Effect of Hydroxychloroquine in Hospitalized Patients with Covid-19
Peter Horby,M Mafham,Louise Linsell,Jennifer L Bell,Natalie Staplin,Jonathan Emberson,Martin Wiselka,Andrew Ustianowski,E Elmahi,B Prudon,Tony Whitehouse,Timothy Felton,John Williams,J Faccenda,Jonathan Underwood,J K Baillie,Lucy C Chappell,Saul N. Faust,Thomas Jaki,Katie Jeffery,Wei Shen Lim,Alan A Montgomery,Kathy Rowan,Joel Tarning,James A Watson,Nicholas J. White,Edmund Juszczak,Richard Haynes,Martin J Landray +28 more
TLDR
In patients hospitalized with COVID-19, hydroxychloroquine was not associated with reductions in 28-day mortality but was associated with an increased length of hospital stay and increased risk of progressing to invasive mechanical ventilation or death.Abstract:
BackgroundHydroxychloroquine and chloroquine have been proposed as treatments for coronavirus disease 2019 (Covid-19) on the basis of in vitro activity and data from uncontrolled studies and small, randomized trials.MethodsIn this randomized, controlled, open-label platform trial comparing a range of possible treatments with usual care in patients hospitalized with Covid-19, we randomly assigned 1561 patients to receive hydroxychloroquine and 3155 to receive usual care. The primary outcome was 28-day mortality.ResultsThe enrollment of patients in the hydroxychloroquine group was closed on June 5, 2020, after an interim analysis determined that there was a lack of efficacy. Death within 28 days occurred in 421 patients (27.0%) in the hydroxychloroquine group and in 790 (25.0%) in the usual-care group (rate ratio, 1.09; 95% confidence interval [CI], 0.97 to 1.23; P=0.15). Consistent results were seen in all prespecified subgroups of patients. The results suggest that patients in the hydroxychloroquine group were less likely to be discharged from the hospital alive within 28 days than those in the usual-care group (59.6% vs. 62.9%; rate ratio, 0.90; 95% CI, 0.83 to 0.98). Among the patients who were not undergoing mechanical ventilation at baseline, those in the hydroxychloroquine group had a higher frequency of invasive mechanical ventilation or death (30.7% vs. 26.9%; risk ratio, 1.14; 95% CI, 1.03 to 1.27). There was a small numerical excess of cardiac deaths (0.4 percentage points) but no difference in the incidence of new major cardiac arrhythmia among the patients who received hydroxychloroquine.ConclusionsAmong patients hospitalized with Covid-19, those who received hydroxychloroquine did not have a lower incidence of death at 28 days than those who received usual care. (Funded by UK Research and Innovation and National Institute for Health Research and others; RECOVERY ISRCTN number, ISRCTN50189673. opens in new tab; ClinicalTrials.gov number, NCT04381936. opens in new tab.)read more
Citations
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Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study
Fei Zhou,Ting Yu,Ronghui Du,Guohui Fan,Ying Liu,Zhibo Liu,Jie Xiang,Yeming Wang,Bin Song,Xiaoying Gu,Xiaoying Gu,Lulu Guan,Yuan Wei,Li Hui,Xudong Wu,Jiuyang Xu,Shengjin Tu,Yi Zhang,Hua Chen,Bin Cao +19 more
TL;DR: Prolonged viral shedding provides the rationale for a strategy of isolation of infected patients and optimal antiviral interventions in the future.
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TL;DR: The effects of the epidemic caused by the new CoV has yet to emerge as the situation is quickly evolving, and world governments are at work to establish countermeasures to stem possible devastating effects.
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Repurposed Antiviral Drugs for Covid-19 - Interim WHO Solidarity Trial Results.
