, No evidence of rapid antiviral clearance or clinical benefit with the combination of hydroxychloroquine and azithromycin in patients with severe COVID-19 infection, Med Mal Infect
Paton, Lee, Xu, Chloroquine for influenza prevention: a randomised, double-blind, placebo controlled trial, Lancet Infect Dis
Pirracchio, Resche-Rigon, Chevret, Evaluation of the propensity score methods for estimating marginal odds ratios in case of small sample size, BMC Med Res Methodol
Touret, De Lamballerie, Of chloroquine and COVID-19, Antiviral Res
Wang, Tang, Wei, Updated understanding of the outbreak of 2019 novel coronavirus (2019-nCoV) in Wuhan, China, J Med Virol
Wu, Mcgoogan, Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China: summary of a report of 72 314 cases from the Chinese Center for Disease Control and Prevention, JAMA
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
Yazdany, Kim, Use of hydroxychloroquine and chloroquine during the COVID-19 pandemic: what every clinician should know, Ann Intern Med
Zheng, Ma, Zhang, Xie, COVID-19 and the cardiovascular system, Nat Rev Cardiol
DOI record:
{
"DOI": "10.1093/cid/ciaa791",
"ISSN": [
"1058-4838",
"1537-6591"
],
"URL": "http://dx.doi.org/10.1093/cid/ciaa791",
"abstract": "<jats:title>Abstract</jats:title>\n <jats:sec>\n <jats:title>Background</jats:title>\n <jats:p>Data from nonrandomized studies have suggested that hydroxychloroquine could be an effective therapeutic agent against coronavirus disease 2019 (COVID-19).</jats:p>\n </jats:sec>\n <jats:sec>\n <jats:title>Methods</jats:title>\n <jats:p>We conducted an observational, retrospective cohort study involving hospitalized adult patients with confirmed, mild to severe COVID-19 in a French university hospital. Patients who received hydroxychloroquine (200 mg 3 times daily dosage for 10 days) on a compassionate basis in addition to standard of care (SOC) were compared with patients without contraindications to hydroxychloroquine who received SOC alone. A propensity score-weighted analysis was performed to control for confounders: age, sex, time between symptom onset and admission ≤ 7 days, Charlson comorbidity index, medical history of arterial hypertension, obesity, National Early Warning Score 2 (NEWS2) score at admission, and pneumonia severity. The primary endpoint was time to unfavorable outcome, defined as: death, admission to an intensive care unit, or decision to withdraw or withhold life-sustaining treatments, whichever came first.</jats:p>\n </jats:sec>\n <jats:sec>\n <jats:title>Results</jats:title>\n <jats:p>Data from 89 patients with laboratory-confirmed COVID-19 were analyzed, 84 of whom were considered in the primary analysis; 38 patients treated with hydroxychloroquine and 46 patients treated with SOC alone. At admission, the mean age of patients was 66 years, the median Charlson comorbidity index was 3, and the median NEWS2 severity score was 3. After propensity score weighting, treatment with hydroxychloroquine was not associated with a significantly reduced risk of unfavorable outcome (hazard ratio, 0.90 [95% confidence interval, .38–2.1], P = .81). Overall survival was not significantly different between the 2 groups (hazard ratio, 0.89 [0.23; 3.47], P = 1).