Effect of pre-exposure use of hydroxychloroquine on COVID-19 mortality: a population-based cohort study in patients with rheumatoid arthritis or systemic lupus erythematosus using the OpenSAFELY platform.
Identifieur interne : 000624 ( Main/Corpus ); précédent : 000623; suivant : 000625Effect of pre-exposure use of hydroxychloroquine on COVID-19 mortality: a population-based cohort study in patients with rheumatoid arthritis or systemic lupus erythematosus using the OpenSAFELY platform.
Auteurs : Christopher T. Rentsch ; Nicholas J. Devito ; Brian Mackenna ; Caroline E. Morton ; Krishnan Bhaskaran ; Jeremy P. Brown ; Anna Schultze ; William J. Hulme ; Richard Croker ; Alex J. Walker ; Elizabeth J. Williamson ; Chris Bates ; Seb Bacon ; Amir Mehrkar ; Helen J. Curtis ; David Evans ; Kevin Wing ; Peter Inglesby ; Rohini Mathur ; Henry Drysdale ; Angel Y S. Wong ; Helen I. Mcdonald ; Jonathan Cockburn ; Harriet Forbes ; John Parry ; Frank Hester ; Sam Harper ; Liam Smeeth ; Ian J. Douglas ; William G. Dixon ; Stephen J W. Evans ; Laurie Tomlinson ; Ben GoldacreSource :
- The Lancet. Rheumatology [ 2665-9913 ] ; 2021.
Abstract
Background
Hydroxychloroquine has been shown to inhibit entry of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) into epithelial cells in vitro, but clinical studies found no evidence of reduced mortality when treating patients with COVID-19. We aimed to evaluate the effectiveness of hydroxychloroquine for prevention of COVID-19 mortality, as opposed to treatment for the disease.
Methods
We did a prespecified observational, population-based cohort study using national primary care data and linked death registrations in the OpenSAFELY platform, which covers approximately 40% of the general population in England, UK. We included all adults aged 18 years and older registered with a general practice for 1 year or more on March 1, 2020. We used Cox regression to estimate the association between ongoing routine hydroxychloroquine use before the COVID-19 outbreak in England (considered as March 1, 2020) compared with non-users of hydroxychloroquine and risk of COVID-19 mortality among people with rheumatoid arthritis or systemic lupus erythematosus. Model adjustment was informed by a directed acyclic graph.
Findings
Between Sept 1, 2019, and March 1, 2020, of 194 637 people with rheumatoid arthritis or systemic lupus erythematosus, 30 569 (15·7%) received two or more prescriptions of hydroxychloroquine. Between March 1 and July 13, 2020, there were 547 COVID-19 deaths, 70 among hydroxychloroquine users. Estimated standardised cumulative COVID-19 mortality was 0·23% (95% CI 0·18 to 0·29) among users and 0·22% (0·20 to 0·25) among non-users; an absolute difference of 0·008% (-0·051 to 0·066). After accounting for age, sex, ethnicity, use of other immunosuppressive drugs, and geographical region, no association with COVID-19 mortality was observed (HR 1·03, 95% CI 0·80 to 1·33). We found no evidence of interactions with age or other immunosuppressive drugs. Quantitative bias analyses indicated that our observed associations were robust to missing information for additional biologic treatments for rheumatological disease. We observed similar associations with the negative control outcome of non-COVID-19 mortality.
Interpretation
We found no evidence of a difference in COVID-19 mortality among people who received hydroxychloroquine for treatment of rheumatological disease before the COVID-19 outbreak in England. Therefore, completion of randomised trials investigating pre-exposure prophylactic use of hydroxychloroquine for prevention of severe outcomes from COVID-19 are warranted.
Funding
Medical Research Council.