Hongchao Pan,Richard Peto,Ana-Maria Henao-Restrepo,Marie-Pierre Preziosi,Vasee Sathiyamoorthy,Quarraisha Abdool Karim,Marissa M. Alejandria,César Hernández García,Marie-Paule Kieny,Reza Malekzadeh,Srinivas Murthy,K. Srinath Reddy,Mirta Roses Periago,Pierre Abi Hanna,Florence Ader,Abdullah M. Al-Bader,Almonther Alhasawi,Emma Allum,Athari Alotaibi,Carlos A Alvarez-Moreno,Sheila Appadoo,Abdullah Asiri,Pål Aukrust,Andreas Barratt-Due,Samir Bellani,Mattia Branca,Heike B. C. Cappel-Porter,Nery Cerrato,Ting S. Chow,Najada Como,Joseph A. Eustace,Patricia J. Garcia,Sheela Godbole,Eduardo Gotuzzo,Laimonas Griskevicius,Rasha Hamra,Mariam Hassan,Mohamed Hassany,David Hutton,Irmansyah Irmansyah,Ligita Jancoriene,Jana Kirwan,Suresh Kumar,Peter Lennon,Gustavo Lopardo,Patrick Lydon,Nicola Magrini,Teresa Maguire,Suzana Manevska,Oriol Manuel,Sibylle McGinty,Marco T. Medina,María L. Mesa Rubio,Maria C. Miranda-Montoya,Jeremy Nel,Estevão Portela Nunes,Markus Perola,Antonio Portolés,Menaldi R. Rasmin,Aun Raza,Helen Rees,Paula P. S. Reges,Chris A Rogers,Kolawole Salami,Marina I. Salvadori,Narvina Sinani,Jonathan A C Sterne,Milena Stevanovikj,Evelina Tacconelli,Kari A.O. Tikkinen,Sven Trelle,Hala Zaid,John-Arne Røttingen,Soumya Swaminathan +73 more
TL;DR: These remdesivir, hydroxychloroquine, lopinavir, and interferon regimens had little or no effect on hospitalized patients with Covid-19, as indicated by overall mortality, initiation of ventilation, and duration of hospital stay.
Journal ArticleDOI
Early High-Titer Plasma Therapy to Prevent Severe Covid-19 in Older Adults.
Romina Libster,Gonzalo Pérez Marc,Diego Wappner,Silvina Coviello,Alejandra Bianchi,Virginia Braem,Ignacio Esteban,Mauricio T. Caballero,Cristian Wood,Mabel Berrueta,Anibal Rondan,Gabriela Lescano,Pablo Cruz,Yvonne Ritou,Valeria Fernandez Vina,Damian Alvarez Paggi,Sebastian Esperante,Adrián Ferreti,Gaston Ofman,Alvaro Ciganda,Rocio Rodriguez,Jorge Lantos,Ricardo Valentini,Nicolas Itcovici,Alejandra Hintze,M Laura Oyarvide,Candela Etchegaray,Alejandra Neira,Ivonne Name,Julieta Alfonso,Rocio Lopez Castelo,Gisela Caruso,Sofia Rapelius,Fernando Alvez,Federico Cesar Etchenique,Federico Dimase,Dario Raul Alvarez,Sofia Sol Aranda,Clara Sanchez Yanotti,Julian De Luca,Sofia Jares Baglivo,Sofia Lujan Laudanno,Florencia Nowogrodzki,Ramiro Manuel Larrea,Maria Dolores Silveyra,Gabriel Leberzstein,Alejandra Debonis,Juan Molinos,Miguel Santiago Gonzalez,Eduardo Perez,Nicolás Kreplak,Susana Pastor Arguello,Luz Gibbons,Fernando Althabe,Eduardo Bergel,Fernando P. Polack +55 more
TL;DR: In this paper, a randomized, double-blind, placebo-controlled trial of convalescent plasma with high IgG titers against SARS-CoV-2 in older adult patients within 72 hours after the onset of mild Covid-19 symptoms was conducted.
References
More filters
Journal ArticleDOI
A Novel Coronavirus from Patients with Pneumonia in China, 2019.
