Early hydroxychloroquine but not chloroquine use reduces ICU admission in COVID-19 patients.
Identifieur interne : 000B11 ( Main/Corpus ); précédent : 000B10; suivant : 000B12Early hydroxychloroquine but not chloroquine use reduces ICU admission in COVID-19 patients.
Auteurs : A J J. Lammers ; R M Brohet ; R E P. Theunissen ; C. Koster ; R. Rood ; D W M. Verhagen ; K. Brinkman ; R J Hassing ; A. Dofferhoff ; R. El Moussaoui ; G. Hermanides ; J. Ellerbroek ; N. Bokhizzou ; H. Visser ; M. Van Den Berge ; H. Bax ; D F Postma ; P H P. GroeneveldSource :
- International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases [ 1878-3511 ] ; 2020.
English descriptors
- KwdEn :
- Adult (MeSH), Aged (MeSH), Aged, 80 and over (MeSH), Antiviral Agents (therapeutic use), COVID-19 (drug therapy), COVID-19 (epidemiology), COVID-19 (virology), Chloroquine (therapeutic use), Female (MeSH), Hospitalization (MeSH), Humans (MeSH), Hydroxychloroquine (therapeutic use), Intensive Care Units (statistics & numerical data), Male (MeSH), Middle Aged (MeSH), Netherlands (epidemiology), Patient Admission (statistics & numerical data), Prospective Studies (MeSH), SARS-CoV-2 (drug effects), SARS-CoV-2 (physiology), Treatment Outcome (MeSH).
- MESH :
- chemical , therapeutic use : Antiviral Agents, Chloroquine, Hydroxychloroquine.
- geographic , epidemiology : Netherlands.
- drug effects : SARS-CoV-2.
- drug therapy : COVID-19.
- epidemiology : COVID-19.
- physiology : SARS-CoV-2.
- statistics & numerical data : Intensive Care Units, Patient Admission.
- virology : COVID-19.
- Adult, Aged, Aged, 80 and over, Female, Hospitalization, Humans, Male, Middle Aged, Prospective Studies, Treatment Outcome.
Abstract
BACKGROUND
The global push for the use of hydroxychloroquine (HCQ) and chloroquine (CQ) against COVID-19 has resulted in an ongoing discussion about the effectivity and toxicity of these drugs. Recent studies report no effect of (H)CQ on 28-day mortality. We investigated the effect of HCQ and CQ in hospitalized patients on the non-ICU COVID-ward.
METHODS
A nationwide, observational cohort study was performed in The Netherlands. Hospitals were given the opportunity to decide independently on the use of three different COVID-19 treatment strategies: HCQ, CQ, or no treatment. We compared the outcomes between these groups. The primary outcomes were 1) death on the COVID-19 ward, and 2) transfer to the intensive care unit (ICU).
RESULTS
The analysis included 1064 patients from 14 hospitals: 566 patients received treatment with either HCQ (n = 189) or CQ (n = 377), and 498 patients received no treatment. In a multivariate propensity-matched weighted competing regression analysis, there was no significant effect of (H)CQ on mortality on the COVID ward. However, HCQ was associated with a significantly decreased risk of transfer to the ICU (hazard ratio (HR) = 0.47, 95% CI = 0.27-0.82, p = 0.008) when compared with controls. This effect was not found in the CQ group (HR = 0.80, 95% CI = 0.55-1.15, p = 0.207), and remained significant after competing risk analysis.
CONCLUSION
The results of this observational study demonstrate a lack of effect of (H)CQ on non-ICU mortality. However, we show that the use of HCQ - but not CQ - is associated with a 53% reduction in risk of transfer of COVID-19 patients from the regular ward to the ICU. Recent prospective studies have reported on 28-day, all-cause mortality only; therefore, additional prospective data on the early effects of HCQ in preventing transfer to the ICU are still needed.
