Clinical outcomes of patients with mild COVID-19 following treatment with hydroxychloroquine in an outpatient setting.
Identifieur interne : 000001 ( Main/Corpus ); précédent : 000000; suivant : 000002Clinical outcomes of patients with mild COVID-19 following treatment with hydroxychloroquine in an outpatient setting.
Auteurs : Majid Mokhtari ; Minoo Mohraz ; Mohammad Mehdi Gouya ; Hengameh Namdari Tabar ; Jafar-Sadegh Tabrizi ; Katayoun Tayeri ; Saeide Aghamohamadi ; Zahra Rajabpoor ; Manoochehr Karami ; Alireza Raeisi ; Hamid Rahmani ; Hossein KhaliliSource :
- International immunopharmacology [ 1878-1705 ] ; 2021.
Abstract
The role of hydroxychloroquine (HCQ) in early outpatient management of mild coronavirus disease 2019 (COVID-19) needs further investigation. This study was a multicenter, population-based national retrospective-cohort investigation of 28,759 adults with mild COVID-19 seen at the network of Comprehensive Healthcare Centers (CHC) between March and September 2020 throughout Iran. The baseline characteristics and outcome variables were extracted from the national integrated health system database. A total of 7295 (25.37%) patients who presented with mild COVID-19 within 3-7 days of symptoms onset received HCQ (400 mg twice daily on day 1 followed by 200 mg twice daily for the next four days and were then followed for 14 days). The main outcome measures were hospitalization or death for six months follow-up. COVID-19-related hospitalizations or deaths occurred in 523 (7.17%) and 27 (0.37%) respectively, in HCQ recipients and 2382 (11.10%) and 287 (1.34%) respectively, in non-recipients. The odds of hospitalization or death was reduced by 38% (odds ratio [OR] = 0.62; 95% confidence interval [CI]: 0.56-0.68, p = < 0.001) and 73% (OR = 0.27; 95% CI: 0.18-0.41, p = < 0.001) in HCQ recipients and non-recipients. These effects were maintained after adjusting for age, comorbidities, and diagnostic modality. No serious HCQ-related adverse drug reactions were reported. In our large outpatient national cohort of adults with mild COVID-19 disease who were given HCQ early in the course of the disease, the odds of hospitalization or death was reduced significantly regardless of age or comorbidities.
DOI: 10.1016/j.intimp.2021.107636
PubMed: 34015598
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Clinical outcomes of patients with mild COVID-19 following treatment with hydroxychloroquine in an outpatient setting.</title><author><name sortKey="Mokhtari, Majid" sort="Mokhtari, Majid" uniqKey="Mokhtari M" first="Majid" last="Mokhtari">Majid Mokhtari</name><affiliation><nlm:affiliation>Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Electronic address: m.mokhtari@sbmu.ac.ir.</nlm:affiliation></affiliation></author><author><name sortKey="Mohraz, Minoo" sort="Mohraz, Minoo" uniqKey="Mohraz M" first="Minoo" last="Mohraz">Minoo Mohraz</name><affiliation><nlm:affiliation>Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran.</nlm:affiliation></affiliation></author><author><name sortKey="Gouya, Mohammad Mehdi" sort="Gouya, Mohammad Mehdi" uniqKey="Gouya M" first="Mohammad Mehdi" last="Gouya">Mohammad Mehdi Gouya</name><affiliation><nlm:affiliation>Center for Communicable Disease Control (CDC), IHR National Focal Point, Ministry of Health & Medical Education, Tehran, Iran.</nlm:affiliation></affiliation></author><author><name sortKey="Namdari Tabar, Hengameh" sort="Namdari Tabar, Hengameh" uniqKey="Namdari Tabar H" first="Hengameh" last="Namdari Tabar">Hengameh Namdari Tabar</name><affiliation><nlm:affiliation>Ministry of Health and Medical Education, AIDS/STI Control Dep. Ministry of Health and Medical Education, Eyvanak Street, Shahrak-e-Gharb, Tehran, Iran.</nlm:affiliation></affiliation></author><author><name sortKey="Tabrizi, Jafar Sadegh" sort="Tabrizi, Jafar Sadegh" uniqKey="Tabrizi J" first="Jafar-Sadegh" last="Tabrizi">Jafar-Sadegh Tabrizi</name><affiliation><nlm:affiliation>Tabriz Health Services Management Research Center, Tabriz, Iran. Electronic address: js.tabrizi@gmail.com.