Hydroxychloroquine: First Large Study Does Not Support its Routine Use in COVID-19 Patients
To date, hydroxychloroquine has been widely administered to COVID-19 patients but with little scientific evidence to support its use. Today, the New England Journal of Medicine has released results from the largest study of nearly 1,400 patients with moderate to severe COVID-19 and found patients who received the drug did not fare any better than patients who did not get the drug.
“These results come at a pivotal time as medical professionals and scientists everywhere are working diligently to find effective treatments for the SARS-CoV-2 virus. As new treatments are tested and administered, we must continue to evaluate their effects in larger scale studies and trials to form a more targeted and effective patient care regimen.
“The findings support the NIH guidance that hospitalized COVID-19 patients should not be treated routinely with hydroxychloroquine. But, given the observational design of the study our results cannot completely exclude the possibility of either modest benefit or harm of the treatment. We therefore support enrolling patients into other hydroxychloroquine randomized controlled trials, many of which are underway across the United States and globally.”
About the Study
The study included the first 1,376 patients hospitalized with COVID-19 at a large medical center in New York City (excluding patients who were discharged, intubated, or died within 24 hours of arriving at the emergency department).
Among these patients, 811 (58.9%) received hydroxychloroquine and 565 patients (41.1%) did not. The researchers examined the relationship between hydroxychloroquine use and the development of respiratory failure that led to intubation or death.
Overall, 346 patients developed respiratory failure; 180 were intubated and 166 died without intubation.
After using established and sophisticated statistical techniques to account for known differences between patients in the two groups, including age, sex, and initial vital signs, the researchers found that patients who received hydroxychloroquine had the same risk of intubation or death as patients who did not receive the drug.
About Dr. Neil Schluger
Dr. Neil Schluger is the Senior Advisor for Science at Vital Strategies – a global health organization addressing the world’s leading public health challenges – where he provides expert medical advice to inform the organization’s positions and policy and programmatic work.
Neil also currently serves as Professor of Medicine, Epidemiology and Environmental Health Sciences, and Chief of the Division of Pulmonary, Allergy and Critical Care Medicine at Columbia University Medical Center in New York City. He is the author of over 160 articles, chapters and books, and his work has been published in The New England Journal of Medicine, JAMA, The Lancet, The Lancet Respiratory Medicine and the American Journal of Respiratory and Critical Care Medicine, among others. He is an Associate Editor of The American Journal of Respiratory and Critical Medicine.
About Vital Strategies
Vital Strategies is a global health organization that believes every person should be protected by a strong public health system. Our programs reach into 73 countries and help prevent death and illness from noncommunicable disease, reduce harm caused by environmental factors, and support cities as engines for public health. To find out more, please visit www.vitalstrategies.org or Twitter @VitalStrat.
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