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

Authors

Samar Aboulenain, University of Miami Palm Beach Regional Campus/JFK Medical CenterFollow
Nakeya Dewaswala, University of Miami Palm Beach Regional Campus/JFK Medical CenterFollow
Fergie Ramos, University of Miami Palm Beach Regional Campus/JFK Medical CenterFollow
Pedro Torres, University of Miami Palm Beach Regional Campus/JFK Medical CenterFollow
Ahmed Abdallah, University of Miami Palm Beach Regional Campus/JFK Medical CenterFollow
Mohamed Abdul Qader, University of Miami Palm Beach Regional Campus/JFK Medical CenterFollow
Baher Al-Abbasi, University of Miami Palm Beach Regional Campus/JFK Medical CenterFollow
Charles R. Bornmann, University of Miami Palm Beach Regional Campus/JFK Medical CenterFollow
Karolina N. Dziadkowiec, University of Miami Palm Beach Regional Campus/JFK Medical CenterFollow
Kai Chen, University of Miami Palm Beach Regional Campus/JFK Medical CenterFollow
Jesus E. Pino, University of Miami Palm Beach Regional Campus/JFK Medical CenterFollow
Robert Chait, University of Miami Palm Beach Regional Campus/JFK Medical CenterFollow
Kleper de Almeida, University of Miami Palm Beach Regional CampusFollow

Keywords

coronavirus; COVID-19; SARS-CoV-2; pandemics; cohort studies; mortality; hospital mortality; survival; hydroxychloroquine, QTc interval; therapeutics

Disciplines

Pharmaceutical Preparations | Respiratory Tract Diseases | Therapeutics | Virus Diseases

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.

Recommended Citation

Aboulenain, Samar; Dewaswala, Nakeya; Ramos, Fergie; Torres, Pedro; Abdallah, Ahmed; Abdul Qader, Mohamed; Al-Abbasi, Baher; Bornmann, Charles R.; Dziadkowiec, Karolina N.; Chen, Kai; Pino, Jesus E.; Chait, Robert; and de Almeida, Kleper (2020) "The Effect of Hydroxychloroquine on In-Hospital Mortality in COVID-19," HCA Healthcare Journal of Medicine: Vol. 1: Iss. 0, Article 20.
DOI: 10.36518/2689-0216.1169
Available at: https://scholarlycommons.hcahealthcare.com/hcahealthcarejournal/vol1/iss0/20