DOI: 10.1016/S2665-9913(20)30378-7
PubMed: 33349815
PubMed Central: PMC7745258
Links to Exploration step
pubmed:33349815Le document en format XML
<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Effect of pre-exposure use of hydroxychloroquine on COVID-19 mortality: a population-based cohort study in patients with rheumatoid arthritis or systemic lupus erythematosus using the OpenSAFELY platform.</title><author><name sortKey="Rentsch, Christopher T" sort="Rentsch, Christopher T" uniqKey="Rentsch C" first="Christopher T" last="Rentsch">Christopher T. Rentsch</name><affiliation><nlm:affiliation>Electronic Health Records Research Group, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK.</nlm:affiliation></affiliation></author><author><name sortKey="Devito, Nicholas J" sort="Devito, Nicholas J" uniqKey="Devito N" first="Nicholas J" last="Devito">Nicholas J. Devito</name><affiliation><nlm:affiliation>The DataLab, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.</nlm:affiliation></affiliation></author><author><name sortKey="Mackenna, Brian" sort="Mackenna, Brian" uniqKey="Mackenna B" first="Brian" last="Mackenna">Brian Mackenna</name><affiliation><nlm:affiliation>The DataLab, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.</nlm:affiliation></affiliation></author><author><name sortKey="Morton, Caroline E" sort="Morton, Caroline E" uniqKey="Morton C" first="Caroline E" last="Morton">Caroline E. Morton</name><affiliation><nlm:affiliation>The DataLab, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.</nlm:affiliation></affiliation></author><author><name sortKey="Bhaskaran, Krishnan" sort="Bhaskaran, Krishnan" uniqKey="Bhaskaran K" first="Krishnan" last="Bhaskaran">Krishnan Bhaskaran</name><affiliation><nlm:affiliation>Electronic Health Records Research Group, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK.</nlm:affiliation></affiliation></author><author><name sortKey="Brown, Jeremy P" sort="Brown, Jeremy P" uniqKey="Brown J" first="Jeremy P" last="Brown">Jeremy P. Brown</name><affiliation><nlm:affiliation>Electronic Health Records Research Group, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK.</nlm:affiliation></affiliation></author><author><name sortKey="Schultze, Anna" sort="Schultze, Anna" uniqKey="Schultze A" first="Anna" last="Schultze">Anna Schultze</name><affiliation><nlm:affiliation>Electronic Health Records Research Group, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK.</nlm:affiliation></affiliation></author><author><name sortKey="Hulme, William J" sort="Hulme, William J" uniqKey="Hulme W" first="William J" last="Hulme">William J. Hulme</name><affiliation><nlm:affiliation>The DataLab, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.</nlm:affiliation></affiliation></author><author><name sortKey="Croker, Richard" sort="Croker, Richard" uniqKey="Croker R" first="Richard" last="Croker">Richard Croker</name><affiliation><nlm:affiliation>The DataLab, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.</nlm:affiliation></affiliation></author><author><name sortKey="Walker, Alex J" sort="Walker, Alex J" uniqKey="Walker A" first="Alex J" last="Walker">Alex J. Walker</name><affiliation><nlm:affiliation>The DataLab, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.</nlm:affiliation></affiliation></author><author><name sortKey="Williamson, Elizabeth J" sort="Williamson, Elizabeth J" uniqKey="Williamson E" first="Elizabeth J" last="Williamson">Elizabeth J. Williamson</name><affiliation><nlm:affiliation>Electronic Health Records Research Group, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK.</nlm:affiliation></affiliation></author><author><name sortKey="Bates, Chris" sort="Bates, Chris" uniqKey="Bates C" first="Chris" last="Bates">Chris Bates</name><affiliation><nlm:affiliation>The Phoenix Partnership, Horsforth, Leeds, UK.</nlm:affiliation></affiliation></author><author><name sortKey="Bacon, Seb" sort="Bacon, Seb" uniqKey="Bacon S" first="Seb" last="Bacon">Seb Bacon</name><affiliation><nlm:affiliation>The DataLab, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.</nlm:affiliation></affiliation></author><author><name sortKey="Mehrkar, Amir" sort="Mehrkar, Amir" uniqKey="Mehrkar A" first="Amir" last="Mehrkar">Amir Mehrkar</name><affiliation><nlm:affiliation>The DataLab, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.</nlm:affiliation></affiliation></author><author><name sortKey="Curtis, Helen J" sort="Curtis, Helen J" uniqKey="Curtis H" first="Helen J" last="Curtis">Helen J. Curtis</name><affiliation><nlm:affiliation>The DataLab, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.</nlm:affiliation></affiliation></author><author><name sortKey="Evans, David" sort="Evans, David" uniqKey="Evans D" first="David" last="Evans">David Evans</name><affiliation><nlm:affiliation>The DataLab, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.</nlm:affiliation></affiliation></author><author><name sortKey="Wing, Kevin" sort="Wing, Kevin" uniqKey="Wing K" first="Kevin" last="Wing">Kevin Wing</name><affiliation><nlm:affiliation>Electronic Health Records Research Group, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK.</nlm:affiliation></affiliation></author><author><name sortKey="Inglesby, Peter" sort="Inglesby, Peter" uniqKey="Inglesby P" first="Peter" last="Inglesby">Peter Inglesby</name><affiliation><nlm:affiliation>The DataLab, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.