Outcomes of persons with coronavirus disease 2019 in hospitals with and without standard treatment with (hydroxy)chloroquine
Copyright © 2020 The Author(s). Published by Elsevier Ltd.. All rights reserved..
OBJECTIVE: To compare survival of individuals with coronavirus disease 2019 (COVID-19) treated in hospitals that either did or did not routinely treat patients with hydroxychloroquine or chloroquine.
METHODS: We analysed data of COVID-19 patients treated in nine hospitals in the Netherlands. Inclusion dates ranged from 27 February to 15 May 2020, when the Dutch national guidelines no longer supported the use of (hydroxy)chloroquine. Seven hospitals routinely treated patients with (hydroxy)chloroquine, two hospitals did not. Primary outcome was 21-day all-cause mortality. We performed a survival analysis using log-rank test and Cox regression with adjustment for age, sex and covariates based on premorbid health, disease severity and the use of steroids for adult respiratory distress syndrome, including dexamethasone.
RESULTS: Among 1949 individuals, 21-day mortality was 21.5% in 1596 patients treated in hospitals that routinely prescribed (hydroxy)chloroquine, and 15.0% in 353 patients treated in hospitals that did not. In the adjusted Cox regression models this difference disappeared, with an adjusted hazard ratio of 1.09 (95% CI 0.81-1.47). When stratified by treatment actually received in individual patients, the use of (hydroxy)chloroquine was associated with an increased 21-day mortality (HR 1.58; 95% CI 1.24-2.02) in the full model.
CONCLUSIONS: After adjustment for confounders, mortality was not significantly different in hospitals that routinely treated patients with (hydroxy)chloroquine compared with hospitals that did not. We compared outcomes of hospital strategies rather than outcomes of individual patients to reduce the chance of indication bias. This study adds evidence against the use of (hydroxy)chloroquine in hospitalised patients with COVID-19.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2021 |
|---|---|
| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:27 |
|---|---|
| Enthalten in: |
Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases - 27(2021), 2 vom: 16. Feb., Seite 264-268 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Peters, Edgar Jg [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
4QWG6N8QKH |
|---|
| Anmerkungen: |
Date Completed 25.02.2021 Date Revised 07.12.2022 published: Print-Electronic Citation Status MEDLINE |
|---|
| doi: |
10.1016/j.cmi.2020.10.004 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM316381977 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM316381977 | ||
| 003 | DE-627 | ||
| 005 | 20231225160947.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231225s2021 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1016/j.cmi.2020.10.004 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1054.xml |
| 035 | |a (DE-627)NLM316381977 | ||
| 035 | |a (NLM)33068758 | ||
| 035 | |a (PII)S1198-743X(20)30615-7 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Peters, Edgar Jg |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Outcomes of persons with coronavirus disease 2019 in hospitals with and without standard treatment with (hydroxy)chloroquine |
| 264 | 1 | |c 2021 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 25.02.2021 | ||
| 500 | |a Date Revised 07.12.2022 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2020 The Author(s). Published by Elsevier Ltd.. All rights reserved. | ||
| 520 | |a OBJECTIVE: To compare survival of individuals with coronavirus disease 2019 (COVID-19) treated in hospitals that either did or did not routinely treat patients with hydroxychloroquine or chloroquine | ||