</nlm:affiliation></affiliation></author><author><name sortKey="Tayeri, Katayoun" sort="Tayeri, Katayoun" uniqKey="Tayeri K" first="Katayoun" last="Tayeri">Katayoun Tayeri</name><affiliation><nlm:affiliation>Ministry of Health and Medical Education, Tehran Iran, Eyvanak Street, Shahrak-e-Gharb, Tehran, Iran.</nlm:affiliation></affiliation></author><author><name sortKey="Aghamohamadi, Saeide" sort="Aghamohamadi, Saeide" uniqKey="Aghamohamadi S" first="Saeide" last="Aghamohamadi">Saeide Aghamohamadi</name><affiliation><nlm:affiliation>Health Service Management, Deputy of Health, Ministry of Health and Medical Education, Tehran, Iran. Electronic address: Aghamohamadi@health.gov.ir.</nlm:affiliation></affiliation></author><author><name sortKey="Rajabpoor, Zahra" sort="Rajabpoor, Zahra" uniqKey="Rajabpoor Z" first="Zahra" last="Rajabpoor">Zahra Rajabpoor</name><affiliation><nlm:affiliation>Ministry of Health and Medical Education, Eyvanak Street, Shahrak-e-Gharb, Tehran, Iran.</nlm:affiliation></affiliation></author><author><name sortKey="Karami, Manoochehr" sort="Karami, Manoochehr" uniqKey="Karami M" first="Manoochehr" last="Karami">Manoochehr Karami</name><affiliation><nlm:affiliation>Research Center for Health Sciences, Hamadan University of Medical Sciences, Hamadan, Iran.</nlm:affiliation></affiliation></author><author><name sortKey="Raeisi, Alireza" sort="Raeisi, Alireza" uniqKey="Raeisi A" first="Alireza" last="Raeisi">Alireza Raeisi</name><affiliation><nlm:affiliation>School of Medicine, Shiraz University of Medical Sciences, Shiraz Iran, Deputy of Health, Ministry of Health and Medical Education, Tehran, Iran.</nlm:affiliation></affiliation></author><author><name sortKey="Rahmani, Hamid" sort="Rahmani, Hamid" uniqKey="Rahmani H" first="Hamid" last="Rahmani">Hamid Rahmani</name><affiliation><nlm:affiliation>Department of Pharmacotherapy, Tehran University of Medical Sciences, Tehran, Iran.</nlm:affiliation></affiliation></author><author><name sortKey="Khalili, Hossein" sort="Khalili, Hossein" uniqKey="Khalili H" first="Hossein" last="Khalili">Hossein Khalili</name><affiliation><nlm:affiliation>Department of Pharmacotherapy, Tehran University of Medical Sciences, Postal Code: 1417614411, P.O. Box: 14155/6451, Tehran, Iran. Electronic address: khalilih@tums.ac.ir.</nlm:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2021">2021</date><idno type="RBID">pubmed:34015598</idno><idno type="pmid">34015598</idno><idno type="doi">10.1016/j.intimp.2021.107636</idno><idno type="wicri:Area/Main/Corpus">000001</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Corpus" wicri:corpus="PubMed">000001</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Clinical outcomes of patients with mild COVID-19 following treatment with hydroxychloroquine in an outpatient setting.</title><author><name sortKey="Mokhtari, Majid" sort="Mokhtari, Majid" uniqKey="Mokhtari M" first="Majid" last="Mokhtari">Majid Mokhtari</name><affiliation><nlm:affiliation>Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Electronic address: m.mokhtari@sbmu.ac.ir.</nlm:affiliation></affiliation></author><author><name sortKey="Mohraz, Minoo" sort="Mohraz, Minoo" uniqKey="Mohraz M" first="Minoo" last="Mohraz">Minoo Mohraz</name><affiliation><nlm:affiliation>Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran.</nlm:affiliation></affiliation></author><author><name sortKey="Gouya, Mohammad Mehdi" sort="Gouya, Mohammad Mehdi" uniqKey="Gouya M" first="Mohammad Mehdi" last="Gouya">Mohammad Mehdi Gouya</name><affiliation><nlm:affiliation>Center for Communicable Disease Control (CDC), IHR National Focal Point, Ministry of Health & Medical Education, Tehran, Iran.