</nlm:affiliation></affiliation></author><author><name sortKey="Mathur, Rohini" sort="Mathur, Rohini" uniqKey="Mathur R" first="Rohini" last="Mathur">Rohini Mathur</name><affiliation><nlm:affiliation>Electronic Health Records Research Group, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK.</nlm:affiliation></affiliation></author><author><name sortKey="Drysdale, Henry" sort="Drysdale, Henry" uniqKey="Drysdale H" first="Henry" last="Drysdale">Henry Drysdale</name><affiliation><nlm:affiliation>The DataLab, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.</nlm:affiliation></affiliation></author><author><name sortKey="Wong, Angel Y S" sort="Wong, Angel Y S" uniqKey="Wong A" first="Angel Y S" last="Wong">Angel Y S. Wong</name><affiliation><nlm:affiliation>Electronic Health Records Research Group, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK.</nlm:affiliation></affiliation></author><author><name sortKey="Mcdonald, Helen I" sort="Mcdonald, Helen I" uniqKey="Mcdonald H" first="Helen I" last="Mcdonald">Helen I. Mcdonald</name><affiliation><nlm:affiliation>Electronic Health Records Research Group, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK.</nlm:affiliation></affiliation></author><author><name sortKey="Cockburn, Jonathan" sort="Cockburn, Jonathan" uniqKey="Cockburn J" first="Jonathan" last="Cockburn">Jonathan Cockburn</name><affiliation><nlm:affiliation>The Phoenix Partnership, Horsforth, Leeds, UK.</nlm:affiliation></affiliation></author><author><name sortKey="Forbes, Harriet" sort="Forbes, Harriet" uniqKey="Forbes H" first="Harriet" last="Forbes">Harriet Forbes</name><affiliation><nlm:affiliation>Electronic Health Records Research Group, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK.</nlm:affiliation></affiliation></author><author><name sortKey="Parry, John" sort="Parry, John" uniqKey="Parry J" first="John" last="Parry">John Parry</name><affiliation><nlm:affiliation>The Phoenix Partnership, Horsforth, Leeds, UK.</nlm:affiliation></affiliation></author><author><name sortKey="Hester, Frank" sort="Hester, Frank" uniqKey="Hester F" first="Frank" last="Hester">Frank Hester</name><affiliation><nlm:affiliation>The Phoenix Partnership, Horsforth, Leeds, UK.</nlm:affiliation></affiliation></author><author><name sortKey="Harper, Sam" sort="Harper, Sam" uniqKey="Harper S" first="Sam" last="Harper">Sam Harper</name><affiliation><nlm:affiliation>The Phoenix Partnership, Horsforth, Leeds, UK.</nlm:affiliation></affiliation></author><author><name sortKey="Smeeth, Liam" sort="Smeeth, Liam" uniqKey="Smeeth L" first="Liam" last="Smeeth">Liam Smeeth</name><affiliation><nlm:affiliation>Electronic Health Records Research Group, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK.</nlm:affiliation></affiliation></author><author><name sortKey="Douglas, Ian J" sort="Douglas, Ian J" uniqKey="Douglas I" first="Ian J" last="Douglas">Ian J. Douglas</name><affiliation><nlm:affiliation>Electronic Health Records Research Group, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK.</nlm:affiliation></affiliation></author><author><name sortKey="Dixon, William G" sort="Dixon, William G" uniqKey="Dixon W" first="William G" last="Dixon">William G. Dixon</name><affiliation><nlm:affiliation>Centre for Epidemiology Versus Arthritis, The University of Manchester, Manchester, UK.</nlm:affiliation></affiliation></author><author><name sortKey="Evans, Stephen J W" sort="Evans, Stephen J W" uniqKey="Evans S" first="Stephen J W" last="Evans">Stephen J W. Evans</name><affiliation><nlm:affiliation>Electronic Health Records Research Group, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK.</nlm:affiliation></affiliation></author><author><name sortKey="Tomlinson, Laurie" sort="Tomlinson, Laurie" uniqKey="Tomlinson L" first="Laurie" last="Tomlinson">Laurie Tomlinson</name><affiliation><nlm:affiliation>Electronic Health Records Research Group, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK.</nlm:affiliation></affiliation></author><author><name sortKey="Goldacre, Ben" sort="Goldacre, Ben" uniqKey="Goldacre B" first="Ben" last="Goldacre">Ben Goldacre</name><affiliation><nlm:affiliation>The DataLab, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.</nlm:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2021">2021</date><idno type="RBID">pubmed:33349815</idno><idno type="pmid">33349815</idno><idno type="doi">10.1016/S2665-9913(20)30378-7</idno><idno type="pmc">PMC7745258</idno><idno type="wicri:Area/Main/Corpus">000624</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Corpus" wicri:corpus="PubMed">000624</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Effect of pre-exposure use of hydroxychloroquine on COVID-19 mortality: a population-based cohort study in patients with rheumatoid arthritis or systemic lupus erythematosus using the OpenSAFELY platform.</title><author><name sortKey="Rentsch, Christopher T" sort="Rentsch, Christopher T" uniqKey="Rentsch C" first="Christopher T" last="Rentsch">Christopher T. Rentsch</name><affiliation><nlm:affiliation>Electronic Health Records Research Group, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK.