Chen Zhe, Liu Aihua, Cheng Yongjing, Wang Xutao, Xu Xiaomao, Huang Jia, Ma Yuqing, Gao Ming, Huang Cibo
Department of Rheumatology, Beijing Hospital, National Center of Gerontology, Beijing, China.
Department of Emergency, Beijing Hospital, National Center of Gerontology, Beijing, China.
BMC Infect Dis. 2021 Aug 12;21(1):805. doi: 10.1186/s12879-021-06477-x.
Since the COVID-19 pandemic, several therapeutic agents have been used in COVID-19 management. However, the results were controversial. Here, we aimed to evaluate the efficacy and safety of hydroxychloroquine (HCQ)/chloroquine (CQ) in COVID-19.
We retrospectively reviewed the medical charts of patients with COVID-19 admitted to an inpatient ward in Wuhan from 2020/Feb/08 to 2020/Mar/05. Patients with HCQ/CQ and age, gender, disease severity matched ones without HCQ/CQ were selected at a 1:2 ratio. The clinical, laboratory and imaging findings were compared between these two groups. The multivariate linear regression analysis was performed to identify the factors that might influence patients' virus shedding periods (VSPs).
A total of 14 patients with HCQ/CQ and 21 matched ones were analyzed. The HCQ/CQ treatment lasted for an average of 10.36 ± 3.12 days. The mean VSPs were longer in the HCQ/CQ treatment group (26.57 ± 10.35 days vs. 19.10 ± 7.80 days, P = 0.020). There were 3 patients deceased during inpatient period, two patients were with HCQ/CQ treatment (P = 0.551). In the multivariate linear regression analysis, disease durations at admission (t = 3.643, P = 0.001) and HCQ/CQ treatment (t = 2.637, P = 0.013) were independent parameters for patients' VSPs. One patient with CQ had recurrent first-degree atrioventricular block (AVB) and obvious QTc elongation, another one complained about dizziness and blurred vision which disappeared after CQ discontinuation. One patient with HCQ had transient AVB.
In summary, we identify that the HCQ/CQ administration is not related to less mortality cases at later phase of COVID-19. More studies are needed to explore whether HCQ/CQ treatment would lead to SARS-Cov-2 RNA clearance delay or not.
自新冠疫情以来，多种治疗药物被用于新冠病毒病（COVID-19）的治疗。然而，结果存在争议。在此，我们旨在评估羟氯喹（HCQ）/氯喹（CQ）治疗COVID-19的疗效和安全性。
我们回顾性分析了2020年2月8日至2020年3月5日期间收治于武汉某住院病房的COVID-19患者的病历。按照1:2的比例选取使用HCQ/CQ的患者以及年龄、性别、疾病严重程度匹配的未使用HCQ/CQ的患者。比较两组患者的临床、实验室及影像学检查结果。进行多因素线性回归分析以确定可能影响患者病毒清除期（VSP）的因素。
共分析了14例使用HCQ/CQ的患者和21例匹配患者。HCQ/CQ治疗平均持续10.36±3.12天。HCQ/CQ治疗组的平均VSP更长（26.57±10.35天 vs. 19.10±7.80天，P = 0.020）。住院期间有3例患者死亡，2例接受HCQ/CQ治疗（P = 0.551）。在多因素线性回归分析中，入院时的病程（t = 3.643，P = 0.001）和HCQ/CQ治疗（t = 2.637，P = 0.013）是影响患者VSP的独立参数。1例使用CQ的患者出现一度房室传导阻滞（AVB）复发且QTc明显延长，另1例患者主诉头晕和视力模糊，停用CQ后症状消失。1例使用HCQ的患者出现短暂性AVB。
总之，我们发现使用HCQ/CQ与COVID-19后期较低的死亡率无关。需要更多研究来探讨HCQ/CQ治疗是否会导致严重急性呼吸综合征冠状病毒2（SARS-CoV-2）RNA清除延迟。