DOI: 10.1016/j.ijid.2020.09.1460
PubMed: 33007454
PubMed Central: PMC7524430
Links to Exploration step
pubmed:33007454Le document en format XML
<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Early hydroxychloroquine but not chloroquine use reduces ICU admission in COVID-19 patients.</title><author><name sortKey="Lammers, A J J" sort="Lammers, A J J" uniqKey="Lammers A" first="A J J" last="Lammers">A J J. Lammers</name><affiliation><nlm:affiliation>Isala, Zwolle, The Netherlands. Electronic address: a.j.j.lammers@isala.nl.</nlm:affiliation></affiliation></author><author><name sortKey="Brohet, R M" sort="Brohet, R M" uniqKey="Brohet R" first="R M" last="Brohet">R M Brohet</name><affiliation><nlm:affiliation>Department of Epidemiology and Statistics, Isala Academy, Zwolle, The Netherlands.</nlm:affiliation></affiliation></author><author><name sortKey="Theunissen, R E P" sort="Theunissen, R E P" uniqKey="Theunissen R" first="R E P" last="Theunissen">R E P. Theunissen</name><affiliation><nlm:affiliation>Isala, Zwolle, The Netherlands.</nlm:affiliation></affiliation></author><author><name sortKey="Koster, C" sort="Koster, C" uniqKey="Koster C" first="C" last="Koster">C. Koster</name><affiliation><nlm:affiliation>Isala, Zwolle, The Netherlands.</nlm:affiliation></affiliation></author><author><name sortKey="Rood, R" sort="Rood, R" uniqKey="Rood R" first="R" last="Rood">R. Rood</name><affiliation><nlm:affiliation>Diakonessen Hospital, Utrecht, The Netherlands.</nlm:affiliation></affiliation></author><author><name sortKey="Verhagen, D W M" sort="Verhagen, D W M" uniqKey="Verhagen D" first="D W M" last="Verhagen">D W M. Verhagen</name><affiliation><nlm:affiliation>Medisch Centrum Jan van Goyen, Amsterdam, The Netherlands.</nlm:affiliation></affiliation></author><author><name sortKey="Brinkman, K" sort="Brinkman, K" uniqKey="Brinkman K" first="K" last="Brinkman">K. Brinkman</name><affiliation><nlm:affiliation>OLVG, Amsterdam, The Netherlands.</nlm:affiliation></affiliation></author><author><name sortKey="Hassing, R J" sort="Hassing, R J" uniqKey="Hassing R" first="R J" last="Hassing">R J Hassing</name><affiliation><nlm:affiliation>Rijnstate, Arnhem, The Netherlands.</nlm:affiliation></affiliation></author><author><name sortKey="Dofferhoff, A" sort="Dofferhoff, A" uniqKey="Dofferhoff A" first="A" last="Dofferhoff">A. Dofferhoff</name><affiliation><nlm:affiliation>Canisius Wilhelmina Hospital, Nijmegen, The Netherlands.</nlm:affiliation></affiliation></author><author><name sortKey="El Moussaoui, R" sort="El Moussaoui, R" uniqKey="El Moussaoui R" first="R" last="El Moussaoui">R. El Moussaoui</name><affiliation><nlm:affiliation>Maasstad Hospital Rotterdam, The Netherlands.</nlm:affiliation></affiliation></author><author><name sortKey="Hermanides, G" sort="Hermanides, G" uniqKey="Hermanides G" first="G" last="Hermanides">G. Hermanides</name><affiliation><nlm:affiliation>Rode Kruis Hospital, Beverwijk, The Netherlands.</nlm:affiliation></affiliation></author><author><name sortKey="Ellerbroek, J" sort="Ellerbroek, J" uniqKey="Ellerbroek J" first="J" last="Ellerbroek">J. Ellerbroek</name><affiliation><nlm:affiliation>Reinier de Graaf Gasthuis, Delft, The Netherlands.</nlm:affiliation></affiliation></author><author><name sortKey="Bokhizzou, N" sort="Bokhizzou, N" uniqKey="Bokhizzou N" first="N" last="Bokhizzou">N. Bokhizzou</name><affiliation><nlm:affiliation>BovenIJ Hospital, Amsterdam, The Netherlands.</nlm:affiliation></affiliation></author><author><name sortKey="Visser, H" sort="Visser, H" uniqKey="Visser H" first="H" last="Visser">H. Visser</name><affiliation><nlm:affiliation>Beatrix Hospital Gorinchem, The Netherlands.