</nlm:affiliation></affiliation></author><author><name sortKey="Devito, Nicholas J" sort="Devito, Nicholas J" uniqKey="Devito N" first="Nicholas J" last="Devito">Nicholas J. Devito</name><affiliation><nlm:affiliation>The DataLab, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.</nlm:affiliation></affiliation></author><author><name sortKey="Mackenna, Brian" sort="Mackenna, Brian" uniqKey="Mackenna B" first="Brian" last="Mackenna">Brian Mackenna</name><affiliation><nlm:affiliation>The DataLab, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.</nlm:affiliation></affiliation></author><author><name sortKey="Morton, Caroline E" sort="Morton, Caroline E" uniqKey="Morton C" first="Caroline E" last="Morton">Caroline E. Morton</name><affiliation><nlm:affiliation>The DataLab, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.</nlm:affiliation></affiliation></author><author><name sortKey="Bhaskaran, Krishnan" sort="Bhaskaran, Krishnan" uniqKey="Bhaskaran K" first="Krishnan" last="Bhaskaran">Krishnan Bhaskaran</name><affiliation><nlm:affiliation>Electronic Health Records Research Group, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK.</nlm:affiliation></affiliation></author><author><name sortKey="Brown, Jeremy P" sort="Brown, Jeremy P" uniqKey="Brown J" first="Jeremy P" last="Brown">Jeremy P. Brown</name><affiliation><nlm:affiliation>Electronic Health Records Research Group, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK.</nlm:affiliation></affiliation></author><author><name sortKey="Schultze, Anna" sort="Schultze, Anna" uniqKey="Schultze A" first="Anna" last="Schultze">Anna Schultze</name><affiliation><nlm:affiliation>Electronic Health Records Research Group, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK.</nlm:affiliation></affiliation></author><author><name sortKey="Hulme, William J" sort="Hulme, William J" uniqKey="Hulme W" first="William J" last="Hulme">William J. Hulme</name><affiliation><nlm:affiliation>The DataLab, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.</nlm:affiliation></affiliation></author><author><name sortKey="Croker, Richard" sort="Croker, Richard" uniqKey="Croker R" first="Richard" last="Croker">Richard Croker</name><affiliation><nlm:affiliation>The DataLab, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.</nlm:affiliation></affiliation></author><author><name sortKey="Walker, Alex J" sort="Walker, Alex J" uniqKey="Walker A" first="Alex J" last="Walker">Alex J. Walker</name><affiliation><nlm:affiliation>The DataLab, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.</nlm:affiliation></affiliation></author><author><name sortKey="Williamson, Elizabeth J" sort="Williamson, Elizabeth J" uniqKey="Williamson E" first="Elizabeth J" last="Williamson">Elizabeth J. Williamson</name><affiliation><nlm:affiliation>Electronic Health Records Research Group, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK.</nlm:affiliation></affiliation></author><author><name sortKey="Bates, Chris" sort="Bates, Chris" uniqKey="Bates C" first="Chris" last="Bates">Chris Bates</name><affiliation><nlm:affiliation>The Phoenix Partnership, Horsforth, Leeds, UK.</nlm:affiliation></affiliation></author><author><name sortKey="Bacon, Seb" sort="Bacon, Seb" uniqKey="Bacon S" first="Seb" last="Bacon">Seb Bacon</name><affiliation><nlm:affiliation>The DataLab, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.</nlm:affiliation></affiliation></author><author><name sortKey="Mehrkar, Amir" sort="Mehrkar, Amir" uniqKey="Mehrkar A" first="Amir" last="Mehrkar">Amir Mehrkar</name><affiliation><nlm:affiliation>The DataLab, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.</nlm:affiliation></affiliation></author><author><name sortKey="Curtis, Helen J" sort="Curtis, Helen J" uniqKey="Curtis H" first="Helen J" last="Curtis">Helen J. Curtis</name><affiliation><nlm:affiliation>The DataLab, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.</nlm:affiliation></affiliation></author><author><name sortKey="Evans, David" sort="Evans, David" uniqKey="Evans D" first="David" last="Evans">David Evans</name><affiliation><nlm:affiliation>The DataLab, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.</nlm:affiliation></affiliation></author><author><name sortKey="Wing, Kevin" sort="Wing, Kevin" uniqKey="Wing K" first="Kevin" last="Wing">Kevin Wing</name><affiliation><nlm:affiliation>Electronic Health Records Research Group, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK.</nlm:affiliation></affiliation></author><author><name sortKey="Inglesby, Peter" sort="Inglesby, Peter" uniqKey="Inglesby P" first="Peter" last="Inglesby">Peter Inglesby</name><affiliation><nlm:affiliation>The DataLab, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.</nlm:affiliation></affiliation></author><author><name sortKey="Mathur, Rohini" sort="Mathur, Rohini" uniqKey="Mathur R" first="Rohini" last="Mathur">Rohini Mathur</name><affiliation><nlm:affiliation>Electronic Health Records Research Group, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK.</nlm:affiliation></affiliation></author><author><name sortKey="Drysdale, Henry" sort="Drysdale, Henry" uniqKey="Drysdale H" first="Henry" last="Drysdale">Henry Drysdale</name><affiliation><nlm:affiliation>The DataLab, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.