Multinational analysis of treatments for COVID-19

22 May, 2020

The Lancet has published a multinational registry analysis of the use of of hydroxychloroquine or chloroquine with or without a macrolide (antibiotic) for treatment of COVID-19. The registry comprised data from 671 hospitals in six continents and included patients hospitalised between 20 December 2019 and 14 April 2020, who tested positive for SARS-CoV-2. The patients who received one of the treatments of interest within 48 hours of diagnosis were included in one of four treatment groups:

  • chloroquine alone, 1,868 patients
  • chloroquine with a macrolide, 3,783 patients
  • hydroxychloroquine alone, 3,016 patients or
  • hydroxychloroquine with a macrolide 6,221 patients

Patients who received none of these treatments formed the control group. Patients who received one of the treatments more than 48 hours after diagnosis or while on mechanical ventilation, as well as patients who received remdesivir, were excluded. 96,032 patients (mean age 53·8 years, 46·3% women) with COVID-19 were hospitalised during the study period and met the inclusion criteria, 14,888 were in the treatment groups (see above) and 81,144 made up the control group.

The authors stated "We were unable to confirm a benefit of hydroxychloroquine or chloroquine, when used alone or with a macrolide, on in-hospital outcomes for COVID-19. Each of these drug regimens was associated with decreased in-hospital survival and an increased frequency of ventricular arrhythmias when used for treatment of COVID-19."

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