</nlm:affiliation></affiliation></author><author><name sortKey="Van Den Berge, M" sort="Van Den Berge, M" uniqKey="Van Den Berge M" first="M" last="Van Den Berge">M. Van Den Berge</name><affiliation><nlm:affiliation>Admiraal de Ruiter Hospital, Goes, The Netherlands.</nlm:affiliation></affiliation></author><author><name sortKey="Bax, H" sort="Bax, H" uniqKey="Bax H" first="H" last="Bax">H. Bax</name><affiliation><nlm:affiliation>Erasmus MC Rotterdam, The Netherlands.</nlm:affiliation></affiliation></author><author><name sortKey="Postma, D F" sort="Postma, D F" uniqKey="Postma D" first="D F" last="Postma">D F Postma</name><affiliation><nlm:affiliation>University Medical Center Groningen, Groningen, The Netherlands.</nlm:affiliation></affiliation></author><author><name sortKey="Groeneveld, P H P" sort="Groeneveld, P H P" uniqKey="Groeneveld P" first="P H P" last="Groeneveld">P H P. Groeneveld</name><affiliation><nlm:affiliation>Isala, Zwolle, The Netherlands.</nlm:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2020">2020</date><idno type="RBID">pubmed:33007454</idno><idno type="pmid">33007454</idno><idno type="doi">10.1016/j.ijid.2020.09.1460</idno><idno type="pmc">PMC7524430</idno><idno type="wicri:Area/Main/Corpus">000B11</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Corpus" wicri:corpus="PubMed">000B11</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Early hydroxychloroquine but not chloroquine use reduces ICU admission in COVID-19 patients.</title><author><name sortKey="Lammers, A J J" sort="Lammers, A J J" uniqKey="Lammers A" first="A J J" last="Lammers">A J J. Lammers</name><affiliation><nlm:affiliation>Isala, Zwolle, The Netherlands. Electronic address: a.j.j.lammers@isala.nl.</nlm:affiliation></affiliation></author><author><name sortKey="Brohet, R M" sort="Brohet, R M" uniqKey="Brohet R" first="R M" last="Brohet">R M Brohet</name><affiliation><nlm:affiliation>Department of Epidemiology and Statistics, Isala Academy, Zwolle, The Netherlands.</nlm:affiliation></affiliation></author><author><name sortKey="Theunissen, R E P" sort="Theunissen, R E P" uniqKey="Theunissen R" first="R E P" last="Theunissen">R E P. Theunissen</name><affiliation><nlm:affiliation>Isala, Zwolle, The Netherlands.</nlm:affiliation></affiliation></author><author><name sortKey="Koster, C" sort="Koster, C" uniqKey="Koster C" first="C" last="Koster">C. Koster</name><affiliation><nlm:affiliation>Isala, Zwolle, The Netherlands.</nlm:affiliation></affiliation></author><author><name sortKey="Rood, R" sort="Rood, R" uniqKey="Rood R" first="R" last="Rood">R. Rood</name><affiliation><nlm:affiliation>Diakonessen Hospital, Utrecht, The Netherlands.</nlm:affiliation></affiliation></author><author><name sortKey="Verhagen, D W M" sort="Verhagen, D W M" uniqKey="Verhagen D" first="D W M" last="Verhagen">D W M. Verhagen</name><affiliation><nlm:affiliation>Medisch Centrum Jan van Goyen, Amsterdam, The Netherlands.</nlm:affiliation></affiliation></author><author><name sortKey="Brinkman, K" sort="Brinkman, K" uniqKey="Brinkman K" first="K" last="Brinkman">K. Brinkman</name><affiliation><nlm:affiliation>OLVG, Amsterdam, The Netherlands.</nlm:affiliation></affiliation></author><author><name sortKey="Hassing, R J" sort="Hassing, R J" uniqKey="Hassing R" first="R J" last="Hassing">R J Hassing</name><affiliation><nlm:affiliation>Rijnstate, Arnhem, The Netherlands.</nlm:affiliation></affiliation></author><author><name sortKey="Dofferhoff, A" sort="Dofferhoff, A" uniqKey="Dofferhoff A" first="A" last="Dofferhoff">A. Dofferhoff</name><affiliation><nlm:affiliation>Canisius Wilhelmina Hospital, Nijmegen, The Netherlands.</nlm:affiliation></affiliation></author><author><name sortKey="El Moussaoui, R" sort="El Moussaoui, R" uniqKey="El Moussaoui R" first="R" last="El Moussaoui">R. El Moussaoui</name><affiliation><nlm:affiliation>Maasstad Hospital Rotterdam, The Netherlands.