Int J Infect Dis. 2020 Dec 23:S1201-9712(20)32583-2. doi: 10.1016/j.ijid.2020.12.060. Online ahead of print.
BACKGROUND: The use of hydroxychloroquine (HCQ), with or without concurrent administration of azithromycin (AZM), for treatment of COVID-19 has received considerable attention. The purpose of this study was to determine whether HCQ administration is associated with improved mortality in COVID-19 patients.
METHODS: We conducted a retrospective analysis of data collected during the care process for COVID-19 positive patients discharged from facilities affiliated with a large healthcare system in the United States as of April 27, 2020. Patients were categorized by treatment with HCQ (in addition to standard supportive therapy) or receipt of supportive therapy with no HCQ. Patient outcomes were evaluated for in-hospital mortality. Patient demographics and clinical characteristics were accounted for through a multivariable regression analysis.
RESULTS: A total of 1669 patients were evaluated (no HCQ, n = 696; HCQ, n = 973). When adjusting for patient characteristics, receipt of AZM, and severity of disease at admission, there was no beneficial effect on the odds of death associated with receipt of HCQ. In this population, there was an 81% increase in the odds of mortality among patients who received HCQ at any time during their encounter versus with no HCQ exposure (OR: 1.81, 95% CI: 1.20-2.77, p = 0.01).
CONCLUSIONS: In this retrospective analysis, we found that there was no benefit of administration of HCQ on mortality in COVID-19 patients. These results support recent changes to clinical trials that discourage the use of HCQ in COVID-19 patients.
SUMMARY: This retrospective analysis of data from a large healthcare system in the United States sought to determine whether hydroxychloroquine administration is associated with improved mortality in 1669 COVID-19 patients. Hydroxychloroquine was associated with an increase in the odds of mortality.