Lack of efficacy of hydroxychloroquine and azithromycin in patients hospitalized for COVID-19 pneumonia: A retrospective study
Saib et al.
, Lack of efficacy of hydroxychloroquine and azithromycin in patients hospitalized for COVID-19 pneumonia: A..
, PLOS ONE, doi:10.1371/journal.pone.0252388
203 hospitalized patients in France, not showing significant differences with treatment. Confounding by indication
is likely. Authors do not discuss confounding.
This study is excluded in the after exclusion results of meta
substantial unadjusted confounding by indication
risk of death/intubation, 125.0% higher, RR 2.25, p = 0.23, treatment 9 of 52 (17.3%), control 4 of 52 (7.7%), PSM.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Saib et al., 9 Jun 2021, prospective, propensity score matching, France, peer-reviewed, 9 authors, average treatment delay 7.2 days.
Abstract: PLOS ONE
Lack of efficacy of hydroxychloroquine and
azithromycin in patients hospitalized for
COVID-19 pneumonia: A retrospective study
Anis Saib1, Walid Amara1, Pascal Wang ID2, Simon Cattan1, Azeddine Dellal3,
Kais Regaieg4, Stephane Nahon5, Olivier Nallet1, Lee S. Nguyen ID6*
1 Cardiology Department, Groupe Hospitalier Intercommunal Le Raincy-Montfermeil, Montfermeil, France,
2 Pneumology Department, Groupe Hospitalier Intercommunal Le Raincy-Montfermeil, Montfermeil, France,
3 Rheumatology Department, Groupe Hospitalier Intercommunal Le Raincy-Montfermeil, Montfermeil,
France, 4 Intensive Care Medicine Department, Groupe Hospitalier Intercommunal Le Raincy-Montfermeil,
Montfermeil, France, 5 Gastroenterology Department, Groupe Hospitalier Intercommunal Le RaincyMontfermeil, Montfermeil, France, 6 Research & Innovation Department (RICAP), CMC Ambroise Paré,
Citation: Saib A, Amara W, Wang P, Cattan S,
Dellal A, Regaieg K, et al. (2021) Lack of efficacy of
hydroxychloroquine and azithromycin in patients
hospitalized for COVID-19 pneumonia: A
retrospective study. PLoS ONE 16(6): e0252388.
Editor: Andrea Cortegiani, University of Palermo,
Received: January 14, 2021
Accepted: May 17, 2021
Published: June 9, 2021
Copyright: © 2021 Saib et al. This is an open
access article distributed under the terms of the
Creative Commons Attribution License, which
permits unrestricted use, distribution, and
reproduction in any medium, provided the original
author and source are credited.
Data Availability Statement: All relevant data are
within the manuscript and its Supporting
Funding: The author(s) received no specific
funding for this work.
Competing interests: The authors have declared
that no competing interests exist.
Hydroxychloroquine combined with azithromycin (HCQ/AZI) has initially been used against
coronavirus disease-2019 (COVID-19). In this retrospective study, we assessed the clinical
effects of HCQ/AZI, with a 28-days follow-up.
In a registry-study which included patients hospitalized for COVID-19 between March 15
and April 2, 2020, we compared patients who received HCQ/AZI to those who did not,
regarding a composite outcome of mortality and mechanical ventilation with a 28-days follow-up. QT was monitored for patients treated with HCQ/AZI. Were excluded patients in
intensive care units, palliative care and ventilated within 24 hours of admission. Three analyses were performed to adjust for selection bias: propensity score matching, multivariable
survival, and inverse probability score weighting (IPSW) analyses.
Overall, 203 patients were included: 60 patients treated by HCQ/AZI and 143 control
patients. During the 28-days follow-up, 32 (16.3%) patients presented the primary outcome
and 23 (12.3%) patients died. Propensity-score matching identified 52 unique pairs of
patients with similar characteristics. In the matched cohort (n = 104), HCQ/AZI was not
associated with the primary composite outcome (log-rank p-value = 0.16). In the overall
cohort (n = 203), survival and IPSW analyses also found no benefit from HCQ/AZI. In the
HCQ/AZI group, 11 (18.3%) patients prolonged QT interval duration, requiring treatment
PLOS ONE | https://doi.org/10.1371/journal.pone.0252388 June 9,..
is less effective
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