</nlm:affiliation></affiliation></author><author><name sortKey="Hermanides, G" sort="Hermanides, G" uniqKey="Hermanides G" first="G" last="Hermanides">G. Hermanides</name><affiliation><nlm:affiliation>Rode Kruis Hospital, Beverwijk, The Netherlands.</nlm:affiliation></affiliation></author><author><name sortKey="Ellerbroek, J" sort="Ellerbroek, J" uniqKey="Ellerbroek J" first="J" last="Ellerbroek">J. Ellerbroek</name><affiliation><nlm:affiliation>Reinier de Graaf Gasthuis, Delft, The Netherlands.</nlm:affiliation></affiliation></author><author><name sortKey="Bokhizzou, N" sort="Bokhizzou, N" uniqKey="Bokhizzou N" first="N" last="Bokhizzou">N. Bokhizzou</name><affiliation><nlm:affiliation>BovenIJ Hospital, Amsterdam, The Netherlands.</nlm:affiliation></affiliation></author><author><name sortKey="Visser, H" sort="Visser, H" uniqKey="Visser H" first="H" last="Visser">H. Visser</name><affiliation><nlm:affiliation>Beatrix Hospital Gorinchem, The Netherlands.</nlm:affiliation></affiliation></author><author><name sortKey="Van Den Berge, M" sort="Van Den Berge, M" uniqKey="Van Den Berge M" first="M" last="Van Den Berge">M. Van Den Berge</name><affiliation><nlm:affiliation>Admiraal de Ruiter Hospital, Goes, The Netherlands.</nlm:affiliation></affiliation></author><author><name sortKey="Bax, H" sort="Bax, H" uniqKey="Bax H" first="H" last="Bax">H. Bax</name><affiliation><nlm:affiliation>Erasmus MC Rotterdam, The Netherlands.</nlm:affiliation></affiliation></author><author><name sortKey="Postma, D F" sort="Postma, D F" uniqKey="Postma D" first="D F" last="Postma">D F Postma</name><affiliation><nlm:affiliation>University Medical Center Groningen, Groningen, The Netherlands.</nlm:affiliation></affiliation></author><author><name sortKey="Groeneveld, P H P" sort="Groeneveld, P H P" uniqKey="Groeneveld P" first="P H P" last="Groeneveld">P H P. Groeneveld</name><affiliation><nlm:affiliation>Isala, Zwolle, The Netherlands.</nlm:affiliation></affiliation></author></analytic><series><title level="j">International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases</title><idno type="eISSN">1878-3511</idno><imprint><date when="2020" type="published">2020</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adult (MeSH)</term><term>Aged (MeSH)</term><term>Aged, 80 and over (MeSH)</term><term>Antiviral Agents (therapeutic use)</term><term>COVID-19 (drug therapy)</term><term>COVID-19 (epidemiology)</term><term>COVID-19 (virology)</term><term>Chloroquine (therapeutic use)</term><term>Female (MeSH)</term><term>Hospitalization (MeSH)</term><term>Humans (MeSH)</term><term>Hydroxychloroquine (therapeutic use)</term><term>Intensive Care Units (statistics & numerical data)</term><term>Male (MeSH)</term><term>Middle Aged (MeSH)</term><term>Netherlands (epidemiology)</term><term>Patient Admission (statistics & numerical data)</term><term>Prospective Studies (MeSH)</term><term>SARS-CoV-2 (drug effects)</term><term>SARS-CoV-2 (physiology)</term><term>Treatment Outcome (MeSH)</term></keywords><keywords scheme="MESH" type="chemical" qualifier="therapeutic use" xml:lang="en"><term>Antiviral Agents</term><term>Chloroquine</term><term>Hydroxychloroquine</term></keywords><keywords scheme="MESH" type="geographic" qualifier="epidemiology" xml:lang="en"><term>Netherlands</term></keywords><keywords scheme="MESH" qualifier="drug effects" xml:lang="en"><term>SARS-CoV-2</term></keywords><keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>COVID-19</term></keywords><keywords scheme="MESH" qualifier="epidemiology" xml:lang="en"><term>COVID-19</term></keywords><keywords