</jats:p>\n </jats:sec>\n <jats:sec>\n <jats:title>Conclusion</jats:title>\n <jats:p>In hospitalized adults with COVID-19, no significant reduction of the risk of unfavorable outcomes was observed with hydroxychloroquine in comparison to SOC. Unmeasured confounders may have persisted however, despite careful propensity-weighted analysis and the study might be underpowered. Ongoing controlled trials in patients with varying degrees of initial severity on a larger scale will help determine whether there is a place for hydroxychloroquine in the treatment of COVID-19. In hospitalized adults with COVID-19, no significant reduction of the risk of unfavorable outcomes was observed with hydroxychloroquine in comparison to SOC.</jats:p>\n </jats:sec>",
"author": [
{
"affiliation": [
{
"name": "Assistance Publique — Hôpitaux de Paris, Hôpitaux Universitaires Pitié-Salpêtrière Charles Foix, Service de Maladies infectieuses et Tropicales, Paris, France"
}
],
"family": "Paccoud",
"given": "Olivier",
"sequence": "first"
},
{
"affiliation": [
{
"name": "Sorbonne Université, INSERM UMR 1136, Département de Santé Publique, Unité de Recherche Clinique Pitié Salpêtrière — Charles Foix, Centre de Pharmaco-épidémiologie de l’AP-HP, Hôpitaux Universitaires Pitié-Salpêtrière Charles Foix, Paris, France"
}
],
"family": "Tubach",
"given": "Florence",
"sequence": "additional"
},
{
"affiliation": [
{
"name": "Sorbonne Université, INSERM UMR 1136, Département de Santé Publique, Unité de Recherche Clinique Pitié Salpêtrière — Charles Foix, Centre de Pharmaco-épidémiologie de l’AP-HP, Hôpitaux Universitaires Pitié-Salpêtrière Charles Foix, Paris, France"
}
],
"family": "Baptiste",
"given": "Amandine",
"sequence": "additional"
},
{
"affiliation": [
{
"name": "Assistance Publique — Hôpitaux de Paris, Hôpitaux Universitaires Pitié-Salpêtrière Charles Foix, Service de Maladies infectieuses et Tropicales, Paris, France"
}
],
"family": "Bleibtreu",
"given": "Alexandre",
"sequence": "additional"
},
{
"affiliation": [
{
"name": "Sorbonne Université, INSERM UMR 1136, Département de Santé Publique, Unité de Recherche Clinique Pitié Salpêtrière — Charles Foix, Centre de Pharmaco-épidémiologie de l’AP-HP, Hôpitaux Universitaires Pitié-Salpêtrière Charles Foix, Paris, France"
}
],
"family": "Hajage",
"given": "David",
"sequence": "additional"
},
{
"affiliation": [
{
"name": "Assistance Publique — Hôpitaux de Paris, Hôpitaux Universitaires Pitié-Salpêtrière Charles Foix, Service de Maladies infectieuses et Tropicales, Paris, France"
}
],
"family": "Monsel",
"given": "Gentiane",
"sequence": "additional"
},
{
"affiliation": [
{
"name": "Assistance Publique — Hôpitaux de Paris, Hôpitaux Universitaires Pitié-Salpêtrière Charles Foix, Service de Maladies infectieuses et Tropicales, Paris, France"
}
],
"family": "Tebano",
"given": "Gianpiero",
"sequence": "additional"
},
{
"affiliation": [
{
"name": "Sorbonne Université, INSERM, Institut Pierre Louis d’Epidémiologie et de Santé Publique, AP-HP, Hôpitaux Universitaires Pitié-Salpêtrière—Charles Foix, laboratoire de virologie, Paris, France"
},
{
"name": "Sorbonne Université, INSERM 1136, Institut Pierre Louis d’Epidémiologie et de Santé Publique, Paris, France"
}
],
"family": "Boutolleau",
"given": "David",
"sequence": "additional"
},
{
"affiliation": [
{
"name": "Assistance Publique — Hôpitaux de Paris, Hôpitaux Universitaires Pitié-Salpêtrière Charles Foix, Service de Maladies infectieuses et Tropicales, Paris, France"
}
],
"family": "Klement",
"given": "Elise",
"sequence": "additional"
},
{
"affiliation": [
{