</nlm:affiliation></affiliation></author><author><name sortKey="Namdari Tabar, Hengameh" sort="Namdari Tabar, Hengameh" uniqKey="Namdari Tabar H" first="Hengameh" last="Namdari Tabar">Hengameh Namdari Tabar</name><affiliation><nlm:affiliation>Ministry of Health and Medical Education, AIDS/STI Control Dep. Ministry of Health and Medical Education, Eyvanak Street, Shahrak-e-Gharb, Tehran, Iran.</nlm:affiliation></affiliation></author><author><name sortKey="Tabrizi, Jafar Sadegh" sort="Tabrizi, Jafar Sadegh" uniqKey="Tabrizi J" first="Jafar-Sadegh" last="Tabrizi">Jafar-Sadegh Tabrizi</name><affiliation><nlm:affiliation>Tabriz Health Services Management Research Center, Tabriz, Iran. Electronic address: js.tabrizi@gmail.com.</nlm:affiliation></affiliation></author><author><name sortKey="Tayeri, Katayoun" sort="Tayeri, Katayoun" uniqKey="Tayeri K" first="Katayoun" last="Tayeri">Katayoun Tayeri</name><affiliation><nlm:affiliation>Ministry of Health and Medical Education, Tehran Iran, Eyvanak Street, Shahrak-e-Gharb, Tehran, Iran.</nlm:affiliation></affiliation></author><author><name sortKey="Aghamohamadi, Saeide" sort="Aghamohamadi, Saeide" uniqKey="Aghamohamadi S" first="Saeide" last="Aghamohamadi">Saeide Aghamohamadi</name><affiliation><nlm:affiliation>Health Service Management, Deputy of Health, Ministry of Health and Medical Education, Tehran, Iran. Electronic address: Aghamohamadi@health.gov.ir.</nlm:affiliation></affiliation></author><author><name sortKey="Rajabpoor, Zahra" sort="Rajabpoor, Zahra" uniqKey="Rajabpoor Z" first="Zahra" last="Rajabpoor">Zahra Rajabpoor</name><affiliation><nlm:affiliation>Ministry of Health and Medical Education, Eyvanak Street, Shahrak-e-Gharb, Tehran, Iran.</nlm:affiliation></affiliation></author><author><name sortKey="Karami, Manoochehr" sort="Karami, Manoochehr" uniqKey="Karami M" first="Manoochehr" last="Karami">Manoochehr Karami</name><affiliation><nlm:affiliation>Research Center for Health Sciences, Hamadan University of Medical Sciences, Hamadan, Iran.</nlm:affiliation></affiliation></author><author><name sortKey="Raeisi, Alireza" sort="Raeisi, Alireza" uniqKey="Raeisi A" first="Alireza" last="Raeisi">Alireza Raeisi</name><affiliation><nlm:affiliation>School of Medicine, Shiraz University of Medical Sciences, Shiraz Iran, Deputy of Health, Ministry of Health and Medical Education, Tehran, Iran.</nlm:affiliation></affiliation></author><author><name sortKey="Rahmani, Hamid" sort="Rahmani, Hamid" uniqKey="Rahmani H" first="Hamid" last="Rahmani">Hamid Rahmani</name><affiliation><nlm:affiliation>Department of Pharmacotherapy, Tehran University of Medical Sciences, Tehran, Iran.</nlm:affiliation></affiliation></author><author><name sortKey="Khalili, Hossein" sort="Khalili, Hossein" uniqKey="Khalili H" first="Hossein" last="Khalili">Hossein Khalili</name><affiliation><nlm:affiliation>Department of Pharmacotherapy, Tehran University of Medical Sciences, Postal Code: 1417614411, P.O. Box: 14155/6451, Tehran, Iran. Electronic address: khalilih@tums.ac.ir.</nlm:affiliation></affiliation></author></analytic><series><title level="j">International immunopharmacology</title><idno type="eISSN">1878-1705</idno><imprint><date when="2021" type="published">2021</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">The role of hydroxychloroquine (HCQ) in early outpatient management of mild coronavirus disease 2019 (COVID-19) needs further investigation. This study was a multicenter, population-based national retrospective-cohort investigation of 28,759 adults with mild COVID-19 seen at the network of Comprehensive Healthcare Centers (CHC) between March and September 2020 throughout Iran. The baseline characteristics and outcome variables were extracted from the national integrated health system database. A total of 7295 (25.37%) patients who presented with mild COVID-19 within 3-7 days of symptoms onset received HCQ (400 mg twice daily on day 1 followed by 200 mg twice daily for the next four days and were then followed for 14 days). The main outcome measures