scheme="MESH" qualifier="physiology" xml:lang="en"><term>SARS-CoV-2</term></keywords><keywords scheme="MESH" qualifier="statistics & numerical data" xml:lang="en"><term>Intensive Care Units</term><term>Patient Admission</term></keywords><keywords scheme="MESH" qualifier="virology" xml:lang="en"><term>COVID-19</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adult</term><term>Aged</term><term>Aged, 80 and over</term><term>Female</term><term>Hospitalization</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Prospective Studies</term><term>Treatment Outcome</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>BACKGROUND</b></p><p>The global push for the use of hydroxychloroquine (HCQ) and chloroquine (CQ) against COVID-19 has resulted in an ongoing discussion about the effectivity and toxicity of these drugs. Recent studies report no effect of (H)CQ on 28-day mortality. We investigated the effect of HCQ and CQ in hospitalized patients on the non-ICU COVID-ward.</p></div><div type="abstract" xml:lang="en"><p><b>METHODS</b></p><p>A nationwide, observational cohort study was performed in The Netherlands. Hospitals were given the opportunity to decide independently on the use of three different COVID-19 treatment strategies: HCQ, CQ, or no treatment. We compared the outcomes between these groups. The primary outcomes were 1) death on the COVID-19 ward, and 2) transfer to the intensive care unit (ICU).</p></div><div type="abstract" xml:lang="en"><p><b>RESULTS</b></p><p>The analysis included 1064 patients from 14 hospitals: 566 patients received treatment with either HCQ (n = 189) or CQ (n = 377), and 498 patients received no treatment. In a multivariate propensity-matched weighted competing regression analysis, there was no significant effect of (H)CQ on mortality on the COVID ward. However, HCQ was associated with a significantly decreased risk of transfer to the ICU (hazard ratio (HR) = 0.47, 95% CI = 0.27-0.82, p = 0.008) when compared with controls. This effect was not found in the CQ group (HR = 0.80, 95% CI = 0.55-1.15, p = 0.207), and remained significant after competing risk analysis.</p></div><div type="abstract" xml:lang="en"><p><b>CONCLUSION</b></p><p>The results of this observational study demonstrate a lack of effect of (H)CQ on non-ICU mortality. However, we show that the use of HCQ - but not CQ - is associated with a 53% reduction in risk of transfer of COVID-19 patients from the regular ward to the ICU. Recent prospective studies have reported on 28-day, all-cause mortality only; therefore, additional prospective data on the early effects of HCQ in preventing transfer to the ICU are still needed.</p></div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" IndexingMethod="Curated" Owner="NLM"><PMID Version="1">33007454</PMID><DateCompleted><Year>2020</Year><Month>12</Month><Day>22</Day></DateCompleted><DateRevised><Year>2021</Year><Month>05</Month><Day>18</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1878-3511</ISSN><JournalIssue CitedMedium="Internet"><Volume>101</Volume><PubDate><Year>2020</Year><Month>Dec</Month></PubDate></JournalIssue><Title>International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases</Title><ISOAbbreviation>Int J Infect Dis</ISOAbbreviation></Journal><ArticleTitle>Early hydroxychloroquine but not chloroquine use reduces ICU admission in COVID-19 patients.</ArticleTitle><Pagination><MedlinePgn>283-289</MedlinePgn></Pagination><ELocationID EIdType="pii" ValidYN="Y">S1201-9712(20)32175-5</ELocationID><ELocationID EIdType="doi" ValidYN="Y">10.1016/j.ijid.2020.09.1460</ELocationID><Abstract><AbstractText Label="BACKGROUND" NlmCategory="BACKGROUND">The global push for the use of hydroxychloroquine (HCQ) and chloroquine (CQ) against COVID-19 has resulted in an ongoing discussion about the effectivity and toxicity of these drugs. Recent studies report no effect of (H)CQ on 28-day mortality. We investigated the effect of HCQ and CQ in hospitalized patients on the non-ICU COVID-ward.