</nlm:affiliation></affiliation></author><author><name sortKey="Wong, Angel Y S" sort="Wong, Angel Y S" uniqKey="Wong A" first="Angel Y S" last="Wong">Angel Y S. Wong</name><affiliation><nlm:affiliation>Electronic Health Records Research Group, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK.</nlm:affiliation></affiliation></author><author><name sortKey="Mcdonald, Helen I" sort="Mcdonald, Helen I" uniqKey="Mcdonald H" first="Helen I" last="Mcdonald">Helen I. Mcdonald</name><affiliation><nlm:affiliation>Electronic Health Records Research Group, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK.</nlm:affiliation></affiliation></author><author><name sortKey="Cockburn, Jonathan" sort="Cockburn, Jonathan" uniqKey="Cockburn J" first="Jonathan" last="Cockburn">Jonathan Cockburn</name><affiliation><nlm:affiliation>The Phoenix Partnership, Horsforth, Leeds, UK.</nlm:affiliation></affiliation></author><author><name sortKey="Forbes, Harriet" sort="Forbes, Harriet" uniqKey="Forbes H" first="Harriet" last="Forbes">Harriet Forbes</name><affiliation><nlm:affiliation>Electronic Health Records Research Group, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK.</nlm:affiliation></affiliation></author><author><name sortKey="Parry, John" sort="Parry, John" uniqKey="Parry J" first="John" last="Parry">John Parry</name><affiliation><nlm:affiliation>The Phoenix Partnership, Horsforth, Leeds, UK.</nlm:affiliation></affiliation></author><author><name sortKey="Hester, Frank" sort="Hester, Frank" uniqKey="Hester F" first="Frank" last="Hester">Frank Hester</name><affiliation><nlm:affiliation>The Phoenix Partnership, Horsforth, Leeds, UK.</nlm:affiliation></affiliation></author><author><name sortKey="Harper, Sam" sort="Harper, Sam" uniqKey="Harper S" first="Sam" last="Harper">Sam Harper</name><affiliation><nlm:affiliation>The Phoenix Partnership, Horsforth, Leeds, UK.</nlm:affiliation></affiliation></author><author><name sortKey="Smeeth, Liam" sort="Smeeth, Liam" uniqKey="Smeeth L" first="Liam" last="Smeeth">Liam Smeeth</name><affiliation><nlm:affiliation>Electronic Health Records Research Group, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK.</nlm:affiliation></affiliation></author><author><name sortKey="Douglas, Ian J" sort="Douglas, Ian J" uniqKey="Douglas I" first="Ian J" last="Douglas">Ian J. Douglas</name><affiliation><nlm:affiliation>Electronic Health Records Research Group, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK.</nlm:affiliation></affiliation></author><author><name sortKey="Dixon, William G" sort="Dixon, William G" uniqKey="Dixon W" first="William G" last="Dixon">William G. Dixon</name><affiliation><nlm:affiliation>Centre for Epidemiology Versus Arthritis, The University of Manchester, Manchester, UK.</nlm:affiliation></affiliation></author><author><name sortKey="Evans, Stephen J W" sort="Evans, Stephen J W" uniqKey="Evans S" first="Stephen J W" last="Evans">Stephen J W. Evans</name><affiliation><nlm:affiliation>Electronic Health Records Research Group, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK.</nlm:affiliation></affiliation></author><author><name sortKey="Tomlinson, Laurie" sort="Tomlinson, Laurie" uniqKey="Tomlinson L" first="Laurie" last="Tomlinson">Laurie Tomlinson</name><affiliation><nlm:affiliation>Electronic Health Records Research Group, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK.</nlm:affiliation></affiliation></author><author><name sortKey="Goldacre, Ben" sort="Goldacre, Ben" uniqKey="Goldacre B" first="Ben" last="Goldacre">Ben Goldacre</name><affiliation><nlm:affiliation>The DataLab, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.</nlm:affiliation></affiliation></author></analytic><series><title level="j">The Lancet. Rheumatology</title><idno type="eISSN">2665-9913</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"><p><b>Background</b></p><p>Hydroxychloroquine has been shown to inhibit entry of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) into epithelial cells in vitro, but clinical studies found no evidence of reduced mortality when treating patients with COVID-19. We aimed to evaluate the effectiveness of hydroxychloroquine for prevention of COVID-19 mortality, as opposed to treatment for the disease.</p></div><div type="abstract" xml:lang="en"><p><b>Methods</b></p><p>We did a prespecified observational, population-based cohort study using national primary care data and linked death registrations in the OpenSAFELY platform, which covers approximately 40% of the general population in England, UK. We included all adults aged 18 years and older registered with a general practice for 1 year or more on March 1, 2020. We used Cox regression to estimate the association between ongoing routine hydroxychloroquine use before the COVID-19 outbreak in England (considered as March 1, 2020) compared with non-users of hydroxychloroquine and risk of COVID-19 mortality among people with rheumatoid arthritis or systemic lupus erythematosus. Model adjustment was informed by a directed acyclic graph.