Safety and Effectiveness of Hydroxychloroquine and Azithromycin Combination Therapy for Treatment of Hospitalized Patients with COVID-19: A Propensity-Matched Study
Abstract Introduction We sought to determine the effectiveness and safety of hydroxychloroquine–azithromycin (HCQ-AZM) therapy in hospitalized patients with COVID-19. Methods This was a retrospective cohort study of 613 patients hospitalized (integrated health system involving three hospitals) for R...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Adis, Springer Healthcare
2020-10-01
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| Series: | Cardiology and Therapy |
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| Online Access: | https://doi.org/10.1007/s40119-020-00201-7 |
| _version_ | 1819043312682663936 |
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| author | Henry D. Huang Hani Jneid Mariam Aziz Venkatesh Ravi Parikshit S. Sharma Timothy Larsen Neal Chatterjee Basil Saour Zaid Aziz Hemal Nayak Richard G. Trohman Kousik Krishnan |
| author_facet | Henry D. Huang Hani Jneid Mariam Aziz Venkatesh Ravi Parikshit S. Sharma Timothy Larsen Neal Chatterjee Basil Saour Zaid Aziz Hemal Nayak Richard G. Trohman Kousik Krishnan |
| author_sort | Henry D. Huang |
| collection | DOAJ |
| description | Abstract Introduction We sought to determine the effectiveness and safety of hydroxychloroquine–azithromycin (HCQ-AZM) therapy in hospitalized patients with COVID-19. Methods This was a retrospective cohort study of 613 patients hospitalized (integrated health system involving three hospitals) for RT-PCR-confirmed COVID-19 infection between March 1, 2020 and April 25, 2020. Intervention was treatment with HCQ-AZM in hospitalized patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Outcomes of interest were in-hospital all-cause mortality, cardiovascular mortality, pulseless electrical activity (PEA) arrest, non-lethal arrhythmias, and length of hospital stay. Secondary measures included in-hospital corrected QT (QTc) interval parameters and serum biomarkers levels. Results Propensity-matched groups were composed of 173 patients given HCQ-AZM and 173 matched patients who did not receive treatment. There was no significant difference in in-hospital mortality (odds ratio [OR] 1.52; 95% confidence interval [CI] 0.80–2.89; p = 0.2), PEA arrest (OR 1.68, CI 0.68–4.15; p = 0.27), or incidence of non-lethal arrhythmias (10.4% vs. 6.8%; p = 0.28). Length of hospital stay (10.5 ± 7.4 vs. 5.8 ± 6.1; p < 0.001), peak CRP levels (252 ± 136 vs. 166 ± 124; p < 0.0001), and degree of QTc interval prolongation was higher for the HCQ-AZM group (28 ± 32 vs. 9 ± 32; p < 0.0001), but there was no significant difference in incidence of sustained ventricular arrhythmias (2.8% vs. 1.7%; p = 0.52). HCQ-AZM was stopped in 10 patients because of QT interval prolongation and 1 patient because of drug-related polymorphic ventricular tachycardia. Conclusion In this propensity-matched study, there was no difference in in-hospital mortality, life-threatening arrhythmias, or incidence of PEA arrest between the HCQ-AZM and untreated control groups. QTc intervals were longer in patients receiving HCQ-AZM, but only one patient developed drug-related ventricular tachycardia. |
| first_indexed | 2024-12-21T09:54:47Z |
| format | Article |
| id | doaj.art-b06d3c01f5cd4b6db518801356695112 |
| institution | Directory Open Access Journal |
| issn | 2193-8261 2193-6544 |
| language | English |
| last_indexed | 2024-12-21T09:54:47Z |
| publishDate | 2020-10-01 |
| publisher | Adis, Springer Healthcare |
| record_format | Article |
| series | Cardiology and Therapy |
| spelling | doaj.art-b06d3c01f5cd4b6db5188013566951122022-12-21T19:08:05ZengAdis, Springer HealthcareCardiology and Therapy2193-82612193-65442020-10-019252353410.1007/s40119-020-00201-7Safety and Effectiveness of Hydroxychloroquine and Azithromycin Combination Therapy for Treatment of Hospitalized Patients with COVID-19: A Propensity-Matched StudyHenry D. Huang0Hani Jneid1Mariam Aziz2Venkatesh Ravi3Parikshit S. Sharma4Timothy Larsen5Neal Chatterjee6Basil Saour7Zaid Aziz8Hemal Nayak9Richard G. Trohman10Kousik Krishnan11Department of Cardiology, Rush University Medical CenterDivision of Cardiology, Baylor College of MedicineDepartment of Cardiology, Rush