Efficacy of early hydroxychloroquine treatment in preventing COVID-19 pneumonia aggravation, the experience from Shanghai, China.
Identifieur interne : 000632 ( Main/Corpus ); précédent : 000631; suivant : 000633Efficacy of early hydroxychloroquine treatment in preventing COVID-19 pneumonia aggravation, the experience from Shanghai, China.
Auteurs : Yi Su ; Yun Ling ; Yuyan Ma ; Lili Tao ; Qing Miao ; Qingfeng Shi ; Jue Pan ; Hongzhou Lu ; Bijie HuSource :
- Bioscience trends [ 1881-7823 ] ; 2021.
English descriptors
- KwdEn :
- MESH :
- chemical , administration & dosage : Antimalarials, Hydroxychloroquine.
- geographic : China.
- drug therapy : COVID-19.
- Adult, Aged, Female, Humans, Male, Middle Aged, Retrospective Studies, Treatment Outcome.
Abstract
The aim of this study is to assess the efficacy of multiple treatments, especially hydroxychloroquine, used in different disease stages of coronavirus disease 2019 (COVID-19). All consecutive patients with COVID-19 admitted to Shanghai Public Health Clinical Center (Shanghai, China) between January 20, 2020, and April 30, 2020, were enrolled, and their clinical data were retrospectively collected. Binary logistic regression was used to screen the factors associated with disease aggravation, and multivariable analyses with the Cox proportional hazards model were used to estimate the effects of prognostic factors on the improvement time and PCR conversion days in throat swabs and stool swabs. A total of 616 patients, including 50 (8.11%) severe and 18 (2.92%) critical patients, were enrolled in our retrospective cohort study. The early use of hydroxychloroquine was a protective factor associated with disease aggravation (95% CI: 0.040-0.575, p = 0.006). Clinical improvement by 20 days was significantly different between patients with hydroxychloroquine used early and those with hydroxychloroquine not used (p = 0.016, 95% CI: 1.052-1.647). The median time to clinical improvement was 6 days in the hydroxychloroquine used early group, compared with 9 days in the without hydroxychloroquine used group and 8 days in the with hydroxychloroquine not used early group (p < 0.001). Hydroxychloroquine used early was associated with earlier PCR conversion in both throat swabs (HR = 1.558, p = 0.001) and stool swabs (HR = 1.400, p = 0.028). The use of hydroxychloroquine at an early stage is a potential therapeutic strategy for treating patients before irreversible severe respiratory complications occur. The early use of hydroxychloroquine decreased the improvement time and the duration of COVID-19 detection in throat and stool swabs.
DOI: 10.5582/bst.2020.03340
PubMed: 33342929
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pubmed:33342929Le document en format XML
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sortKey="Tao, Lili" sort="Tao, Lili" uniqKey="Tao L" first="Lili" last="Tao">Lili Tao</name><affiliation><nlm:affiliation>UT Southwestern Medical Center, Department of Immunology, Texas, USA.</nlm:affiliation></affiliation></author><author><name sortKey="Miao, Qing" sort="Miao, Qing" uniqKey="Miao Q" first="Qing" last="Miao">Qing Miao</name><affiliation><nlm:affiliation>Department of Infectious Diseases, Zhongshan Hospital Fudan University, Shanghai, China.</nlm:affiliation></affiliation></author><author><name sortKey="Shi, Qingfeng" sort="Shi, Qingfeng" uniqKey="Shi Q" first="Qingfeng" last="Shi">Qingfeng Shi</name><affiliation><nlm:affiliation>Department of Infectious Control, Zhongshan Hospital Fudan University, Shanghai, China.</nlm:affiliation></affiliation></author><author><name sortKey="Pan, Jue" sort="Pan, Jue" uniqKey="Pan J" first="Jue" last="Pan">Jue Pan</name><affiliation><nlm:affiliation>Department of Infectious Diseases, Zhongshan Hospital Fudan University, Shanghai, China.</nlm:affiliation></affiliation></author><author><name sortKey="Lu, Hongzhou" sort="Lu, Hongzhou" uniqKey="Lu H" first="Hongzhou" last="Lu">Hongzhou Lu</name><affiliation><nlm:affiliation>Department of Infectious Diseases, Shanghai Public Health Clinical Center, China.</nlm:affiliation></affiliation></author><author><name sortKey="Hu, Bijie" sort="Hu, Bijie" uniqKey="Hu B" first="Bijie" last="Hu">Bijie Hu</name><affiliation><nlm:affiliation>Department of Infectious Diseases, Zhongshan Hospital Fudan University, Shanghai, China.