| 520 | |a METHODS: We analysed data of COVID-19 patients treated in nine hospitals in the Netherlands. Inclusion dates ranged from 27 February to 15 May 2020, when the Dutch national guidelines no longer supported the use of (hydroxy)chloroquine. Seven hospitals routinely treated patients with (hydroxy)chloroquine, two hospitals did not. Primary outcome was 21-day all-cause mortality. We performed a survival analysis using log-rank test and Cox regression with adjustment for age, sex and covariates based on premorbid health, disease severity and the use of steroids for adult respiratory distress syndrome, including dexamethasone | ||
| 520 | |a RESULTS: Among 1949 individuals, 21-day mortality was 21.5% in 1596 patients treated in hospitals that routinely prescribed (hydroxy)chloroquine, and 15.0% in 353 patients treated in hospitals that did not. In the adjusted Cox regression models this difference disappeared, with an adjusted hazard ratio of 1.09 (95% CI 0.81-1.47). When stratified by treatment actually received in individual patients, the use of (hydroxy)chloroquine was associated with an increased 21-day mortality (HR 1.58; 95% CI 1.24-2.02) in the full model | ||
| 520 | |a CONCLUSIONS: After adjustment for confounders, mortality was not significantly different in hospitals that routinely treated patients with (hydroxy)chloroquine compared with hospitals that did not. We compared outcomes of hospital strategies rather than outcomes of individual patients to reduce the chance of indication bias. This study adds evidence against the use of (hydroxy)chloroquine in hospitalised patients with COVID-19 | ||
| 650 | 4 | |a Comparative Study | |
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Multicenter Study | |
| 650 | 4 | |a Chloroquine | |
| 650 | 4 | |a Coronavirus disease 2019 | |
| 650 | 4 | |a Hydroxychloroquine | |
| 650 | 4 | |a Mortality | |
| 650 | 4 | |a Severe acute respiratory syndrome coronavirus 2 | |
| 650 | 7 | |a Hydroxychloroquine |2 NLM | |
| 650 | 7 | |a 4QWG6N8QKH |2 NLM | |
| 650 | 7 | |a Chloroquine |2 NLM | |
| 650 | 7 | |a 886U3H6UFF |2 NLM | |
| 700 | 1 | |a Collard, Didier |e verfasserin |4 aut | |
| 700 | 1 | |a Van Assen, Sander |e verfasserin |4 aut | |
| 700 | 1 | |a Beudel, Martijn |e verfasserin |4 aut | |
| 700 | 1 | |a Bomers, Marije K |e verfasserin |4 aut | |
| 700 | 1 | |a Buijs, Jacqueline |e verfasserin |4 aut | |
| 700 | 1 | |a De Haan, Lianne R |e verfasserin |4 aut | |
| 700 | 1 | |a De Ruijter, Wouter |e verfasserin |4 aut | |
| 700 | 1 | |a Douma, Renée A |e verfasserin |4 aut | |
| 700 | 1 | |a Elbers, Paul Wg |e verfasserin |4 aut | |
| 700 | 1 | |a Goorhuis, Abraham |e verfasserin |4 aut | |
| 700 | 1 | |a Gritters van den Oever, Niels C |e verfasserin |4 aut | |
| 700 | 1 | |a Knarren, Lieve Ghh |e verfasserin |4 aut | |
| 700 | 1 | |a Moeniralam, Hazra S |e verfasserin |4 aut | |
| 700 | 1 | |a Mostard, Remy Lm |e verfasserin |4 aut | |
| 700 | 1 | |a Quanjel, Marian Jr |e verfasserin |4 aut | |
| 700 | 1 | |a Reidinga, Auke C |e verfasserin |4 aut | |
| 700 | 1 | |a Renckens, Roos |e verfasserin |4 aut | |
| 700 | 1 | |a Van Den Bergh, Joop Pw |e verfasserin |4 aut | |
| 700 | 1 | |a Vlasveld, Imro N |e verfasserin |4 aut | |
| 700 | 1 | |a Sikkens, Jonne J |e verfasserin |4 aut | |
| 700 | 0 | |a CovidPredict Study Group |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases |d 1995 |g 27(2021), 2 vom: 16. Feb., Seite 264-268 |w (DE-627)NLM094580014 |x 1469-0691 |7 nnns |
| 773 | 1 | 8 | |g volume:27 |g year:2021 |g number:2 |g day:16 |g month:02 |g pages:264-268 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1016/j.cmi.2020.10.004 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 27 |j 2021 |e 2 |b 16 |c 02 |h 264-268 | ||