were hospitalization or death for six months follow-up. COVID-19-related hospitalizations or deaths occurred in 523 (7.17%) and 27 (0.37%) respectively, in HCQ recipients and 2382 (11.10%) and 287 (1.34%) respectively, in non-recipients. The odds of hospitalization or death was reduced by 38% (odds ratio [OR] = 0.62; 95% confidence interval [CI]: 0.56-0.68, p = < 0.001) and 73% (OR = 0.27; 95% CI: 0.18-0.41, p = < 0.001) in HCQ recipients and non-recipients. These effects were maintained after adjusting for age, comorbidities, and diagnostic modality. No serious HCQ-related adverse drug reactions were reported. In our large outpatient national cohort of adults with mild COVID-19 disease who were given HCQ early in the course of the disease, the odds of hospitalization or death was reduced significantly regardless of age or comorbidities.</div></front></TEI><pubmed><MedlineCitation Status="Publisher" Owner="NLM"><PMID Version="1">34015598</PMID><DateRevised><Year>2021</Year><Month>05</Month><Day>20</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1878-1705</ISSN><JournalIssue CitedMedium="Internet"><Volume>96</Volume><PubDate><Year>2021</Year><Month>Apr</Month><Day>06</Day></PubDate></JournalIssue><Title>International immunopharmacology</Title><ISOAbbreviation>Int Immunopharmacol</ISOAbbreviation></Journal><ArticleTitle>Clinical outcomes of patients with mild COVID-19 following treatment with hydroxychloroquine in an outpatient setting.</ArticleTitle><Pagination><MedlinePgn>107636</MedlinePgn></Pagination><ELocationID EIdType="pii" ValidYN="Y">S1567-5769(21)00272-1</ELocationID><ELocationID EIdType="doi" ValidYN="Y">10.1016/j.intimp.2021.107636</ELocationID><Abstract><AbstractText>The role of hydroxychloroquine (HCQ) in early outpatient management of mild coronavirus disease 2019 (COVID-19) needs further investigation. This study was a multicenter, population-based national retrospective-cohort investigation of 28,759 adults with mild COVID-19 seen at the network of Comprehensive Healthcare Centers (CHC) between March and September 2020 throughout Iran. The baseline characteristics and outcome variables were extracted from the national integrated health system database. A total of 7295 (25.37%) patients who presented with mild COVID-19 within 3-7 days of symptoms onset received HCQ (400 mg twice daily on day 1 followed by 200 mg twice daily for the next four days and were then followed for 14 days). The main outcome measures were hospitalization or death for six months follow-up. COVID-19-related hospitalizations or deaths occurred in 523 (7.17%) and 27 (0.37%) respectively, in HCQ recipients and 2382 (11.10%) and 287 (1.34%) respectively, in non-recipients. The odds of hospitalization or death was reduced by 38% (odds ratio [OR] = 0.62; 95% confidence interval [CI]: 0.56-0.68, p = < 0.001) and 73% (OR = 0.27; 95% CI: 0.18-0.41, p = < 0.001) in HCQ recipients and non-recipients. These effects were maintained after adjusting for age, comorbidities, and diagnostic modality. No serious HCQ-related adverse drug reactions were reported. In our large outpatient national cohort of adults with mild COVID-19 disease who were given HCQ early in the course of the disease, the odds of hospitalization or death was reduced significantly regardless of age or comorbidities.</AbstractText><CopyrightInformation>Copyright © 2021 Elsevier B.V. All rights reserved.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Mokhtari</LastName><ForeName>Majid</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Electronic address: m.mokhtari@sbmu.ac.ir.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Mohraz</LastName><ForeName>Minoo</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Gouya</LastName><ForeName>Mohammad Mehdi</ForeName><Initials>MM</Initials><AffiliationInfo><Affiliation>Center for Communicable Disease Control (CDC), IHR National Focal Point, Ministry of Health & Medical Education, Tehran, Iran.