Safety of hydroxychloroquine, alone and in combination with azithromycin, in light of rapid wide-spread use for COVID-19: a multinational, network cohort and self-controlled case series study

Jennifer C.E Lane; James Weaver; Kristin Kostka; Talita Duarte-Salles; Maria Tereza F. Abrahao; Heba Alghoul; Osaid Alser; Thamir M Alshammari; Patricia Biedermann; Edward Burn; Paula Casajust; Mitch Conover; Aedin C. Culhane; Alexander Davydov; Scott L. DuVall; Dmitry Dymshyts; Sergio Fernández Bertolín; Kristina Fišter; Jill Hardin; Laura Hester; George Hripcsak; Seamus Kent; Sajan Khosla; Spyros Kolovos; Christophe G. Lambert; Johan ver der Lei; Ajit A. Londhe; Kristine E. Lynch; Rupa Makadia; Andrea V. Margulis; Michael E. Matheny; Paras Mehta; Daniel R. Morales; Henry Morgan-Stewart; Mees Mosseveld; Danielle Newby; Fredrik Nyberg; Anna Ostropolets; Rae Woong Park; Albert Prats-Uribe; Gowtham A. Rao; Christian Reich; Jenna Reps; Peter Rijnbeek; Selva Muthu Kumaran Sathappan; Martijn Schuemie; Sarah Seager; Anthony Sena; Azza Shoaibi; Matthew Spotnitz; Marc A. Suchard; Joel Swerdel; Carmen Olga Torre; David Vizcaya; Haini Wen; Marcel de Wilde; Seng Chan You; Lin Zhang; Oleg Zhuk; Patrick Ryan; Daniel Prieto-Alhambra

is the (which was not peer-reviewed) The copyright holder for this preprint . https://doi.org/10.1101/2020.04.08.20054551 doi: medRxiv preprint has been proposed at higher doses than used in the treatment of auto-immune disorders and alongside azithromycin (AZM), a macrolide antibiotic. 23 24 Results from this open label observational study suggest that the combination of HCQ and azithromycin AZM might lead to a faster recovery and reductions in viral load in the treatment of COVID-19. However, many authors have criticised the study due to lack of low power, limited follow-up, confounding by indication, and lack of adherence to the allocated treatment arm. 25 The efficacy of HCQ in combination with AZM is therefore yet to be established, but approval for compassionate use by regulators and media attention will likely lead to an increase in use of this combined therapy for the management of COVID-19 worldwide.