"name": "Assistance Publique — Hôpitaux de Paris, Hôpitaux Universitaires Pitié-Salpêtrière Charles Foix, Service de Maladies infectieuses et Tropicales, Paris, France"
}
],
"family": "Godefroy",
"given": "Nagisa",
"sequence": "additional"
},
{
"affiliation": [
{
"name": "Assistance Publique — Hôpitaux de Paris, Hôpitaux Universitaires Pitié-Salpêtrière Charles Foix, Service de Maladies infectieuses et Tropicales, Paris, France"
}
],
"family": "Palich",
"given": "Romain",
"sequence": "additional"
},
{
"affiliation": [
{
"name": "Assistance Publique — Hôpitaux de Paris, Hôpitaux Universitaires Pitié-Salpêtrière Charles Foix, Service de Maladies infectieuses et Tropicales, Paris, France"
}
],
"family": "Itani",
"given": "Oula",
"sequence": "additional"
},
{
"affiliation": [
{
"name": "Assistance Publique — Hôpitaux de Paris, Hôpitaux Universitaires Pitié-Salpêtrière Charles Foix, Service de Maladies infectieuses et Tropicales, Paris, France"
}
],
"family": "Faiçal",
"given": "Antoine",
"sequence": "additional"
},
{
"affiliation": [
{
"name": "Assistance Publique — Hôpitaux de Paris, Hôpitaux Universitaires Pitié-Salpêtrière Charles Foix, Service de Maladies infectieuses et Tropicales, Paris, France"
}
],
"family": "Valantin",
"given": "Marc-Antoine",
"sequence": "additional"
},
{
"affiliation": [
{
"name": "Assistance Publique — Hôpitaux de Paris, Hôpitaux Universitaires Pitié-Salpêtrière Charles Foix, Service de Maladies infectieuses et Tropicales, Paris, France"
}
],
"family": "Tubiana",
"given": "Roland",
"sequence": "additional"
},
{
"affiliation": [
{
"name": "Sorbonne Université, INSERM, Institut Pierre Louis d’Epidémiologie et de Santé Publique, AP-HP, Hôpitaux Universitaires Pitié-Salpêtrière—Charles Foix, laboratoire de virologie, Paris, France"
},
{
"name": "Sorbonne Université, INSERM 1136, Institut Pierre Louis d’Epidémiologie et de Santé Publique, Paris, France"
}
],
"family": "Burrel",
"given": "Sonia",
"sequence": "additional"
},
{
"affiliation": [
{
"name": "Sorbonne Université, INSERM, Institut Pierre Louis d’Epidémiologie et de Santé Publique, AP-HP, Hôpitaux Universitaires Pitié-Salpêtrière—Charles Foix, laboratoire de virologie, Paris, France"
},
{
"name": "Sorbonne Université, INSERM 1136, Institut Pierre Louis d’Epidémiologie et de Santé Publique, Paris, France"
}
],
"family": "Calvez",
"given": "Vincent",
"sequence": "additional"
},
{
"affiliation": [
{
"name": "Assistance Publique — Hôpitaux de Paris, Hôpitaux Universitaires Pitié-Salpêtrière Charles Foix, Service de Maladies infectieuses et Tropicales, Paris, France"
},
{
"name": "Sorbonne Université, INSERM 1136, Institut Pierre Louis d’Epidémiologie et de Santé Publique, Paris, France"
}
],
"family": "Caumes",
"given": "Eric",
"sequence": "additional"
},
{
"affiliation": [
{
"name": "Sorbonne Université, INSERM, Institut Pierre Louis d’Epidémiologie et de Santé Publique, AP-HP, Hôpitaux Universitaires Pitié-Salpêtrière—Charles Foix, laboratoire de virologie, Paris, France"
},
{
"name": "Sorbonne Université, INSERM 1136, Institut Pierre Louis d’Epidémiologie et de Santé Publique, Paris, France"
}
],
"family": "Marcelin",
"given": "Anne-Geneviève",
"sequence": "additional"
},
{
"ORCID": "http://orcid.org/0000-0001-7378-2179",
"affiliation": [
{
"name": "Assistance Publique — Hôpitaux de Paris, Hôpitaux Universitaires Pitié-Salpêtrière Charles Foix, Service de Maladies infectieuses et Tropicales, Paris, France"
},
{