</nlm:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2021">2021</date><idno type="RBID">pubmed:33342929</idno><idno type="pmid">33342929</idno><idno type="doi">10.5582/bst.2020.03340</idno><idno type="wicri:Area/Main/Corpus">000632</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Corpus" wicri:corpus="PubMed">000632</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Efficacy of early hydroxychloroquine treatment in preventing COVID-19 pneumonia aggravation, the experience from Shanghai, China.</title><author><name sortKey="Su, Yi" sort="Su, Yi" uniqKey="Su Y" first="Yi" last="Su">Yi Su</name><affiliation><nlm:affiliation>Department of Infectious Diseases, Zhongshan Hospital Fudan University, Shanghai, China.</nlm:affiliation></affiliation></author><author><name sortKey="Ling, Yun" sort="Ling, Yun" uniqKey="Ling Y" first="Yun" last="Ling">Yun Ling</name><affiliation><nlm:affiliation>Department of Infectious Diseases, Shanghai Public Health Clinical Center, China.</nlm:affiliation></affiliation></author><author><name sortKey="Ma, Yuyan" sort="Ma, Yuyan" uniqKey="Ma Y" first="Yuyan" last="Ma">Yuyan Ma</name><affiliation><nlm:affiliation>Department of Infectious Diseases, Zhongshan Hospital Fudan University, Shanghai, China.</nlm:affiliation></affiliation></author><author><name sortKey="Tao, Lili" sort="Tao, Lili" uniqKey="Tao L" first="Lili" last="Tao">Lili Tao</name><affiliation><nlm:affiliation>UT Southwestern Medical Center, Department of Immunology, Texas, USA.</nlm:affiliation></affiliation></author><author><name sortKey="Miao, Qing" sort="Miao, Qing" uniqKey="Miao Q" first="Qing" last="Miao">Qing Miao</name><affiliation><nlm:affiliation>Department of Infectious Diseases, Zhongshan Hospital Fudan University, Shanghai, China.</nlm:affiliation></affiliation></author><author><name sortKey="Shi, Qingfeng" sort="Shi, Qingfeng" uniqKey="Shi Q" first="Qingfeng" last="Shi">Qingfeng Shi</name><affiliation><nlm:affiliation>Department of Infectious Control, Zhongshan Hospital Fudan University, Shanghai, China.</nlm:affiliation></affiliation></author><author><name sortKey="Pan, Jue" sort="Pan, Jue" uniqKey="Pan J" first="Jue" last="Pan">Jue Pan</name><affiliation><nlm:affiliation>Department of Infectious Diseases, Zhongshan Hospital Fudan University, Shanghai, China.</nlm:affiliation></affiliation></author><author><name sortKey="Lu, Hongzhou" sort="Lu, Hongzhou" uniqKey="Lu H" first="Hongzhou" last="Lu">Hongzhou Lu</name><affiliation><nlm:affiliation>Department of Infectious Diseases, Shanghai Public Health Clinical Center, China.</nlm:affiliation></affiliation></author><author><name sortKey="Hu, Bijie" sort="Hu, Bijie" uniqKey="Hu B" first="Bijie" last="Hu">Bijie Hu</name><affiliation><nlm:affiliation>Department of Infectious Diseases, Zhongshan Hospital Fudan University, Shanghai, China.</nlm:affiliation></affiliation></author></analytic><series><title level="j">Bioscience trends</title><idno type="eISSN">1881-7823</idno><imprint><date when="2021" type="published">2021</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adult (MeSH)</term><term>Aged (MeSH)</term><term>Antimalarials (administration & dosage)</term><term>COVID-19 (drug therapy)</term><term>China (MeSH)</term><term>Female (MeSH)</term><term>Humans (MeSH)</term><term>Hydroxychloroquine (administration & dosage)</term><term>Male (MeSH)</term><term>Middle Aged (MeSH)</term><term>Retrospective Studies (MeSH)</term><term>Treatment Outcome (MeSH)</term></keywords><keywords scheme="MESH" type="chemical" qualifier="administration & dosage" xml:lang="en"><term>Antimalarials</term><term>Hydroxychloroquine</term></keywords><keywords scheme="MESH" type="geographic" xml:lang="en"><term>China</term></keywords><keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>COVID-19</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adult</term><term>Aged</term><term>Female</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Retrospective Studies</term><term>Treatment Outcome</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">The aim of this study is to assess the efficacy of multiple treatments, especially hydroxychloroquine, used in different disease stages of coronavirus disease 2019 (COVID-19). All consecutive patients with COVID-19 admitted to Shanghai Public Health Clinical Center (Shanghai, China) between January 20, 2020, and April 30, 2020, were enrolled, and their clinical data were retrospectively collected. Binary logistic regression was used to screen