Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Dec 18;1(1):114-127.e3.
doi: 10.1016/j.medj.2020.06.001. Epub 2020 Jun 5.

Outcomes of Hydroxychloroquine Usage in United States Veterans Hospitalized with COVID-19

Joseph Magagnoli  1   2 , Siddharth Narendran  3   4 , Felipe Pereira  3   4 , Tammy H Cummings  1   2 , James W Hardin  1   5 , S Scott Sutton  1   2 , Jayakrishna Ambati  3   4   6   7
Affiliations

Outcomes of Hydroxychloroquine Usage in United States Veterans Hospitalized with COVID-19

Joseph Magagnoli et al. Med. .

Abstract

Background: Despite limited and conflicting evidence, hydroxychloroquine, alone or in combination with azithromycin, is widely used in COVID-19 therapy.

Methods: We performed a retrospective study of electronic health records of patients hospitalized with confirmed SARS-CoV-2 infection in US Veterans Health Administration medical centers between March 9, 2020 and April 29, 2020. Patients hospitalized within 24 h of diagnosis were classified based on their exposure to hydroxychloroquine alone (HC) or with azithromycin (HC+AZ) or no HC as treatments. The primary outcomes were mortality and use of mechanical ventilation.

Findings: A total of 807 patients were evaluated. Compared to the no HC group, after propensity score adjustment for clinical characteristics, the risk of death from any cause was higher in the HC group (adjusted hazard ratio [aHR], 1.83; 95% confidence interval [CI], 1.16-2.89; p = 0.009), but not in the HC+AZ group (aHR, 1.31; 95% CI, 0.80-2.15; p = 0.28). Both the propensity-score-adjusted risks of mechanical ventilation and death after mechanical ventilation were not significantly different in the HC group (aHR, 1.19; 95% CI, 0.78-1.82; p = 0.42 and aHR, 2.11; 95% CI, 0.96-4.62; p = 0.06, respectively) or in the HC+AZ group (aHR, 1.09; 95% CI, 0.72-1.66; p = 0.69 and aHR, 1.25; 95% CI, 0.59-2.68; p = 0.56, respectively) compared to the no HC group.

Conclusions: Among patients hospitalized with COVID-19, this retrospective study did not identify any significant reduction in mortality or in the need for mechanical ventilation with hydroxychloroquine treatment with or without azithromycin.

Funding: University of Virginia Strategic Investment Fund.

Keywords: COVID-19; SARS-CoV-2; azithromycin; hazard ratio; hydroxychloroquine; mortality; retrospective cohort; ventilation.

PubMed Disclaimer

Conflict of interest statement

J.A. is a co-founder of iVeena Holdings, iVeena Delivery Systems, and Inflammasome Therapeutics; he has received consultancy fees from Allergan, Biogen, Boehringer Ingelheim, Immunovant, Janssen, Olix Pharmaceuticals, Retinal Solutions, and Saksin LifeSciences, all for ophthalmic topics unrelated to COVID-19. J.A. is named as an inventor on a patent application filed by the University of Virginia relating to COVID-19 but unrelated to this work or to any ongoing COVID-19 clinical trials. S.S.S. has received research grants from Boehringer Ingelheim, Gilead Sciences, Portola Pharmaceuticals, and United Therapeutics, all for projects unrelated to COVID-19. J.W.H. has received consulting fees from Celgene Corporation unrelated to this work. The other authors declare no competing interests.

Figures

None
Graphical abstract
Figure 1
Figure 1
Distribution of Treatment Cohorts in the Full Study Cohort of 807 Hospitalized COVID-19 Patients AZ, azithromycin; CI, confidence interval; HC, hydroxychloroquine;
See this image and copyright information in PMC

Update of

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Liu J., Cao R., Xu M., Wang X., Zhang H., Hu H., Li Y., Hu Z., Zhong W., Wang M. Hydroxychloroquine, a less toxic derivative of chloroquine, is effective in inhibiting SARS-CoV-2 infection in vitro. Cell Discov. 2020;6:16. - PMC - PubMed
    1. Gautret P., Lagier J.C., Parola P., Hoang V.T., Meddeb L., Mailhe M., Doudier B., Courjon J., Giordanengo V., Vieira V.E. Hydroxychloroquine and azithromycin as a treatment of COVID-19: results of an open-label non-randomized clinical trial. Int. J. Antimicrob. Agents. 2020 doi: 10.1016/j.ijantimicag.2020.105949. Published online March 20, 2020. - DOI - PMC - PubMed
    1. Food and Drug Administration . 2020. Fact sheet for health care providers: emergency use authorization (EUA) of hyroxychlroquine sulfate supplied from the strategic national stockpile for treatment of COVID-19 in certain hospitalized patients.https://www.fda.gov/media/136537/download
    1. Chorin E., Dai M., Shulman E., Wadhwani L., Bar-Cohen R., Barbhaiya C., Aizer A., Holmes D., Bernstein S., Spinelli M. The QT interval in patients with COVID-19 treated with hydroxychloroquine and azithromycin. Nat. Med. 2020 doi: 10.1038/s41591-020-0888-2. Published online April 24, 2020. - DOI - PubMed
    1. Chen J., Liu D., Liu L., Liu P., Xu Q., Xia L., Ling Y., Huang D., Song S., Zhang D. A pilot study of hydroxychloroquine in treatment of patients with moderate COVID-19. J. Zhejiang Univ. (Med. Sci.) 2020;49:215–219. - PMC - PubMed

Publication types

LinkOut - more resources