</AbstractText><AbstractText Label="METHODS" NlmCategory="METHODS">A nationwide, observational cohort study was performed in The Netherlands. Hospitals were given the opportunity to decide independently on the use of three different COVID-19 treatment strategies: HCQ, CQ, or no treatment. We compared the outcomes between these groups. The primary outcomes were 1) death on the COVID-19 ward, and 2) transfer to the intensive care unit (ICU).</AbstractText><AbstractText Label="RESULTS" NlmCategory="RESULTS">The analysis included 1064 patients from 14 hospitals: 566 patients received treatment with either HCQ (n = 189) or CQ (n = 377), and 498 patients received no treatment. In a multivariate propensity-matched weighted competing regression analysis, there was no significant effect of (H)CQ on mortality on the COVID ward. However, HCQ was associated with a significantly decreased risk of transfer to the ICU (hazard ratio (HR) = 0.47, 95% CI = 0.27-0.82, p = 0.008) when compared with controls. This effect was not found in the CQ group (HR = 0.80, 95% CI = 0.55-1.15, p = 0.207), and remained significant after competing risk analysis.</AbstractText><AbstractText Label="CONCLUSION" NlmCategory="CONCLUSIONS">The results of this observational study demonstrate a lack of effect of (H)CQ on non-ICU mortality. However, we show that the use of HCQ - but not CQ - is associated with a 53% reduction in risk of transfer of COVID-19 patients from the regular ward to the ICU. Recent prospective studies have reported on 28-day, all-cause mortality only; therefore, additional prospective data on the early effects of HCQ in preventing transfer to the ICU are still needed.</AbstractText><CopyrightInformation>Copyright © 2020 The Author(s). Published by Elsevier Ltd.. All rights reserved.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Lammers</LastName><ForeName>A J J</ForeName><Initials>AJJ</Initials><AffiliationInfo><Affiliation>Isala, Zwolle, The Netherlands. Electronic address: a.j.j.lammers@isala.nl.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Brohet</LastName><ForeName>R M</ForeName><Initials>RM</Initials><AffiliationInfo><Affiliation>Department of Epidemiology and Statistics, Isala Academy, Zwolle, The Netherlands.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Theunissen</LastName><ForeName>R E P</ForeName><Initials>REP</Initials><AffiliationInfo><Affiliation>Isala, Zwolle, The Netherlands.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Koster</LastName><ForeName>C</ForeName><Initials>C</Initials><AffiliationInfo><Affiliation>Isala, Zwolle, The Netherlands.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Rood</LastName><ForeName>R</ForeName><Initials>R</Initials><AffiliationInfo><Affiliation>Diakonessen Hospital, Utrecht, The Netherlands.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Verhagen</LastName><ForeName>D W M</ForeName><Initials>DWM</Initials><AffiliationInfo><Affiliation>Medisch Centrum Jan van Goyen, Amsterdam, The Netherlands.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Brinkman</LastName><ForeName>K</ForeName><Initials>K</Initials><AffiliationInfo><Affiliation>OLVG, Amsterdam, The Netherlands.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Hassing</LastName><ForeName>R J</ForeName><Initials>RJ</Initials><AffiliationInfo><Affiliation>Rijnstate, Arnhem, The Netherlands.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Dofferhoff</LastName><ForeName>A</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>Canisius Wilhelmina Hospital, Nijmegen, The Netherlands.