Alliance for Pandemic Preparedness

May 22, 2020

Hydroxychloroquine or Chloroquine with or without a Macrolide for Treatment of COVID-19: A Multinational Registry Analysis

Category:

Topic:

  • A multinational registry analysis of the use of hydroxychloroquine or chloroquine, with or without a macrolide (e.g., azithromycin), included 671 hospitals and 96,032 hospitalized patients across 6 continents. Patients for whom treatment was not initiated within 48 hours or prior to ventilation were excluded, as were those who received remdesivir.  
  • After controlling for confounders, including risk factors for severe COVID-19, all four treatment groups were associated with a higher risk of in-hospital mortality, compared with patients who received no treatment: hydroxychloroquine alone HR=1.34 (95%CI 1.22, 1.46),  hydroxychloroquine with a macrolide HR=1.45 (95%CI 1.37, 1.53), chloroquine alone HR=1.37 (95%CI 1.22, 1.53), and chloroquine with a macrolide HR=1.37 (95% CI 1.27, 1.47). All four treatments were also associated with strong increased risk of de-novo ventricular arrhythmias. 

Mehra et al. Hydroxychloroquine or Chloroquine with or without a Macrolide for Treatment of COVID-19: A Multinational Registry Analysis. The Lancet. https://doi.org/10.1016/S0140-6736(20)31180-6