Charleston Area Medical Center Health Education and Research Institute, Charleston, West Virginia, USA.
Pharmacotherapy. 2020 Nov;40(11):1072-1081. doi: 10.1002/phar.2467.
Hydroxychloroquine (HCQ) for coronavirus disease 2019 (COVID-19) is presently being used off-label or within a clinical trial.
We investigated a multinational database of patients with COVID-19 with real-world data containing outcomes and their relationship to HCQ use. The primary outcome was all-cause mortality within 30 days of follow-up.
This was a retrospective cohort study of patients receiving HCQ within 48 hours of hospital admission. Medications, preexisting conditions, clinical measures on admission, and outcomes were recorded.
Among patients with a diagnosis of COVID-19 in our propensity-matched cohort, the mean ages ± SD were 62.3 ± 15.9 years (53.7% male) and 61.9 ± 16.0 years (53.0% male) in the HCQ and no-HCQ groups, respectively. There was no difference in overall 30-day mortality between the HCQ and no-HCQ groups (HCQ 13.1%, n=367; no HCQ 13.6%, n=367; odds ratio 0.95, 95% confidence interval 0.62-1.46) after propensity matching. Although statistically insignificant, the HCQ-azithromycin (AZ) group had an overall mortality rate of 14.6% (n=199) compared with propensity-matched no-HCQ-AZ cohort's rate of 12.1% (n=199, OR 1.24, 95% CI 0.70-2.22). Importantly, however, there was no trend in this cohort's overall mortality/arrhythmogenesis outcome (HCQ-AZ 17.1%, no HCQ-no AZ 17.1%; OR 1.0, 95% CI 0.6-1.7).
We report from a large retrospective multinational database analysis of COVID-19 outcomes with HCQ and overall mortality in hospitalized patients. There was no statistically significant increase in mortality and mortality-arrhythmia with HCQ or HCQ-AZ.
羟氯喹（HCQ）治疗 2019 年冠状病毒病（COVID-19）目前正在被超说明书使用或在临床试验中使用。
我们调查了一个包含 COVID-19 患者真实世界数据的多国数据库，其中包含结局及其与 HCQ 使用的关系。主要结局是随访 30 天内的全因死亡率。
这是一项回顾性队列研究，纳入了在入院后 48 小时内接受 HCQ 治疗的患者。记录了药物、既往疾病、入院时的临床指标和结局。
在我们匹配倾向的队列中，COVID-19 诊断患者的平均年龄±标准差分别为 HCQ 组 62.3±15.9 岁（53.7%为男性）和无 HCQ 组 61.9±16.0 岁（53.0%为男性）。在匹配倾向后，HCQ 组和无 HCQ 组的 30 天总死亡率无差异（HCQ 组 13.1%，n=367；无 HCQ 组 13.6%，n=367；比值比 0.95，95%置信区间 0.62-1.46）。虽然统计学上无显著性，但 HCQ-阿奇霉素（AZ）组的总死亡率为 14.6%（n=199），而匹配倾向的无 HCQ-AZ 组的死亡率为 12.1%（n=199，OR 1.24，95%CI 0.70-2.22）。然而，重要的是，该队列的总死亡率/心律失常发生结局没有趋势（HCQ-AZ 组 17.1%，无 HCQ-无 AZ 组 17.1%；OR 1.0，95%CI 0.6-1.7）。
我们报告了一项来自 COVID-19 结局的大型回顾性多国数据库分析，其中包含了 HCQ 治疗和住院患者的全因死亡率。HCQ 或 HCQ-AZ 并未显著增加死亡率和死亡率-心律失常。
