Day-90 survival in critically-ill patients with COVID-19 and hydroxychloroquine : a propensity analysis
2021 Annals of Translational Medicine. All rights reserved..
BACKGROUND: There are limited data on the effect of hydroxychloroquine on medium term outcomes in patients with coronavirus disease 2019 (COVID-19) requiring intensive care. We aimed to evaluate the effects of hydroxychloroquine on day 90 mortality in this specific population.
METHODS: This retrospective, multicenter, propensity matched cohort analysis, used data of adult patients with laboratory confirmed COVID-19 admitted to 3 university affiliated intensive care units between March 7, 2020, to April 7, 2020 in Lyon, France. Patients received either hydroxychloroquine (loading dose of 400 mg twice daily at day 1 followed by 200 mg twice daily from day 2 to day 10) or standard of care without hydroxychloroquine. We compared all-cause mortality at day-90 after ICU admission between propensity score matched groups receiving hydroxychloroquine or standard of care.
RESULTS: A total of 157 patients were included with a day-28 and day-90 mortality rate of 23.6% and 32.5%, respectively. The median (interquartile) age was 67 years (56-76 years), 105 (66.9%) were men, 65 (41.4%) fulfilled criteria for acute respiratory distress syndrome, and 64 (41%) received hydroxychloroquine (HCQ) for 10 days (4-10 days). In the propensity score matched cohort (59 patients in each group), day-90 mortality was 35.6% for patients who received HCQ and 23.7% for patients who did not (P=0.23). Kaplan Meier survival analysis showed no statistically significant association between HCQ therapy and mortality (P=0.20 by log-rank test).
CONCLUSIONS: In this study, off-label use of HCQ in critically ill patients with COVID-19 was not associated with any significant change in medium-term prognosis, confirming results of studies in less severe patients.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2021 |
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| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:9 |
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| Enthalten in: |
Annals of translational medicine - 9(2021), 7 vom: 11. Apr., Seite 524 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Cour, Martin [VerfasserIn] |
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| Links: |
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| Themen: |
Acute respiratory distress syndrome |
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| Anmerkungen: |
Date Revised 23.04.2022 published: Print Citation Status PubMed-not-MEDLINE |
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| doi: |
10.21037/atm-20-7811 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM325385890 |
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| 500 | |a published: Print | ||
| 500 | |a Citation Status PubMed-not-MEDLINE | ||
| 520 | |a 2021 Annals of Translational Medicine. All rights reserved. | ||
| 520 | |a BACKGROUND: There are limited data on the effect of hydroxychloroquine on medium term outcomes in patients with coronavirus disease 2019 (COVID-19) requiring intensive care. We aimed to evaluate the effects of hydroxychloroquine on day 90 mortality in this specific population | ||
| 520 | |a METHODS: This retrospective, multicenter, propensity matched cohort analysis, used data of adult patients with laboratory confirmed COVID-19 admitted to 3 university affiliated intensive care units between March 7, 2020, to April 7, 2020 in Lyon, France. Patients received either hydroxychloroquine (loading dose of 400 mg twice daily at day 1 followed by 200 mg twice daily from day 2 to day 10) or standard of care without hydroxychloroquine. We compared all-cause mortality at day-90 after ICU admission between propensity score matched groups receiving hydroxychloroquine or standard of care | ||
| 520 | |a RESULTS: A total of 157 patients were included with a day-28 and day-90 mortality rate of 23.6% and 32.5%, respectively. The median (interquartile) age was 67 years (56-76 years), 105 (66.9%) were men, 65 (41.4%) fulfilled criteria for acute respiratory distress syndrome, and 64 (41%) received hydroxychloroquine (HCQ) for 10 days (4-10 days). In the propensity score matched cohort (59 patients in each group), day-90 mortality was 35.6% for patients who received HCQ and 23.7% for patients who did not (P=0.23). Kaplan Meier survival analysis showed no statistically significant association between HCQ therapy and mortality (P=0.20 by log-rank test) | ||
| 520 | |a CONCLUSIONS: In this study, off-label use of HCQ in critically ill patients with COVID-19 was not associated with any significant change in medium-term prognosis, confirming results of studies in less severe patients | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Coronavirus disease 2019 (COVID-19) | |
| 650 | 4 | |a acute respiratory distress syndrome | |
| 650 | 4 | |a hydroxychloroquine (HCQ) | |
| 650 | 4 | |a propensity score | |
| 650 | 4 | |a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) | |
| 700 | 1 | |a Amaz, Camille |e verfasserin |4 aut | |
| 700 | 1 | |a Bohé, Julien |e verfasserin |4 aut | |
| 700 | 1 | |a Rimmelé, Thomas |e verfasserin |4 aut | |
| 700 | 1 | |a Ovize, Michel |e verfasserin |4 aut | |
| 700 | 1 | |a Argaud, Laurent |e verfasserin |4 aut | |
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