"name": "Sorbonne Université, INSERM 1136, Institut Pierre Louis d’Epidémiologie et de Santé Publique, Paris, France"
}
],
"authenticated-orcid": false,
"family": "Pourcher",
"given": "Valérie",
"sequence": "additional"
}
],
"container-title": "Clinical Infectious Diseases",
"content-domain": {
"crossmark-restriction": false,
"domain": []
},
"created": {
"date-parts": [
[
2020,
6,
11
]
],
"date-time": "2020-06-11T19:11:39Z",
"timestamp": 1591902699000
},
"deposited": {
"date-parts": [
[
2021,
12,
10
]
],
"date-time": "2021-12-10T11:26:56Z",
"timestamp": 1639135616000
},
"indexed": {
"date-parts": [
[
2024,
2,
8
]
],
"date-time": "2024-02-08T18:10:29Z",
"timestamp": 1707415829611
},
"is-referenced-by-count": 30,
"issue": "11",
"issued": {
"date-parts": [
[
2020,
6,
18
]
]
},
"journal-issue": {
"issue": "11",
"published-online": {
"date-parts": [
[
2020,
6,
18
]
]
},
"published-print": {
"date-parts": [
[
2021,
12,
6
]
]
}
},
"language": "en",
"license": [
{
"URL": "https://academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model",
"content-version": "vor",
"delay-in-days": 0,
"start": {
"date-parts": [
[
2020,
6,
18
]
],
"date-time": "2020-06-18T00:00:00Z",
"timestamp": 1592438400000
}
}
],
"link": [
{
"URL": "http://academic.oup.com/cid/advance-article-pdf/doi/10.1093/cid/ciaa791/36651585/ciaa791.pdf",
"content-type": "application/pdf",
"content-version": "am",
"intended-application": "syndication"
},
{
"URL": "https://academic.oup.com/cid/article-pdf/73/11/e4064/41608133/ciaa791.pdf",
"content-type": "application/pdf",
"content-version": "vor",
"intended-application": "syndication"
},
{
"URL": "https://academic.oup.com/cid/article-pdf/73/11/e4064/41608133/ciaa791.pdf",
"content-type": "unspecified",
"content-version": "vor",
"intended-application": "similarity-checking"
}
],
"member": "286",
"original-title": [],
"page": "e4064-e4072",
"prefix": "10.1093",
"published": {
"date-parts": [
[
2020,
6,
18
]
]
},
"published-online": {
"date-parts": [
[
2020,
6,
18
]
]
},
"published-other": {
"date-parts": [
[
2021,
12,
1
]
]
},
"published-print": {
"date-parts": [
[
2021,
12,
6
]
]
},
"publisher": "Oxford University Press (OUP)",
"reference": [
{
"DOI": "10.1016/S0140-6736(20)30211-7",
"article-title": "Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study",
"author": "Chen",
"doi-asserted-by": "crossref",
"first-page": "507",
"journal-title": "Lancet",
"key": "2021121011162656000_CIT0001",
"volume": "395",
"year": "2020"
},
{
"DOI": "10.1016/S0140-6736(20)30183-5",
"article-title": "Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China",
"author": "Huang",
"doi-asserted-by": "crossref",
"first-page": "497",
"journal-title": "Lancet",
"key": "2021121011162656000_CIT0002",
"volume": "395",
"year": "2020"
},
{
"DOI": "10.1002/jmv.25689",
"article-title": "Updated understanding of the outbreak of 2019 novel coronavirus (2019-nCoV) in Wuhan, China",
"author": "Wang",
"doi-asserted-by": "crossref",
"first-page": "441",
"journal-title": "J Med Virol",
"key": "2021121011162656000_CIT0003",
"volume": "92",
"year": "2020"
},
{
"DOI": "10.1001/jama.2020.2648",
"article-title": "Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China: summary of a report of 72 314 cases from the Chinese Center for Disease Control and Prevention",
"author": "Wu",
"doi-asserted-by": "crossref",
"first-page": "1239",
"journal-title": "JAMA",
"key": "2021121011162656000_CIT0004",
