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Hydroxychloroquine or chloroquine with or without macrolide for COVID-19 treatment

Hydroxychloroquine or chloroquine with or without macrolide for COVID-19 treatment Hydroxychloroquine or chloroquine with or without macrolide for COVID-19 treatment
Hydroxychloroquine or chloroquine with or without macrolide for COVID-19 treatment Hydroxychloroquine or chloroquine with or without macrolide for COVID-19 treatment

What's new?

For managing COVID-19 patients, HCQ (hydroxychloroquine) or chloroquine (alone or with a macrolide) is not beneficial for in-hospital outcomes (elevated ventricular arrhythmias risk and minimized in-hospital survival).

A multinational, observational, real-world study of COVID-19 patients illustrated no benefit of HCQ or chloroquine (with or without a macrolide) regimen on in-hospital outcomes for managing COVID-19. When utilized for COVID-19 treatment, each of these drug regimens was related to clinically significant ventricular arrhythmias risk, greater risk of in-hospital death, and minimized in-hospital survival with SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2).

Data from 671 hospitals in six continents were encompassed in this registry. Individuals hospitalized between 20 Dec 2019, and 14 April 2020 with a positive lab finding for COVID-19 were enrolled. After diagnosis, subjects were randomly allocated to the four treatment groups (chloroquine with a macrolide, chloroquine alone, HCQ with a macrolide, and HCQ alone). Control group enrolled subjects who received none of these treatments. The occurrence of ventricular arrhythmias (non-sustained or sustained ventricular tachycardia or ventricular fibrillation) and in-hospital mortality were the main outcomes of interest measured.

During the study period, a total of 96,032 COVID-19 subjects were hospitalized. In the treatment group, a total of 14,888 COVID-19 patients were included (3783 received chloroquine with macrolide, 1868 received chloroquine, 6221 received HCQ with macrolide, and 3016 received HCQ). In the control group, a total of 81,144 patients were enrolled. In the hospital, 10,698 patients died.

These drug regimens should not be utilized outside of clinical trials since each of the drug regimens were independently associated with enhanced in-hospital mortality risk and an elevated ventricular arrhythmia risk during hospitalization as illustrated in the following tables:

Source:

Lancet

Article:

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31180-6/fulltext

Authors:

Mandeep R Mehra et al.

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