</p></div><div type="abstract" xml:lang="en"><p><b>Findings</b></p><p>Between Sept 1, 2019, and March 1, 2020, of 194 637 people with rheumatoid arthritis or systemic lupus erythematosus, 30 569 (15·7%) received two or more prescriptions of hydroxychloroquine. Between March 1 and July 13, 2020, there were 547 COVID-19 deaths, 70 among hydroxychloroquine users. Estimated standardised cumulative COVID-19 mortality was 0·23% (95% CI 0·18 to 0·29) among users and 0·22% (0·20 to 0·25) among non-users; an absolute difference of 0·008% (-0·051 to 0·066). After accounting for age, sex, ethnicity, use of other immunosuppressive drugs, and geographical region, no association with COVID-19 mortality was observed (HR 1·03, 95% CI 0·80 to 1·33). We found no evidence of interactions with age or other immunosuppressive drugs. Quantitative bias analyses indicated that our observed associations were robust to missing information for additional biologic treatments for rheumatological disease. We observed similar associations with the negative control outcome of non-COVID-19 mortality.</p></div><div type="abstract" xml:lang="en"><p><b>Interpretation</b></p><p>We found no evidence of a difference in COVID-19 mortality among people who received hydroxychloroquine for treatment of rheumatological disease before the COVID-19 outbreak in England. Therefore, completion of randomised trials investigating pre-exposure prophylactic use of hydroxychloroquine for prevention of severe outcomes from COVID-19 are warranted.</p></div><div type="abstract" xml:lang="en"><p><b>Funding</b></p><p>Medical Research Council.</p></div></front></TEI><pubmed><MedlineCitation Status="PubMed-not-MEDLINE" Owner="NLM"><PMID Version="1">33349815</PMID><DateRevised><Year>2021</Year><Month>03</Month><Day>17</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">2665-9913</ISSN><JournalIssue CitedMedium="Internet"><Volume>3</Volume><Issue>1</Issue><PubDate><Year>2021</Year><Month>Jan</Month></PubDate></JournalIssue><Title>The Lancet. Rheumatology</Title><ISOAbbreviation>Lancet Rheumatol</ISOAbbreviation></Journal><ArticleTitle>Effect of pre-exposure use of hydroxychloroquine on COVID-19 mortality: a population-based cohort study in patients with rheumatoid arthritis or systemic lupus erythematosus using the OpenSAFELY platform.</ArticleTitle><Pagination><MedlinePgn>e19-e27</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1016/S2665-9913(20)30378-7</ELocationID><Abstract><AbstractText Label="Background" NlmCategory="UNASSIGNED">Hydroxychloroquine has been shown to inhibit entry of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) into epithelial cells in vitro, but clinical studies found no evidence of reduced mortality when treating patients with COVID-19. We aimed to evaluate the effectiveness of hydroxychloroquine for prevention of COVID-19 mortality, as opposed to treatment for the disease.</AbstractText><AbstractText Label="Methods" NlmCategory="UNASSIGNED">We did a prespecified observational, population-based cohort study using national primary care data and linked death registrations in the OpenSAFELY platform, which covers approximately 40% of the general population in England, UK. We included all adults aged 18 years and older registered with a general practice for 1 year or more on March 1, 2020. We used Cox regression to estimate the association between ongoing routine hydroxychloroquine use before the COVID-19 outbreak in England (considered as March 1, 2020) compared with non-users of hydroxychloroquine and risk of COVID-19 mortality among people with rheumatoid arthritis or systemic lupus erythematosus. Model adjustment was informed by a directed acyclic graph.</AbstractText><AbstractText Label="Findings" NlmCategory="UNASSIGNED">Between Sept 1, 2019, and March 1, 2020, of 194 637 people with rheumatoid arthritis or systemic lupus erythematosus, 30 569 (15·7%) received two or more prescriptions of hydroxychloroquine. Between March 1 and July 13, 2020, there were 547 COVID-19 deaths, 70 among hydroxychloroquine users. Estimated standardised cumulative COVID-19 mortality was 0·23% (95% CI 0·18 to 0·29) among users and 0·22% (0·20 to 0·25) among non-users; an absolute difference of 0·008% (-0·051 to 0·066). After accounting for age, sex, ethnicity, use of other immunosuppressive drugs, and geographical region, no association with COVID-19 mortality was observed (HR 1·03, 95% CI 0·80 to 1·33). We found no evidence of interactions with age or other immunosuppressive drugs. Quantitative bias analyses indicated that our observed associations were robust to missing information for additional biologic treatments for rheumatological disease. We observed similar associations with the negative control outcome of non-COVID-19 mortality.</AbstractText><AbstractText Label="Interpretation" NlmCategory="UNASSIGNED">We found no evidence of a difference in COVID-19 mortality among people who received hydroxychloroquine for treatment of rheumatological disease before the COVID-19 outbreak in England. Therefore, completion of randomised trials investigating pre-exposure prophylactic use of hydroxychloroquine for prevention of severe outcomes from COVID-19 are warranted.</AbstractText><AbstractText Label="Funding" NlmCategory="UNASSIGNED">Medical Research Council.