1. Low-dose hydroxychloroquine therapy and mortality in hospitalised patients with COVID-19: a nationwide observational study of 8075 participants
- Author
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Lucy Catteau, Nicolas Dauby, Marion Montourcy, Emmanuel Bottieau, Joris Hautekiet, Els Goetghebeur, Sabrina van Ierssel, Els Duysburgh, Herman Van Oyen, Chloé Wyndham-Thomas, Dominique Van Beckhoven, Kristof Bafort, Leïla Belkhir, Nathalie Bossuyt, Philippe Caprasse, Vincent Colombie, Paul De Munter, Jessika Deblonde, Didier Delmarcelle, Mélanie Delvallee, Rémy Demeester, Thierry Dugernier, Xavier Holemans, Benjamin Kerzmann, Pierre Yves Machurot, Philippe Minette, Jean-Marc Minon, Saphia Mokrane, Catherine Nachtergal, Séverine Noirhomme, Denis Piérard, Camelia Rossi, Carole Schirvel, Erica Sermijn, Frank Staelens, Filip Triest, Nina Van Goethem, Jens Van Praet, Anke Vanhoenacker, Roeland Verstraete, Elise Willems, Belgian Collaborative Grp COVID-19, Sociology, UCL - SSS/IREC/LTAP - Louvain Centre for Toxicology and Applied Pharmacology, and UCL - (SLuc) Service de médecine interne générale
- Subjects
Male ,0301 basic medicine ,Antimalarials -- therapeutic use ,Epidemiology ,T-Lymphocytes ,AZITHROMYCIN ,Pneumonia, Viral -- diagnostic imaging -- drug therapy -- mortality -- pathology ,CORONAVIRUS ,Azithromycin ,0302 clinical medicine ,Observational study ,Hydroxychloroquine -- therapeutic use ,Betacoronavirus -- drug effects -- pathogenicity ,Drug Dosage Calculations ,Pharmacology (medical) ,Pharmacology & Pharmacy ,hospitalised patients ,Hospital Mortality ,030212 general & internal medicine ,Medicine(all) ,Aged, 80 and over ,Pharmacology. Therapy ,Hazard ratio ,General Medicine ,Sciences bio-médicales et agricoles ,Middle Aged ,Prognosis ,Letter to The Editor ,Intensive Care Units ,C-Reactive Protein ,Treatment Outcome ,Infectious Diseases ,Disease Progression ,Female ,Patient Safety ,Coronavirus Infections ,Life Sciences & Biomedicine ,Hydroxychloroquine ,medicine.drug ,Adult ,Microbiology (medical) ,medicine.medical_specialty ,Adolescent ,Coronavirus disease 2019 (COVID-19) ,Pneumonia, Viral ,030106 microbiology ,Coronavirus Infections -- diagnostic imaging -- drug therapy -- mortality -- pathology ,Microbiology ,Article ,Antimalarials ,Betacoronavirus ,03 medical and health sciences ,Immunology and Microbiology(all) ,Internal medicine ,medicine ,Humans ,Mortality ,Biology ,Pandemics ,Aged ,Proportional Hazards Models ,Retrospective Studies ,Science & Technology ,SARS-CoV-2 ,Proportional hazards model ,business.industry ,Drug Repositioning ,COVID-19 ,C-Reactive Protein -- metabolism ,Retrospective cohort study ,T-Lymphocytes -- pathology -- virology ,Confidence interval ,Low-dose hydroxychloroquine therapy ,observational study ,Human medicine ,Tomography, X-Ray Computed ,business - Abstract
Highlights • Hydroxychloroquine (HCQ) 2400 mg over 5 days was used in Belgium for COVID-19. • Impact of HCQ on mortality among 8075 patients with COVID-19 was assessed. • Lower mortality in HCQ-treated patients as compared to supportive care. • Lower mortality was irrespective of symptom duration., Hydroxychloroquine (HCQ) has been largely used and investigated as therapy for COVID-19 across various settings at a total dose usually ranging from 2400 mg to 9600 mg. In Belgium, off-label use of low-dose HCQ (total 2400 mg over 5 days) was recommended for hospitalised patients with COVID-19. We conducted a retrospective analysis of in-hospital mortality in the Belgian national COVID-19 hospital surveillance data. Patients treated either with HCQ monotherapy and supportive care (HCQ group) were compared with patients treated with supportive care only (no-HCQ group) using a competing risks proportional hazards regression with discharge alive as competing risk, adjusted for demographic and clinical features with robust standard errors. Of 8075 patients with complete discharge data on 24 May 2020 and diagnosed before 1 May 2020, 4542 received HCQ in monotherapy and 3533 were in the no-HCQ group. Death was reported in 804/4542 (17.7%) and 957/3533 (27.1%), respectively. In the multivariable analysis, mortality was lower in the HCQ group compared with the no-HCQ group [adjusted hazard ratio (aHR) = 0.684, 95% confidence interval (CI) 0.617–0.758]. Compared with the no-HCQ group, mortality in the HCQ group was reduced both in patients diagnosed ≤5 days (n = 3975) and >5 days (n = 3487) after symptom onset [aHR = 0.701 (95% CI 0.617–0.796) and aHR = 0.647 (95% CI 0.525–0.797), respectively]. Compared with supportive care only, low-dose HCQ monotherapy was independently associated with lower mortality in hospitalised patients with COVID-19 diagnosed and treated early or later after symptom onset.
- Published
- 2020
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