University Medical CenterDepartment of Cardiology, Rush University Medical CenterDepartment of Cardiology, Rush University Medical CenterDepartment of Cardiology, Rush University Medical CenterDivision of Cardiology, University of Washington Medical CenterDivision of Cardiology, University of Washington Medical CenterSection of Cardiology, University of Chicago Medical CenterSection of Cardiology, University of Chicago Medical CenterDepartment of Cardiology, Rush University Medical CenterDepartment of Cardiology, Rush University Medical CenterAbstract Introduction We sought to determine the effectiveness and safety of hydroxychloroquine–azithromycin (HCQ-AZM) therapy in hospitalized patients with COVID-19. Methods This was a retrospective cohort study of 613 patients hospitalized (integrated health system involving three hospitals) for RT-PCR-confirmed COVID-19 infection between March 1, 2020 and April 25, 2020. Intervention was treatment with HCQ-AZM in hospitalized patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Outcomes of interest were in-hospital all-cause mortality, cardiovascular mortality, pulseless electrical activity (PEA) arrest, non-lethal arrhythmias, and length of hospital stay. Secondary measures included in-hospital corrected QT (QTc) interval parameters and serum biomarkers levels. Results Propensity-matched groups were composed of 173 patients given HCQ-AZM and 173 matched patients who did not receive treatment. There was no significant difference in in-hospital mortality (odds ratio [OR] 1.52; 95% confidence interval [CI] 0.80–2.89; p = 0.2), PEA arrest (OR 1.68, CI 0.68–4.15; p = 0.27), or incidence of non-lethal arrhythmias (10.4% vs. 6.8%; p = 0.28). Length of hospital stay (10.5 ± 7.4 vs. 5.8 ± 6.1; p < 0.001), peak CRP levels (252 ± 136 vs. 166 ± 124; p < 0.0001), and degree of QTc interval prolongation was higher for the HCQ-AZM group (28 ± 32 vs. 9 ± 32; p < 0.0001), but there was no significant difference in incidence of sustained ventricular arrhythmias (2.8% vs. 1.7%; p = 0.52). HCQ-AZM was stopped in 10 patients because of QT interval prolongation and 1 patient because of drug-related polymorphic ventricular tachycardia. Conclusion In this propensity-matched study, there was no difference in in-hospital mortality, life-threatening arrhythmias, or incidence of PEA arrest between the HCQ-AZM and untreated control groups. QTc intervals were longer in patients receiving HCQ-AZM, but only one patient developed drug-related ventricular tachycardia.https://doi.org/10.1007/s40119-020-00201-7COVID-19HydroxychloroquineSARS-CoV-2Torsades de pointes |
| spellingShingle | Henry D. Huang Hani Jneid Mariam Aziz Venkatesh Ravi Parikshit S. Sharma Timothy Larsen Neal Chatterjee Basil Saour Zaid Aziz Hemal Nayak Richard G. Trohman Kousik Krishnan Safety and Effectiveness of Hydroxychloroquine and Azithromycin Combination Therapy for Treatment of Hospitalized Patients with COVID-19: A Propensity-Matched Study Cardiology and Therapy COVID-19 Hydroxychloroquine SARS-CoV-2 Torsades de pointes |
| title | Safety and Effectiveness of Hydroxychloroquine and Azithromycin Combination Therapy for Treatment of Hospitalized Patients with COVID-19: A Propensity-Matched Study |
| title_full | Safety and Effectiveness of Hydroxychloroquine and Azithromycin Combination Therapy for Treatment of Hospitalized Patients with COVID-19: A Propensity-Matched Study |
| title_fullStr | Safety and Effectiveness of Hydroxychloroquine and Azithromycin Combination Therapy for Treatment of Hospitalized Patients with COVID-19: A Propensity-Matched Study |
| title_full_unstemmed | Safety and Effectiveness of Hydroxychloroquine and Azithromycin Combination Therapy for Treatment of Hospitalized Patients with COVID-19: A Propensity-Matched Study |
| title_short | Safety and Effectiveness of Hydroxychloroquine and Azithromycin Combination Therapy for Treatment of Hospitalized Patients with COVID-19: A Propensity-Matched Study |
| title_sort | safety and effectiveness of hydroxychloroquine and azithromycin combination therapy for treatment of hospitalized patients with covid 19 a propensity matched study |
| topic | COVID-19 Hydroxychloroquine SARS-CoV-2 Torsades de pointes |
| url | https://doi.org/10.1007/s40119-020-00201-7 |
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