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>El Moussaoui</LastName><ForeName>R</ForeName><Initials>R</Initials><AffiliationInfo><Affiliation>Maasstad Hospital Rotterdam, The Netherlands.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Hermanides</LastName><ForeName>G</ForeName><Initials>G</Initials><AffiliationInfo><Affiliation>Rode Kruis Hospital, Beverwijk, The Netherlands.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Ellerbroek</LastName><ForeName>J</ForeName><Initials>J</Initials><AffiliationInfo><Affiliation>Reinier de Graaf Gasthuis, Delft, The Netherlands.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Bokhizzou</LastName><ForeName>N</ForeName><Initials>N</Initials><AffiliationInfo><Affiliation>BovenIJ Hospital, Amsterdam, The Netherlands.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Visser</LastName><ForeName>H</ForeName><Initials>H</Initials><AffiliationInfo><Affiliation>Beatrix Hospital Gorinchem, The Netherlands.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>van den Berge</LastName><ForeName>M</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Admiraal de Ruiter Hospital, Goes, The Netherlands.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Bax</LastName><ForeName>H</ForeName><Initials>H</Initials><AffiliationInfo><Affiliation>Erasmus MC Rotterdam, The Netherlands.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Postma</LastName><ForeName>D F</ForeName><Initials>DF</Initials><AffiliationInfo><Affiliation>University Medical Center Groningen, Groningen, The Netherlands.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Groeneveld</LastName><ForeName>P H P</ForeName><Initials>PHP</Initials><AffiliationInfo><Affiliation>Isala, Zwolle, The Netherlands.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2020</Year><Month>09</Month><Day>29</Day></ArticleDate></Article><MedlineJournalInfo><Country>Canada</Country><MedlineTA>Int J Infect Dis</MedlineTA><NlmUniqueID>9610933</NlmUniqueID><ISSNLinking>1201-9712</ISSNLinking></MedlineJournalInfo><ChemicalList><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D000998">Antiviral Agents</NameOfSubstance></Chemical><Chemical><RegistryNumber>4QWG6N8QKH</RegistryNumber><NameOfSubstance UI="D006886">Hydroxychloroquine</NameOfSubstance></Chemical><Chemical><RegistryNumber>886U3H6UFF</RegistryNumber><NameOfSubstance UI="D002738">Chloroquine</NameOfSubstance></Chemical></ChemicalList><SupplMeshList><SupplMeshName Type="Protocol" UI="C000705127">COVID-19 drug treatment</SupplMeshName></SupplMeshList><CitationSubset>IM</CitationSubset><CommentsCorrectionsList><CommentsCorrections RefType="CommentIn"><RefSource>Int J Infect Dis. 2021 Feb;103:516</RefSource><PMID Version="1">33310025</PMID></CommentsCorrections><CommentsCorrections RefType="CommentIn"><RefSource>Int J Infect Dis. 2021 Feb;103:402-403</RefSource><PMID Version="1">33310106</PMID></CommentsCorrections><CommentsCorrections RefType="CommentIn"><RefSource>Int J Infect Dis. 2021 Feb;103:478-479</RefSource><PMID Version="1">33310107</PMID></CommentsCorrections><CommentsCorrections RefType="CommentIn"><RefSource>Int J Infect Dis. 2021 Feb;103:560-561</RefSource><PMID Version="1">33310109</PMID></CommentsCorrections></CommentsCorrectionsList><MeshHeadingList><MeshHeading><DescriptorName UI="D000328" MajorTopicYN="N">Adult</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000368" MajorTopicYN="N">Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000369" MajorTopicYN="N">Aged, 80 and over</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000998" MajorTopicYN="N">Antiviral Agents</DescriptorName><QualifierName UI="Q000627" 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