</AbstractText><CopyrightInformation>© 2020 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Rentsch</LastName><ForeName>Christopher T</ForeName><Initials>CT</Initials><AffiliationInfo><Affiliation>Electronic Health Records Research Group, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>DeVito</LastName><ForeName>Nicholas J</ForeName><Initials>NJ</Initials><AffiliationInfo><Affiliation>The DataLab, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>MacKenna</LastName><ForeName>Brian</ForeName><Initials>B</Initials><AffiliationInfo><Affiliation>The DataLab, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Morton</LastName><ForeName>Caroline E</ForeName><Initials>CE</Initials><AffiliationInfo><Affiliation>The DataLab, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Bhaskaran</LastName><ForeName>Krishnan</ForeName><Initials>K</Initials><AffiliationInfo><Affiliation>Electronic Health Records Research Group, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Brown</LastName><ForeName>Jeremy P</ForeName><Initials>JP</Initials><AffiliationInfo><Affiliation>Electronic Health Records Research Group, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Schultze</LastName><ForeName>Anna</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>Electronic Health Records Research Group, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Hulme</LastName><ForeName>William J</ForeName><Initials>WJ</Initials><AffiliationInfo><Affiliation>The DataLab, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Croker</LastName><ForeName>Richard</ForeName><Initials>R</Initials><AffiliationInfo><Affiliation>The DataLab, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Walker</LastName><ForeName>Alex J</ForeName><Initials>AJ</Initials><AffiliationInfo><Affiliation>The DataLab, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Williamson</LastName><ForeName>Elizabeth J</ForeName><Initials>EJ</Initials><AffiliationInfo><Affiliation>Electronic Health Records Research Group, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Bates</LastName><ForeName>Chris</ForeName><Initials>C</Initials><AffiliationInfo><Affiliation>The Phoenix Partnership, Horsforth, Leeds, UK.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Bacon</LastName><ForeName>Seb</ForeName><Initials>S</Initials><AffiliationInfo><Affiliation>The DataLab, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Mehrkar</LastName><ForeName>Amir</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>The DataLab, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Curtis</LastName><ForeName>Helen J</ForeName><Initials>HJ</Initials><AffiliationInfo><Affiliation>The DataLab, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Evans</LastName><ForeName>David</ForeName><Initials>D</Initials><AffiliationInfo><Affiliation>The DataLab, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Wing</LastName><ForeName>Kevin</ForeName><Initials>K</Initials><AffiliationInfo><Affiliation>Electronic Health Records Research Group, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Inglesby</LastName><ForeName>Peter</ForeName><Initials>P</Initials><AffiliationInfo><Affiliation>The DataLab, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Mathur</LastName><ForeName>Rohini</ForeName><Initials>R</Initials><AffiliationInfo><Affiliation>Electronic Health Records Research Group, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Drysdale</LastName><ForeName>Henry</ForeName><Initials>H</Initials><AffiliationInfo><Affiliation>The DataLab, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Wong</LastName><ForeName>Angel Y S</ForeName><Initials>AYS</Initials><AffiliationInfo><Affiliation>Electronic Health Records Research Group, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>McDonald</LastName><ForeName>Helen I</ForeName><Initials>HI</Initials><AffiliationInfo><Affiliation>Electronic Health Records Research Group, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Cockburn</LastName><ForeName>Jonathan</ForeName><Initials>J</Initials><AffiliationInfo><Affiliation>The Phoenix Partnership, Horsforth, Leeds, UK.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Forbes</LastName><ForeName>Harriet</ForeName><Initials>H</Initials><AffiliationInfo><Affiliation>Electronic Health Records Research Group, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Parry</LastName><ForeName>John</ForeName><Initials>J</Initials><AffiliationInfo><Affiliation>The Phoenix Partnership, Horsforth, Leeds, UK.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Hester</LastName><ForeName>Frank</ForeName><Initials>F</Initials><AffiliationInfo><Affiliation>The Phoenix Partnership, Horsforth, Leeds, UK.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Harper</LastName><ForeName>Sam</ForeName><Initials>S</Initials><AffiliationInfo><Affiliation>The Phoenix Partnership, Horsforth, Leeds, UK.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Smeeth</LastName><ForeName>Liam</ForeName><Initials>L</Initials><AffiliationInfo><Affiliation>Electronic Health Records Research Group, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Douglas</LastName><ForeName>Ian J</ForeName><Initials>IJ</Initials><AffiliationInfo><Affiliation>Electronic Health Records Research Group, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Dixon</LastName><ForeName>William G</ForeName><Initials>WG</Initials><AffiliationInfo><Affiliation>Centre for Epidemiology Versus Arthritis, The University of Manchester, Manchester, UK.