the factors associated with disease aggravation, and multivariable analyses with the Cox proportional hazards model were used to estimate the effects of prognostic factors on the improvement time and PCR conversion days in throat swabs and stool swabs. A total of 616 patients, including 50 (8.11%) severe and 18 (2.92%) critical patients, were enrolled in our retrospective cohort study. The early use of hydroxychloroquine was a protective factor associated with disease aggravation (95% CI: 0.040-0.575, p = 0.006). Clinical improvement by 20 days was significantly different between patients with hydroxychloroquine used early and those with hydroxychloroquine not used (p = 0.016, 95% CI: 1.052-1.647). The median time to clinical improvement was 6 days in the hydroxychloroquine used early group, compared with 9 days in the without hydroxychloroquine used group and 8 days in the with hydroxychloroquine not used early group (p < 0.001). Hydroxychloroquine used early was associated with earlier PCR conversion in both throat swabs (HR = 1.558, p = 0.001) and stool swabs (HR = 1.400, p = 0.028). The use of hydroxychloroquine at an early stage is a potential therapeutic strategy for treating patients before irreversible severe respiratory complications occur. The early use of hydroxychloroquine decreased the improvement time and the duration of COVID-19 detection in throat and stool swabs.</div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">33342929</PMID><DateCompleted><Year>2021</Year><Month>01</Month><Day>29</Day></DateCompleted><DateRevised><Year>2021</Year><Month>01</Month><Day>29</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1881-7823</ISSN><JournalIssue CitedMedium="Internet"><Volume>14</Volume><Issue>6</Issue><PubDate><Year>2021</Year><Month>Jan</Month><Day>23</Day></PubDate></JournalIssue><Title>Bioscience trends</Title><ISOAbbreviation>Biosci Trends</ISOAbbreviation></Journal><ArticleTitle>Efficacy of early hydroxychloroquine treatment in preventing COVID-19 pneumonia aggravation, the experience from Shanghai, China.</ArticleTitle><Pagination><MedlinePgn>408-414</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.5582/bst.2020.03340</ELocationID><Abstract><AbstractText>The aim of this study is to assess the efficacy of multiple treatments, especially hydroxychloroquine, used in different disease stages of coronavirus disease 2019 (COVID-19). All consecutive patients with COVID-19 admitted to Shanghai Public Health Clinical Center (Shanghai, China) between January 20, 2020, and April 30, 2020, were enrolled, and their clinical data were retrospectively collected. Binary logistic regression was used to screen the factors associated with disease aggravation, and multivariable analyses with the Cox proportional hazards model were used to estimate the effects of prognostic factors on the improvement time and PCR conversion days in throat swabs and stool swabs. A total of 616 patients, including 50 (8.11%) severe and 18 (2.92%) critical patients, were enrolled in our retrospective cohort study. The early use of hydroxychloroquine was a protective factor associated with disease aggravation (95% CI: 0.040-0.575, p = 0.006). Clinical improvement by 20 days was significantly different between patients with hydroxychloroquine used early and those with hydroxychloroquine not used (p = 0.016, 95% CI: 1.052-1.647). The median time to clinical improvement was 6 days in the hydroxychloroquine used early group, compared with 9 days in the without hydroxychloroquine used group and 8 days in the with hydroxychloroquine not used early group (p < 0.001). Hydroxychloroquine used early was associated with earlier PCR conversion in both throat swabs (HR = 1.558, p = 0.001) and stool swabs (HR = 1.400, p = 0.028). The use of hydroxychloroquine at an early stage is a potential therapeutic strategy for treating patients before irreversible severe respiratory complications occur. The early use of hydroxychloroquine decreased the improvement time and the duration of COVID-19 detection in throat and stool swabs.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Su</LastName><ForeName>Yi</ForeName><Initials>Y</Initials><AffiliationInfo><Affiliation>Department of Infectious Diseases, Zhongshan Hospital Fudan University, Shanghai, China.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Ling</LastName><ForeName>Yun</ForeName><Initials>Y</Initials><AffiliationInfo><Affiliation>Department of Infectious Diseases, Shanghai Public Health Clinical Center, China.