Effect of Hydroxychloroquine in Hospitalized Patients with Covid-19
Peter Horby, M.D Marion Mafham, Louise Linsell, D Phil, M.Sc Jennifer L Bell, Ph.D Natalie Staplin, Ph.D Jona- Than R Emberson, Ph.D Martin Wiselka, Ph.D Andrew Ustianowski, Einas Elmahi, M Phil, Benjamin Prudon, Tony Whitehouse, Ph.D Timothy Fel- Ton, John Williams, M.D Jakki Faccenda, Ph.D Jonathan Underwood, M.D J Kenneth Baillie, Ph.D Lucy C Chappell, Ph.D Saul N Faust, F.R.C.P.C.H Thomas Jaki, Ph.D Katie Jeffery, Ph.D Wei Shen Lim, Ph.D Alan Montgomery, Ph.D Kathryn Rowan, Ph.D Joel Tarning, James A Wat- Son, Nicholas J White, M.Sc Ed- Mund Juszczak, Richard Haynes, Ph.D Martin J Landray, Mafham Drs Horby, Prof Linsell Juszczak, Dr Haynes, Dr Landray
New England Journal of Medicine, doi:10.1056/nejmoa2022926
This is the New England Journal of Medicine version of record, which includes all Journal editing and enhancements. The Author Final Manuscript, which is the author's version after external peer review and before publication in the Journal, is available under a CC BY license at PMC7556338.
A data sharing statement provided by the authors is available with the full text of this article at NEJM.org. We thank the thousands of patients who participated in this trial; the doctors, nurses, pharmacists, other allied health professionals, and research administrators at 176 NHS hospitals across the United Kingdom who were assisted by the NIHR Clinical Research Network, NHS DigiTrials, Public Health England, the Department of Health and Social Care, the Intensive Care National Audit and Research Centre, Public Health Scotland, National Records Service of Scotland, the Secure Anonymised Information Linkage at University of Swansea, and the NHS in England, Scotland, Wales, and Northern Ireland; and the members of the independent data monitoring committee: Peter Sandercock, Janet Darbyshire, David DeMets, Robert Fowler, David Lalloo, Ian Roberts, and Janet Wittes.
Appendix The authors' full names and academic degrees are as follows: The RECOVERY Collaborative GroupPeter Horby, F.
References
Abate, Ali, Mantfardo, Basu, Rate of intensive care unit admission and outcomes among patients with coronavirus: a systematic review and meta-analysis, PLoS One
Armstrong, Kane, Cook, Outcomes from intensive care in patients with COVID-19: a systematic review and meta-analysis of observational studies, Anaesthesia
Austin, Okour, Evaluation of potential therapeutic options for COVID-19, J Clin Pharmacol
Borba, Val, Sampaio, Effect of high vs low doses of chloroquine diphosphate as adjunctive therapy for patients hospitalized with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection: a randomized clinical trial, JAMA Netw Open
Cao, Tu, Cheng, Clinical features and short-term outcomes of 102 patients with coronavirus disease 2019 in Wuhan, China, Clin Infect Dis
Carmichael, Charles, Tett, Population pharmacokinetics of hydroxychloroquine in patients with rheumatoid arthritis, Ther Drug Monit
Cavalcanti, Zampieri, Rosa, Hydroxychloroquine with or without azithromycin in mild-to-moderate Covid-19, N Engl J Med
Chen, Liu, Liu, A pilot study of hydroxychloroquine in treatment of patients with moderate COVID-19, Zhejiang Da Xue Xue Bao Yi Xue Ban
Chen, Zhou, Dong, Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study, Lancet
Dagens, Sigfrid, Cai, Scope, quality, and inclusivity of clinical guidelines produced early in the covid-19 pandemic: rapid review, BMJ
Fantini, Chahinian, Yahi, Synergistic antiviral effect of hydroxychloroquine and azithromycin in combination against SARS-CoV-2: what molecular dynamics studies of virus-host interactions reveal, Int J Antimicrob Agents
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
Gautret, Lagier, Parola, The New England Journal of Medicine
Geleris, Sun, Platt, Observational study of hydroxychloroquine in hospitalized patients with Covid-19, N Engl J Med
Huang, Tang, Pang, Treating COVID-19 with chloroquine, J Mol Cell Biol
Keyaerts, Vijgen, Maes, Neyts, Van Ranst, In vitro inhibition of severe acute respiratory syndrome coronavirus by chloroquine, Biochem Biophys Res Commun
Knight, Ho, Pius, Risk stratification of patients admitted to hospital with covid-19 using the ISARIC WHO Clinical Characterisation Protocol: development and validation of the 4C Mortality Score, BMJ
Lenzer, Covid-19: US gives emergency approval to hydroxychloroquine despite lack of evidence
Lu, Zhao, Li, Genomic characterisation and epidemiology of 2019 novel coronavirus: implications for virus origins and receptor binding, Lancet
Mahévas, Tran, Roumier, Clinical efficacy of hydroxychloroquine in patients with covid-19 pneumonia who require oxygen: observational comparative study using routine care data, BMJ
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
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
Rodrigo, Fernando, Rajapakse, Clinical evidence for repurposing chloroquine and hydroxychloroquine as antiviral agents: a systematic review, Clin Microbiol Infect
Ruan, Yang, Wang, Jiang, Song, Clinical predictors of mortality due to COVID-19 based on an analysis of data of 150 patients from Wuhan, China, Intensive Care Med
Tang, Cao, Han, Hydroxychloroquine in patients with mainly mild to moderate coronavirus disease 2019: open label, randomised controlled trial, BMJ
Verity, Okell, Dorigatti, Estimates of the severity of coronavirus disease 2019: a model-based analysis, Lancet Infect Dis
Vincent, Bergeron, Benjannet, Chloroquine is a potent inhibitor of SARS coronavirus infection and spread, Virol J
Wang, Cao, Zhang, Remdesivir and chloroquine effectively inhibit the recently emerged novel coronavirus (2019-nCoV) in vitro, Cell Res
Watson, Tarning, Hoglund, Concentration-dependent mortality of chloroquine in overdose, Elife
White, Watson, Hoglund, Chan, Cheah et al., COVID-19 prevention and treatment: a critical analysis of chloroquine and hydroxychloroquine clinical pharmacology, PLoS Med
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
Zhou, Yang, Wang, A pneumonia outbreak associated with a new coronavirus of probable bat origin, Nature
Zhou, Yu, Du, Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study, Lancet
Zhu, Zhang, Wang, A novel coronavirus from patients with pneumonia in China, 2019, N Engl J Med