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Evans</LastName><ForeName>Stephen J W</ForeName><Initials>SJW</Initials><AffiliationInfo><Affiliation>Electronic Health Records Research Group, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Tomlinson</LastName><ForeName>Laurie</ForeName><Initials>L</Initials><AffiliationInfo><Affiliation>Electronic Health Records Research Group, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Goldacre</LastName><ForeName>Ben</ForeName><Initials>B</Initials><AffiliationInfo><Affiliation>The DataLab, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><GrantList CompleteYN="Y"><Grant><Acronym>WT_</Acronym><Agency>Wellcome Trust</Agency><Country>United Kingdom</Country></Grant><Grant><GrantID>MR/V015737/1</GrantID><Acronym>MRC_</Acronym><Agency>Medical Research Council</Agency><Country>United Kingdom</Country></Grant></GrantList><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2020</Year><Month>11</Month><Day>05</Day></ArticleDate></Article><MedlineJournalInfo><Country>England</Country><MedlineTA>Lancet Rheumatol</MedlineTA><NlmUniqueID>101765308</NlmUniqueID><ISSNLinking>2665-9913</ISSNLinking></MedlineJournalInfo></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="pubmed"><Year>2020</Year><Month>12</Month><Day>23</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2020</Year><Month>12</Month><Day>23</Day><Hour>6</Hour><Minute>1</Minute></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2020</Year><Month>12</Month><Day>22</Day><Hour>5</Hour><Minute>46</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">33349815</ArticleId><ArticleId IdType="doi">10.1016/S2665-9913(20)30378-7</ArticleId><ArticleId IdType="pii">S2665-9913(20)30378-7</ArticleId><ArticleId IdType="pmc">PMC7745258</ArticleId></ArticleIdList><pmc-dir>pmcsd</pmc-dir>
<ReferenceList><Reference><Citation>Int J Epidemiol. 2014 Aug;43(4):1336-9</Citation><ArticleIdList><ArticleId IdType="pubmed">24706730</ArticleId></ArticleIdList></Reference><Reference><Citation>Int J Clin Rheumtol. 2010 Jun 1;5(3):313-326</Citation><ArticleIdList><ArticleId IdType="pubmed">20676388</ArticleId></ArticleIdList></Reference><Reference><Citation>N Engl J Med. 2020 Aug 6;383(6):517-525</Citation><ArticleIdList><ArticleId IdType="pubmed">32492293</ArticleId></ArticleIdList></Reference><Reference><Citation>BMJ. 2020 May 14;369:m1844</Citation><ArticleIdList><ArticleId IdType="pubmed">32409486</ArticleId></ArticleIdList></Reference><Reference><Citation>Cell Discov. 2020 Mar 18;6:16</Citation><ArticleIdList><ArticleId IdType="pubmed">32194981</ArticleId></ArticleIdList></Reference><Reference><Citation>Int J Infect Dis. 2020 Sep;98:216-217</Citation><ArticleIdList><ArticleId IdType="pubmed">32623080</ArticleId></ArticleIdList></Reference><Reference><Citation>Arthritis Rheum. 2008 Sep 15;59(9):1314-21</Citation><ArticleIdList><ArticleId IdType="pubmed">18759262</ArticleId></ArticleIdList></Reference><Reference><Citation>N Engl J Med. 2020 Nov 19;383(21):2030-2040</Citation><ArticleIdList><ArticleId IdType="pubmed">33031652</ArticleId></ArticleIdList></Reference><Reference><Citation>Med (N Y). 2020 Dec 18;1(1):114-127.e3</Citation><ArticleIdList><ArticleId IdType="pubmed">32838355</ArticleId></ArticleIdList></Reference><Reference><Citation>Eur J Epidemiol. 2013 Feb;28(2):113-7</Citation><ArticleIdList><ArticleId IdType="pubmed">23371044</ArticleId></ArticleIdList></Reference><Reference><Citation>Curr Med Res Opin. 2012 Oct;28(10):1733-41</Citation><ArticleIdList><ArticleId IdType="pubmed">22978773</ArticleId></ArticleIdList></Reference><Reference><Citation>BMJ. 2020 Jul 17;370:m2607</Citation><ArticleIdList><ArticleId IdType="pubmed">32680848</ArticleId></ArticleIdList></Reference><Reference><Citation>Stat Med. 2007 Mar 15;26(6):1360-7</Citation><ArticleIdList><ArticleId IdType="pubmed">16900575</ArticleId></ArticleIdList></Reference><Reference><Citation>Ann Intern Med. 2020 Aug 18;173(4):287-296</Citation><ArticleIdList><ArticleId IdType="pubmed">32459529</ArticleId></ArticleIdList></Reference><Reference><Citation>Elife. 2020 Jul 08;9:</Citation><ArticleIdList><ArticleId IdType="pubmed">32639233</ArticleId></ArticleIdList></Reference><Reference><Citation>Clin Infect Dis. 2020 Jul 28;71(15):732-739</Citation><ArticleIdList><ArticleId IdType="pubmed">32150618</ArticleId></ArticleIdList></Reference><Reference><Citation>Ann Intern Med. 2020 Oct 20;173(8):623-631</Citation><ArticleIdList><ArticleId IdType="pubmed">32673060</ArticleId></ArticleIdList></Reference><Reference><Citation>Nat Commun. 2020 Nov 12;11(1):5749</Citation><ArticleIdList><ArticleId IdType="pubmed">33184277</ArticleId></ArticleIdList></Reference><Reference><Citation>JAMA. 2020 Jun 23;323(24):2493-2502</Citation><ArticleIdList><ArticleId IdType="pubmed">32392282</ArticleId></ArticleIdList></Reference><Reference><Citation>Clin Infect Dis. 2020 Jul 16;:</Citation><ArticleIdList><ArticleId IdType="pubmed">32674126</ArticleId></ArticleIdList></Reference><Reference><Citation>Nature. 2020 Aug;584(7821):430-436</Citation><ArticleIdList><ArticleId IdType="pubmed">32640463</ArticleId></ArticleIdList></Reference><Reference><Citation>N Engl J Med. 2020 Nov 19;383(21):2041-2052</Citation><ArticleIdList><ArticleId IdType="pubmed">32706953</ArticleId></ArticleIdList></Reference><Reference><Citation>Int J Antimicrob Agents. 2020 Jun;55(6):105988</Citation><ArticleIdList><ArticleId IdType="pubmed">32305587</ArticleId></ArticleIdList></Reference></ReferenceList></PubmedData></pubmed></record>Pour manipuler ce document sous Unix (Dilib)
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