Hydroxychloroquine in hospitalized COVID‐19 patients: Real world experience assessing mortality

Annie, Frank H.; Sirbu, Cristian; Frazier, Keely R.; Broce, Mike; Lucas, B. Daniel

INTRODUCTION: Hydroxychloroquine (HCQ) for COVID‐19 is presently being used off‐label or within a clinical trial. OBJECTIVES: We investigated a multinational COVID‐19 patient database of real world data containing outcomes and their relationship to HCQ use. The primary outcome was all‐cause mortality within 30 days follow‐up. METHODS: Retrospective cohort study of patients receiving HCQ within 48 hours of hospital admission. Medications, preexisting conditions, clinical measures on admission, and outcomes were recorded. RESULTS: Among patients with a diagnosis of COVID‐19 in our propensity matched cohort, the mean ages±SD were 62.3±15.9 years (53.7% male) and 61.9±16.0 years (53.0% male) in the HCQ and no‐HCQ groups, respectively. There was no difference in overall 30‐day mortality between the HCQ and no‐HCQ groups (HCQ 13.1%, n=367; No‐HCQ 13.6%, n=367; OR 0.95; 95% CI 0.62‐1.46) after propensity‐matching. Although statistically insignificant, the HCQ/azithromycin (AZ) group had an overall mortality rate of 14.6% (n=199) compared with propensity matched no HCQ/+AZ cohort’s rate of 12.1% (n=199) (OR 1.24; 95% CI 0.70‐2.22). Importantly, however, there was no trend in this cohort’s overall mortality/arrhythmogenesis outcome (HCQ/AZ 17.1%, No‐HCQ/No AZ 17.1%; OR 1.0; 95% CI 0.6‐1.7). CONCLUSIONS: We report from a large retrospective multinational database analysis of COVID‐19 outcomes with HCQ and overall mortality in hospitalized patients. There was no statistically significant increase in mortality and mortality/arrhythmia with HCQ or HCQ/AZ.