Na Zhu,Dingyu Zhang,Wenling Wang,Xingwang Li,Bo Yang,Jingdong Song,Xiang Zhao,Baoying Huang,Weifeng Shi,Roujian Lu,Peihua Niu,Faxian Zhan,Xuejun Ma,Dayan Wang,Wenbo Xu,Wenbo Xu,Guizhen Wu,George F. Gao,Wenjie Tan +18 more
TL;DR: Human airway epithelial cells were used to isolate a novel coronavirus, named 2019-nCoV, which formed a clade within the subgenus sarbecovirus, Orthocoronavirinae subfamily, which is the seventh member of the family of coronaviruses that infect humans.
Journal ArticleDOI
Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study.
Fei Zhou,Ting Yu,Ronghui Du,Guohui Fan,Ying Liu,Zhibo Liu,Jie Xiang,Yeming Wang,Bin Song,Xiaoying Gu,Xiaoying Gu,Lulu Guan,Yuan Wei,Li Hui,Xudong Wu,Jiuyang Xu,Shengjin Tu,Yi Zhang,Hua Chen,Bin Cao +19 more
TL;DR: Wang et al. as discussed by the authors used univariable and multivariable logistic regression methods to explore the risk factors associated with in-hospital death, including older age, high SOFA score and d-dimer greater than 1 μg/mL.
Journal ArticleDOI
A pneumonia outbreak associated with a new coronavirus of probable bat origin
Peng Zhou,Xing-Lou Yang,Xian Guang Wang,Ben Hu,Lei Zhang,Wei Zhang,Hao Rui Si,Yan Zhu,Bei Li,Chao Lin Huang,Hui-Dong Chen,Jing Chen,Yun Luo,Hua Guo,Ren Di Jiang,Meiqin Liu,Ying Chen,Xu Rui Shen,Xi Wang,Xiao Shuang Zheng,Kai Zhao,Quanjiao Chen,Fei Deng,Lin Lin Liu,Bing Yan,Fa Xian Zhan,Yan-Yi Wang,Gengfu Xiao,Zhengli Shi +28 more
TL;DR: Identification and characterization of a new coronavirus (2019-nCoV), which caused an epidemic of acute respiratory syndrome in humans in Wuhan, China, and it is shown that this virus belongs to the species of SARSr-CoV, indicates that the virus is related to a bat coronav virus.
Journal ArticleDOI
Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study
Nanshan Chen,Min Zhou,Xuan Dong,Jie-Ming Qu,Fengyun Gong,Yang Han,Yang Qiu,Jingli Wang,Ying Liu,Yuan Wei,Jia'an Xia,Ting Yu,Xinxin Zhang,Li Zhang +13 more
TL;DR: Characteristics of patients who died were in line with the MuLBSTA score, an early warning model for predicting mortality in viral pneumonia, and further investigation is needed to explore the applicability of the Mu LBSTA scores in predicting the risk of mortality in 2019-nCoV infection.
Journal ArticleDOI
Genomic characterisation and epidemiology of 2019 novel coronavirus: implications for virus origins and receptor binding.
Roujian Lu,Xiang Zhao,Juan Li,Peihua Niu,Bo Yang,Honglong Wu,Wenling Wang,Hao Song,Baoying Huang,Na Zhu,Yuhai Bi,Xuejun Ma,Faxian Zhan,Liang Wang,Tao Hu,Hong Zhou,Zhenhong Hu,Weimin Zhou,Li Zhao,Jing Chen,Yao Meng,Ji Wang,Yang Lin,Jianying Yuan,Zhihao Xie,Jinmin Ma,William J. Liu,Dayan Wang,Wenbo Xu,Edward C. Holmes,George F. Gao,George F. Gao,Guizhen Wu,Weijun Chen,Weifeng Shi,Wenjie Tan,Wenjie Tan +36 more
TL;DR: The phylogenetic analysis suggests that bats might be the original host of this virus, an animal sold at the seafood market in Wuhan might represent an intermediate host facilitating the emergence of the virus in humans.
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