Martin Cour1, Camille Amaz2, Julien Bohé3, Thomas Rimmelé4, Michel Ovize2, Laurent Argaud1. 1. Medical Intensive Care Department, Hospices Civils de Lyon, Edouard Herriot Hospital, Lyon, France. 2. Hospices Civils de Lyon, Investigation Clinical Center of Lyon, Lyon, France. 3. Medical Intensive Care Department, Hospices Civils de Lyon, Lyon-Sud Hospital, Lyon, France. 4. Anesthesia and Critical Care Department, Hospices Civils de Lyon, Edouard Herriot Hospital, Lyon, France.
Abstract
BACKGROUND: There are limited data on the effect of hydroxychloroquine on medium term outcomes in patients with coronavirus disease 2019 (COVID-19) requiring intensive care. We aimed to evaluate the effects of hydroxychloroquine on day 90 mortality in this specific population. METHODS: This retrospective, multicenter, propensity matched cohort analysis, used data of adult patients with laboratory confirmed COVID-19 admitted to 3 university affiliated intensive care units between March 7, 2020, to April 7, 2020 in Lyon, France. Patients received either hydroxychloroquine (loading dose of 400 mg twice daily at day 1 followed by 200 mg twice daily from day 2 to day 10) or standard of care without hydroxychloroquine. We compared all-cause mortality at day-90 after ICU admission between propensity score matched groups receiving hydroxychloroquine or standard of care. RESULTS: A total of 157 patients were included with a day-28 and day-90 mortality rate of 23.6% and 32.5%, respectively. The median (interquartile) age was 67 years (56-76 years), 105 (66.9%) were men, 65 (41.4%) fulfilled criteria for acute respiratory distress syndrome, and 64 (41%) received hydroxychloroquine (HCQ) for 10 days (4-10 days). In the propensity score matched cohort (59 patients in each group), day-90 mortality was 35.6% for patients who received HCQ and 23.7% for patients who did not (P=0.23). Kaplan Meier survival analysis showed no statistically significant association between HCQ therapy and mortality (P=0.20 by log-rank test). CONCLUSIONS: In this study, off-label use of HCQ in critically ill patients with COVID-19 was not associated with any significant change in medium-term prognosis, confirming results of studies in less severe patients. 2021 Annals of Translational Medicine. All rights reserved.
BACKGROUND: There are limited data on the effect of hydroxychloroquine on medium term outcomes in patients with coronavirus disease 2019 (COVID-19) requiring intensive care. We aimed to evaluate the effects of hydroxychloroquine on day 90 mortality in this specific population. METHODS: This retrospective, multicenter, propensity matched cohort analysis, used data of adult patients with laboratory confirmed COVID-19 admitted to 3 university affiliated intensive care units between March 7, 2020, to April 7, 2020 in Lyon, France. Patients received either hydroxychloroquine (loading dose of 400 mg twice daily at day 1 followed by 200 mg twice daily from day 2 to day 10) or standard of care without hydroxychloroquine. We compared all-cause mortality at day-90 after ICU admission between propensity score matched groups receiving hydroxychloroquine or standard of care. RESULTS: A total of 157 patients were included with a day-28 and day-90 mortality rate of 23.6% and 32.5%, respectively. The median (interquartile) age was 67 years (56-76 years), 105 (66.9%) were men, 65 (41.4%) fulfilled criteria for acute respiratory distress syndrome, and 64 (41%) received hydroxychloroquine (HCQ) for 10 days (4-10 days). In the propensity score matched cohort (59 patients in each group), day-90 mortality was 35.6% for patients who received HCQ and 23.7% for patients who did not (P=0.23). Kaplan Meier survival analysis showed no statistically significant association between HCQ therapy and mortality (P=0.20 by log-rank test). CONCLUSIONS: In this study, off-label use of HCQ in critically ill patients with COVID-19 was not associated with any significant change in medium-term prognosis, confirming results of studies in less severe patients. 2021 Annals of Translational Medicine. All rights reserved.
Authors: Francis Bessière; Hugo Roccia; Antoine Delinière; Rome Charrière; Philippe Chevalier; Laurent Argaud; Martin Cour Journal: JAMA Cardiol Date: 2020-09-01 Impact factor: 14.676
Authors: Eli S Rosenberg; Elizabeth M Dufort; Tomoko Udo; Larissa A Wilberschied; Jessica Kumar; James Tesoriero; Patti Weinberg; James Kirkwood; Alison Muse; Jack DeHovitz; Debra S Blog; Brad Hutton; David R Holtgrave; Howard A Zucker Journal: JAMA Date: 2020-06-23 Impact factor: 56.272
Authors: Peter Horby; Marion Mafham; Louise Linsell; Jennifer L Bell; Natalie Staplin; Jonathan R Emberson; Martin Wiselka; Andrew Ustianowski; Einas Elmahi; Benjamin Prudon; Tony Whitehouse; Timothy Felton; John Williams; Jakki Faccenda; Jonathan Underwood; J Kenneth Baillie; Lucy C Chappell; Saul N Faust; Thomas Jaki; Katie Jeffery; Wei Shen Lim; Alan Montgomery; Kathryn Rowan; Joel Tarning; James A Watson; Nicholas J White; Edmund Juszczak; Richard Haynes; Martin J Landray Journal: N Engl J Med Date: 2020-10-08 Impact factor: 91.245
Authors: Erik von Elm; Douglas G Altman; Matthias Egger; Stuart J Pocock; Peter C Gøtzsche; Jan P Vandenbroucke Journal: PLoS Med Date: 2007-10-16 Impact factor: 11.069