The Effect of Hydroxychloroquine on In-Hospital Mortality in COVID-19

Abstract

Background Hydroxychloroquine (HCQ) is an antimalarial medication that has been tested against various viral illnesses. The available evidence regarding the role of HCQ in the coronavirus disease 2019 (COVID-19) remains controversial. Methods This is a comparative retrospective cohort study that aims to evaluate the efficacy and safety of HCQ in hospitalized patients with COVID-19. The primary outcome was all-cause in-hospital mortality. Secondary outcomes included ICU admission rate, mechanical ventilation, prolonged length of stay (LOS), QTc prolongation and cardiac arrest. Results A cohort of 175 hospitalized patients with COVID-19 were included with a median (interquartile range [IQR]) age of 66 [48-79] years. Of whom, 82 (47%) patients received HCQ. The overall mortality rate was 34.1%; 95% CI [23.7-44.6] and 16.1%; 95% CI [8.5-23.7] in the HCQ group vs. the control group, respectively (p = 0.67). A Cox regression analysis was performed adjusting for age, gender, BMI, SpO2/FiO2 ratio and CXR findings, and demonstrated that the association between HCQ use and the all-cause in-hospital mortality was not statistically significant (HR = 1.15; 95% CI [0.54-2.48]; p-value = 0.72). Patients who received HCQ were more likely to be admitted to the intensive care unit, require mechanical ventilation and have a prolonged LOS compared to those who did not receive the medication. No statistically significant difference was found in the likelihood of QTc prolongation or cardiac arrest. Conclusions The use of HCQ in patients hospitalized with COVID-19 confers no benefit in patient morbidity or mortality.

Outcomes of Heart Failure in COVID-19 Patients: An Appalachian Experience

“…Second, laboratory data and metrics like SOFA score, APACHE II, and SAPS III that have been validated to predict mortality in critically ill patients were not evaluated in our study [47]. We were not able to examine the effect of different treatments on the population [44,[48][49][50]. We were unable to compare outcomes based on medications that the patients were prescribed for HF prior to admission, thereby, we were unable to determine the effects of guideline-directed medical therapy on the severity of COVID-19 infection.…”