Lack of efficacy of hydroxychloroquine and azithromycin in patients hospitalized for COVID-19 pneumonia: A retrospective study

{ 'indexed': { 'date-parts': [[2023, 10, 12]], 'date-time': '2023-10-12T00:59:58Z', 'timestamp': 1697072398745}, 'reference-count': 32, 'publisher': 'Public Library of Science (PLoS)', 'issue': '6', 'license': [ { 'start': { 'date-parts': [[2021, 6, 9]], 'date-time': '2021-06-09T00:00:00Z', 'timestamp': 1623196800000}, 'content-version': 'vor', 'delay-in-days': 0, 'URL': 'http://creativecommons.org/licenses/by/4.0/'}], 'content-domain': {'domain': ['www.plosone.org'], 'crossmark-restriction': False}, 'abstract': '<jats:sec id="sec001">\n' '<jats:title>Background</jats:title>\n' '<jats:p>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.</jats:p>\n' '</jats:sec>\n' '<jats:sec id="sec002">\n' '<jats:title>Methods</jats:title>\n' '<jats:p>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.</jats:p>\n' '</jats:sec>\n' '<jats:sec id="sec003">\n' '<jats:title>Results</jats:title>\n' '<jats:p>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 cessation.</jats:p>\n' '</jats:sec>\n' '<jats:sec id="sec004">\n' '<jats:title>Conclusions</jats:title>\n' '<jats:p>HCQ/AZI combination therapy was not associated with lower in-hospital mortality and ' 'mechanical ventilation rate, with a 28-days follow-up. In the HCQ/AZI group, 18.3% of ' 'patients presented a prolonged QT interval requiring treatment cessation, however, control ' 'group was not monitored for this adverse event, making comparison impossible.</jats:p>\n' '</jats:sec>', 'DOI': '10.1371/journal.pone.0252388', 'type': 'journal-article', 'created': {'date-parts': [[2021, 6, 9]], 'date-time': '2021-06-09T18:11:20Z', 'timestamp': 1623262280000}, 'page': 'e0252388', 'update-policy': 'http://dx.doi.org/10.1371/journal.pone.corrections_policy', 'source': 'Crossref', 'is-referenced-by-count': 5, 'title': 'Lack of efficacy of hydroxychloroquine and azithromycin in patients hospitalized for COVID-19 ' 'pneumonia: A retrospective study', 'prefix': '10.1371', 'volume': '16', 'author': [ {'given': 'Anis', 'family': 'Saib', 'sequence': 'first', 'affiliation': []}, {'given': 'Walid', 'family': 'Amara', 'sequence': 'additional', 'affiliation': []}, { 'ORCID': 'http://orcid.org/0000-0002-4057-3765', 'authenticated-orcid': True, 'given': 'Pascal', 'family': 'Wang', 'sequence': 'additional', 'affiliation': []}, {'given': 'Simon', 'family': 'Cattan', 'sequence': 'additional', 'affiliation': []}, {'given': 'Azeddine', 'family': 'Dellal', 'sequence': 'additional', 'affiliation': []}, {'given': 'Kais', 'family': 'Regaieg', 'sequence': 'additional', 'affiliation': []}, {'given': 'Stephane', 'family': 'Nahon', 'sequence': 'additional', 'affiliation': []}, {'given': 'Olivier', 'family': 'Nallet', 'sequence': 'additional', 'affiliation': []}, { 'ORCID': 'http://orcid.org/0000-0002-6014-6269', 'authenticated-orcid': True, 'given': 'Lee S.', 'family': 'Nguyen', 'sequence': 'additional', 'affiliation': []}], 'member': '340', 'published-online': {'date-parts': [[2021, 6, 9]]}, 'reference': [ { 'key': 'pone.0252388.ref001', 'article-title': 'Use of Hydroxychloroquine and Chloroquine During the COVID-19 Pandemic: ' 'What Every Clinician Should Know', 'author': 'J Yazdany', 'year': '2020', 'journal-title': 'Ann Intern Med'}, { 'key': 'pone.0252388.ref002', 'first-page': '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': 'X Yao', 'year': '2020', 'journal-title': 'Clinical Infectious Diseases'}, { 'issue': '3', 'key': 'pone.0252388.ref003', 'doi-asserted-by': 'crossref', 'first-page': '269', 'DOI': '10.1038/s41422-020-0282-0', 'article-title': 'Remdesivir and chloroquine effectively inhibit the recently emerged ' 'novel coronavirus (2019-nCoV) in vitro.', 'volume': '30', 'author': 'M Wang', 'year': '2020', 'journal-title': 'Cell Res'}, { 'key': 'pone.0252388.ref004', 'article-title': 'Hydroxychloroquine and azithromycin as a treatment of COVID-19: results ' 'of an open-label non-randomized clinical trial', 'author': 'P Gautret', 'year': '2020', 'journal-title': 'Int J Antimicrob Agents'}, { 'key': 'pone.0252388.ref005', 'doi-asserted-by': 'crossref', 'first-page': '176', 'DOI': '10.1016/j.jcrc.2020.06.019', 'article-title': 'Update I. 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'https://dx.plos.org/10.1371/journal.pone.0252388'}}, 'subtitle': [], 'editor': [{'given': 'Andrea', 'family': 'Cortegiani', 'sequence': 'first', 'affiliation': []}], 'short-title': [], 'issued': {'date-parts': [[2021, 6, 9]]}, 'references-count': 32, 'journal-issue': {'issue': '6', 'published-online': {'date-parts': [[2021, 6, 9]]}}, 'URL': 'http://dx.doi.org/10.1371/journal.pone.0252388', 'relation': {}, 'ISSN': ['1932-6203'], 'subject': ['Multidisciplinary'], 'container-title-short': 'PLoS ONE', 'published': {'date-parts': [[2021, 6, 9]]}}