"volume": "323",
"year": "2020"
},
{
"author": "Hinton",
"key": "2021121011162656000_CIT0005"
},
{
"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)",
"author": "Yao",
"doi-asserted-by": "crossref",
"first-page": "732",
"journal-title": "Clin Infect Dis",
"key": "2021121011162656000_CIT0006",
"volume": "71",
"year": "2020"
},
{
"DOI": "10.1038/s41421-020-0156-0",
"article-title": "Hydroxychloroquine, a less toxic derivative of chloroquine, is effective in inhibiting SARS-CoV-2 infection in vitro",
"author": "Liu",
"doi-asserted-by": "crossref",
"first-page": "16",
"journal-title": "Cell Discov",
"key": "2021121011162656000_CIT0007",
"volume": "6",
"year": "2020"
},
{
"DOI": "10.5582/bst.2020.01047",
"article-title": "Breakthrough: chloroquine phosphate has shown apparent efficacy in treatment of COVID-19 associated pneumonia in clinical studies",
"author": "Gao",
"doi-asserted-by": "crossref",
"first-page": "72",
"journal-title": "Biosci Trends",
"key": "2021121011162656000_CIT0008",
"volume": "14",
"year": "2020"
},
{
"author": "Chinese Clinical Trial registry",
"key": "2021121011162656000_CIT0009"
},
{
"author": "A pilot study of hydroxychloroquine in treatment of patients with common coronavirus disease-19 (COVID-19)",
"key": "2021121011162656000_CIT0010"
},
{
"DOI": "10.1016/j.jcrc.2020.03.005",
"article-title": "A systematic review on the efficacy and safety of chloroquine for the treatment of COVID-19",
"author": "Cortegiani",
"doi-asserted-by": "crossref",
"first-page": "279",
"journal-title": "J Crit Care",
"key": "2021121011162656000_CIT0011",
"volume": "57",
"year": "2020"
},
{
"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",
"doi-asserted-by": "crossref",
"first-page": "105949",
"journal-title": "Int J Antimicrob Agents",
"key": "2021121011162656000_CIT0012",
"volume": "56",
"year": "2020"
},
{
"author": "Liverpool COVID-19 Interactions [Preprint].",
"key": "2021121011162656000_CIT0013"
},
{
"DOI": "10.2807/1560-7917.ES.2020.25.3.2000045",
"article-title": "Detection of 2019 novel coronavirus (2019-nCoV) by real-time RT-PCR",
"author": "Corman",
"doi-asserted-by": "crossref",
"first-page": "2000045",
"journal-title": "Euro Surveill",
"key": "2021121011162656000_CIT0014",
"volume": "25",
"year": "2020"
},
{
"DOI": "10.1016/0021-9681(87)90171-8",
"article-title": "A new method of classifying prognostic comorbidity in longitudinal studies: development and validation",
"author": "Charlson",
"doi-asserted-by": "crossref",
"first-page": "373",
"journal-title": "J Chronic Dis",
"key": "2021121011162656000_CIT0015",
"volume": "40",
"year": "1987"
},
{
"author": "National Early Warning Score (NEWS) 2 | RCP London [Preprint]",
"key": "2021121011162656000_CIT0016"
},
{
"DOI": "10.1002/sim.6607",
"article-title": "Moving towards best practice when using inverse probability of treatment weighting (IPTW) using the propensity score to estimate causal treatment effects in observational studies",
"author": "Austin",
"doi-asserted-by": "crossref",
"first-page": "3661",
"journal-title": "Stat Med",
"key": "2021121011162656000_CIT0017",
"volume": "34",
"year": "2015"
},
{
"DOI": "10.7326/M20-1334",
"article-title": "Use of hydroxychloroquine and chloroquine during the COVID-19 pandemic: what every clinician should know",
"author": "Yazdany",
"doi-asserted-by": "crossref",
"first-page": "754",
"journal-title": "Ann Intern Med",
"key": "2021121011162656000_CIT0018",