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Ma</LastName><ForeName>Yuyan</ForeName><Initials>Y</Initials><AffiliationInfo><Affiliation>Department of Infectious Diseases, Zhongshan Hospital Fudan University, Shanghai, China.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Tao</LastName><ForeName>Lili</ForeName><Initials>L</Initials><AffiliationInfo><Affiliation>UT Southwestern Medical Center, Department of Immunology, Texas, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Miao</LastName><ForeName>Qing</ForeName><Initials>Q</Initials><AffiliationInfo><Affiliation>Department of Infectious Diseases, Zhongshan Hospital Fudan University, Shanghai, China.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Shi</LastName><ForeName>Qingfeng</ForeName><Initials>Q</Initials><AffiliationInfo><Affiliation>Department of Infectious Control, Zhongshan Hospital Fudan University, Shanghai, China.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Pan</LastName><ForeName>Jue</ForeName><Initials>J</Initials><AffiliationInfo><Affiliation>Department of Infectious Diseases, Zhongshan Hospital Fudan University, Shanghai, China.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Lu</LastName><ForeName>Hongzhou</ForeName><Initials>H</Initials><AffiliationInfo><Affiliation>Department of Infectious Diseases, Shanghai Public Health Clinical Center, China.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Hu</LastName><ForeName>Bijie</ForeName><Initials>B</Initials><AffiliationInfo><Affiliation>Department of Infectious Diseases, Zhongshan Hospital Fudan University, Shanghai, China.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2020</Year><Month>12</Month><Day>18</Day></ArticleDate></Article><MedlineJournalInfo><Country>Japan</Country><MedlineTA>Biosci Trends</MedlineTA><NlmUniqueID>101502754</NlmUniqueID><ISSNLinking>1881-7815</ISSNLinking></MedlineJournalInfo><ChemicalList><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D000962">Antimalarials</NameOfSubstance></Chemical><Chemical><RegistryNumber>4QWG6N8QKH</RegistryNumber><NameOfSubstance UI="D006886">Hydroxychloroquine</NameOfSubstance></Chemical></ChemicalList><SupplMeshList><SupplMeshName Type="Protocol" UI="C000705127">COVID-19 drug treatment</SupplMeshName></SupplMeshList><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000328" MajorTopicYN="N">Adult</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000368" MajorTopicYN="N">Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000962" MajorTopicYN="N">Antimalarials</DescriptorName><QualifierName UI="Q000008" MajorTopicYN="Y">administration & dosage</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D000086382" MajorTopicYN="N">COVID-19</DescriptorName><QualifierName UI="Q000188" MajorTopicYN="Y">drug therapy</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D002681" MajorTopicYN="N" Type="Geographic">China</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006886" MajorTopicYN="N">Hydroxychloroquine</DescriptorName><QualifierName UI="Q000008" MajorTopicYN="Y">administration & dosage</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008875" MajorTopicYN="N">Middle Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D012189" MajorTopicYN="N">Retrospective Studies</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D016896" MajorTopicYN="N">Treatment Outcome</DescriptorName></MeshHeading></MeshHeadingList><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">COVID-19</Keyword><Keyword MajorTopicYN="N">SARS-CoV-2</Keyword><Keyword MajorTopicYN="N">clinical management</Keyword><Keyword MajorTopicYN="N">coronavirus</Keyword><Keyword MajorTopicYN="N">hydroxychloroquine</Keyword><Keyword MajorTopicYN="N">treatment</Keyword></KeywordList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="pubmed"><Year>2020</Year><Month>12</Month><Day>22</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2021</Year><Month>1</Month><Day>30</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2020</Year><Month>12</Month><Day>21</Day><Hour>6</Hour><Minute>2</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">33342929</ArticleId><ArticleId IdType="doi">10.5582/bst.2020.03340</ArticleId></ArticleIdList></PubmedData></pubmed></record>Pour manipuler ce document sous Unix (Dilib)
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