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
Observational Study
. 2021 Jan 14;21(1):72.
doi: 10.1186/s12879-021-05773-w.

Hydroxychloroquine in the treatment of outpatients with mildly symptomatic COVID-19: a multi-center observational study

Andrew Ip  1   2   3 , Jaeil Ahn  4 , Yizhao Zhou  4 , Andre H Goy  5 , Eric Hansen  6 , Andrew L Pecora  5 , Brittany A Sinclaire  5 , Urszula Bednarz  5 , Michael Marafelias  5 , Ihor S Sawczuk  7   8 , Joseph P Underwood 3rd  9 , David M Walker  9 , Rajiv Prasad  10 , Robert L Sweeney  11 , Marie G Ponce  11 , Samuel La Capra  12 , Frank J Cunningham  12 , Arthur G Calise  13 , Bradley L Pulver  14 , Dominic Ruocco  15 , Greggory E Mojares  16 , Michael P Eagan  17 , Kristy L Ziontz  18 , Paul Mastrokyriakos  19 , Stuart L Goldberg  20
Affiliations
Observational Study

Hydroxychloroquine in the treatment of outpatients with mildly symptomatic COVID-19: a multi-center observational study

Andrew Ip et al. BMC Infect Dis. .

Abstract

Background: Hydroxychloroquine has not been associated with improved survival among hospitalized COVID-19 patients in the majority of observational studies and similarly was not identified as an effective prophylaxis following exposure in a prospective randomized trial. We aimed to explore the role of hydroxychloroquine therapy in mildly symptomatic patients diagnosed in the outpatient setting.

Methods: We examined the association between outpatient hydroxychloroquine exposure and the subsequent progression of disease among mildly symptomatic non-hospitalized patients with documented SARS-CoV-2 infection. The primary outcome assessed was requirement of hospitalization. Data was obtained from a retrospective review of electronic health records within a New Jersey USA multi-hospital network. We compared outcomes in patients who received hydroxychloroquine with those who did not applying a multivariable logistic model with propensity matching.

Results: Among 1274 outpatients with documented SARS-CoV-2 infection 7.6% were prescribed hydroxychloroquine. In a 1067 patient propensity matched cohort, 21.6% with outpatient exposure to hydroxychloroquine were hospitalized, and 31.4% without exposure were hospitalized. In the primary multivariable logistic regression analysis with propensity matching there was an association between exposure to hydroxychloroquine and a decreased rate of hospitalization from COVID-19 (OR 0.53; 95% CI, 0.29, 0.95). Sensitivity analyses revealed similar associations. QTc prolongation events occurred in 2% of patients prescribed hydroxychloroquine with no reported arrhythmia events among those with data available.

Conclusions: In this retrospective observational study of SARS-CoV-2 infected non-hospitalized patients hydroxychloroquine exposure was associated with a decreased rate of subsequent hospitalization. Additional exploration of hydroxychloroquine in this mildly symptomatic outpatient population is warranted.

Keywords: COVID-19; Hydroxychloroquine; Outpatient.

PubMed Disclaimer

Conflict of interest statement

Potential conflicts of interest: AHG reports being a study investigator for Genentech-Hoffman La Roche, during the conduct of the study; research funding as study investigator from Acerta, AstraZeneca, Celgene, Kite Pharma, Elsevier’s PracticeUpdate Oncology, Gilead, Medscape, MJH Associates, OncLive Peer Exchange, Physicians Education Resource, and Xcenda, outside the submitted work, and research funding as a study investigator for Constellation, Infinity, Infinity Verastem, Janssen, Karyopharm, and Pharmacyclics, outside of the submitted work.

Potential conflicts of interest: EH report consulting for Regional Cancer Care Associates and Hackensack Meridian Health, outside the submitted work.

Potential conflicts of interest: ALP and SLG report having equity ownership in COTA, outside the submitted work.

No conflicts of interest: AI, JA, YZ, BAS, UB, MM, ISS, JPU, DMW, RP, RLS, MGP, SLC, FJC, AGC, BLP, DR, GEM, MPE, KLZ, and PM.

Figures

Fig. 1
Fig. 1
Cohort Selection Flow Diagram. Flow diagram of patient sampling strategy of non-hospitalized COVID-19 patients in Hackensack Meridian Health Network. Follow up occurred until May 22
Fig. 2
Fig. 2
Hospitalization according to Hydroxychloroquine Exposure from Date of Confirmed SARS-CoV-2 Infection. Cumulative prevalence of hospitalization among mildly symptomatic COVID-19 patients according to outpatient exposure to hydroxychloroquine from date of polymerase chain reaction confirmed infection with SARS-CoV-2 in propensity matched cohort. HCQ = hydroxychloroquine
See this image and copyright information in PMC

References

    1. Bhimraj A, Morgan RL, Shumaker AH, Lavergne V, Baden L, Cheng VC, et al. Infectious diseases Society of America guidelines on the treatment and management of patients with COVID-19. 2020. - PMC - PubMed
    1. Pan H, Peto R, Karim QA, Alejandria M, Henao-Restrepo AM, Garcia CH, et al. Repurposed antiviral drugs for COVID-19 -interim WHO SOLIDARITY trial results. medRxiv. 2020. 10.1101/2020.10.15.20209817.
    1. New Jersey COVID-19 Information Hub. https://covid19.nj.gov/. Accessed 18 June 2020.
    1. Centers for Disease Control and Prevention. https://www.cdc.gov/coronavirus/2019-ncov/covid-data/covidview/index.html. Accessed 27 Nov 2020.
    1. Gautret P, Lagier JC, Parola P, Hoang VT, Meddeb L, Mailhe M, et al. Hydroxychloroquine and azithromycin as a treatment of COVID-19: results of an open-label non-randomized clinical trial. Int J Antimicrob Agents. 2020. 10.1016/j.ijantimicag.2020.105949 [published online ahead of print, 2020 Mar 20]. - PMC - PubMed

Publication types

Substances

LinkOut - more resources