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Namdari Tabar</LastName><ForeName>Hengameh</ForeName><Initials>H</Initials><AffiliationInfo><Affiliation>Ministry of Health and Medical Education, AIDS/STI Control Dep. Ministry of Health and Medical Education, Eyvanak Street, Shahrak-e-Gharb, Tehran, Iran.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Tabrizi</LastName><ForeName>Jafar-Sadegh</ForeName><Initials>JS</Initials><AffiliationInfo><Affiliation>Tabriz Health Services Management Research Center, Tabriz, Iran. Electronic address: js.tabrizi@gmail.com.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Tayeri</LastName><ForeName>Katayoun</ForeName><Initials>K</Initials><AffiliationInfo><Affiliation>Ministry of Health and Medical Education, Tehran Iran, Eyvanak Street, Shahrak-e-Gharb, Tehran, Iran.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Aghamohamadi</LastName><ForeName>Saeide</ForeName><Initials>S</Initials><AffiliationInfo><Affiliation>Health Service Management, Deputy of Health, Ministry of Health and Medical Education, Tehran, Iran. Electronic address: Aghamohamadi@health.gov.ir.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Rajabpoor</LastName><ForeName>Zahra</ForeName><Initials>Z</Initials><AffiliationInfo><Affiliation>Ministry of Health and Medical Education, Eyvanak Street, Shahrak-e-Gharb, Tehran, Iran.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Karami</LastName><ForeName>Manoochehr</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Research Center for Health Sciences, Hamadan University of Medical Sciences, Hamadan, Iran.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Raeisi</LastName><ForeName>Alireza</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>School of Medicine, Shiraz University of Medical Sciences, Shiraz Iran, Deputy of Health, Ministry of Health and Medical Education, Tehran, Iran.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Rahmani</LastName><ForeName>Hamid</ForeName><Initials>H</Initials><AffiliationInfo><Affiliation>Department of Pharmacotherapy, Tehran University of Medical Sciences, Tehran, Iran.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Khalili</LastName><ForeName>Hossein</ForeName><Initials>H</Initials><AffiliationInfo><Affiliation>Department of Pharmacotherapy, Tehran University of Medical Sciences, Postal Code: 1417614411, P.O. Box: 14155/6451, Tehran, Iran. Electronic address: khalilih@tums.ac.ir.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2021</Year><Month>04</Month><Day>06</Day></ArticleDate></Article><MedlineJournalInfo><Country>Netherlands</Country><MedlineTA>Int Immunopharmacol</MedlineTA><NlmUniqueID>100965259</NlmUniqueID><ISSNLinking>1567-5769</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">COVID-19</Keyword><Keyword MajorTopicYN="N">Hydroxychloroquine</Keyword><Keyword MajorTopicYN="N">Outpatient</Keyword></KeywordList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2021</Year><Month>02</Month><Day>25</Day></PubMedPubDate><PubMedPubDate PubStatus="revised"><Year>2021</Year><Month>03</Month><Day>30</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2021</Year><Month>03</Month><Day>31</Day></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2021</Year><Month>5</Month><Day>20</Day><Hour>20</Hour><Minute>19</Minute></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2021</Year><Month>5</Month><Day>21</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2021</Year><Month>5</Month><Day>21</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>aheadofprint</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">34015598</ArticleId><ArticleId IdType="pii">S1567-5769(21)00272-1</ArticleId><ArticleId IdType="doi">10.1016/j.intimp.2021.107636</ArticleId></ArticleIdList></PubmedData></pubmed></record>Pour manipuler ce document sous Unix (Dilib)
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