"volume": "172",
"year": "2020"
},
{
"DOI": "10.7326/M20-1223",
"article-title": "A rush to judgment? Rapid reporting and dissemination of results and its consequences regarding the use of hydroxychloroquine for COVID-19",
"author": "Kim",
"doi-asserted-by": "crossref",
"first-page": "819",
"journal-title": "Ann Intern Med",
"key": "2021121011162656000_CIT0019",
"volume": "172",
"year": "2020"
},
{
"DOI": "10.1016/j.medmal.2020.03.006",
"article-title": "No evidence of rapid antiviral clearance or clinical benefit with the combination of hydroxychloroquine and azithromycin in patients with severe COVID-19 infection",
"author": "Molina",
"doi-asserted-by": "crossref",
"first-page": "384",
"journal-title": "Med Mal Infect",
"key": "2021121011162656000_CIT0020",
"volume": "50",
"year": "2020"
},
{
"DOI": "10.1186/1471-2288-12-70",
"article-title": "Evaluation of the propensity score methods for estimating marginal odds ratios in case of small sample size",
"author": "Pirracchio",
"doi-asserted-by": "crossref",
"first-page": "70",
"journal-title": "BMC Med Res Methodol",
"key": "2021121011162656000_CIT0021",
"volume": "12",
"year": "2012"
},
{
"DOI": "10.1016/j.antiviral.2020.104762",
"article-title": "Of chloroquine and COVID-19",
"author": "Touret",
"doi-asserted-by": "crossref",
"first-page": "104762",
"journal-title": "Antiviral Res",
"key": "2021121011162656000_CIT0022",
"volume": "177",
"year": "2020"
},
{
"DOI": "10.1016/j.bbrc.2004.08.085",
"article-title": "In vitro inhibition of severe acute respiratory syndrome coronavirus by chloroquine",
"author": "Keyaerts",
"doi-asserted-by": "crossref",
"first-page": "264",
"journal-title": "Biochem Biophys Res Commun",
"key": "2021121011162656000_CIT0023",
"volume": "323",
"year": "2004"
},
{
"DOI": "10.1016/S1473-3099(11)70065-2",
"article-title": "Chloroquine for influenza prevention: a randomised, double-blind, placebo controlled trial",
"author": "Paton",
"doi-asserted-by": "crossref",
"first-page": "677",
"journal-title": "Lancet Infect Dis",
"key": "2021121011162656000_CIT0024",
"volume": "11",
"year": "2011"
},
{
"DOI": "10.1089/vbz.2008.0049",
"article-title": "On chikungunya acute infection and chloroquine treatment",
"author": "De Lamballerie",
"doi-asserted-by": "crossref",
"first-page": "837",
"journal-title": "Vector Borne Zoonotic Dis",
"key": "2021121011162656000_CIT0025",
"volume": "8",
"year": "2008"
},
{
"author": "Institut National de la Santé Et de la Recherche Médicale, France. Multi-centre, adaptive, randomized trial of the safety and efficacy of treatments of COVID-19 in hospitalized adults [Internet].",
"key": "2021121011162656000_CIT0026"
},
{
"DOI": "10.1038/s41569-020-0360-5",
"article-title": "COVID-19 and the cardiovascular system",
"author": "Zheng",
"doi-asserted-by": "crossref",
"first-page": "259",
"journal-title": "Nat Rev Cardiol",
"key": "2021121011162656000_CIT0027",
"volume": "17",
"year": "2020"
}
],
"reference-count": 27,
"references-count": 27,
"relation": {},
"resource": {
"primary": {
"URL": "https://academic.oup.com/cid/article/73/11/e4064/5859555"
}
},
"score": 1,
"short-title": [],
"source": "Crossref",
"subject": [
"Infectious Diseases",
"Microbiology (medical)"
],
"subtitle": [],
"title": "Compassionate Use of Hydroxychloroquine in Clinical Practice for Patients With Mild to Severe COVID-19 in a French University Hospital",
"type": "journal-article",
"volume": "73"
}
