CovidChloroV1, Main, Corpus, bibRecord, 000E96

Hydroxychloroquine and tocilizumab therapy in COVID-19 patients-An observational study.

Identifieur interne : 000E96 ( Main/Corpus ); précédent : 000E95; suivant : 000E97

Hydroxychloroquine and tocilizumab therapy in COVID-19 patients-An observational study.

Auteurs : Andrew Ip ; Donald A. Berry ; Eric Hansen ; Andre H. Goy ; Andrew L. Pecora ; Brittany A. Sinclaire ; Urszula Bednarz ; Michael Marafelias ; Scott M. Berry ; Nicholas S. Berry ; Shivam Mathura ; Ihor S. Sawczuk ; Noa Biran ; Ronaldo C. Go ; Steven Sperber ; Julia A. Piwoz ; Bindu Balani ; Cristina Cicogna ; Rani Sebti ; Jerry Zuckerman ; Keith M. Rose ; Lisa Tank ; Laurie G. Jacobs ; Jason Korcak ; Sarah L. Timmapuri ; Joseph P. Underwood ; Gregory Sugalski ; Carol Barsky ; Daniel W. Varga ; Arif Asif ; Joseph C. Landolfi ; Stuart L. Goldberg

Source :

PloS one [ 1932-6203 ] ; 2020.

RBID : pubmed:32790733

English descriptors

KwdEn :
- Adolescent (MeSH), Adult (MeSH), Aged (MeSH), Aged, 80 and over (MeSH), Antibodies, Monoclonal, Humanized (pharmacology), Antibodies, Monoclonal, Humanized (therapeutic use), Antimalarials (therapeutic use), Azithromycin (therapeutic use), Betacoronavirus (MeSH), COVID-19 (MeSH), Child (MeSH), Child, Preschool (MeSH), Coronavirus Infections (drug therapy), Coronavirus Infections (mortality), Coronavirus Infections (virology), Drug Therapy, Combination (MeSH), Female (MeSH), Follow-Up Studies (MeSH), Hospitalization (MeSH), Humans (MeSH), Hydroxychloroquine (therapeutic use), Infant (MeSH), Infant, Newborn (MeSH), Intensive Care Units (MeSH), Interleukin-6 (antagonists & inhibitors), Kaplan-Meier Estimate (MeSH), Male (MeSH), Middle Aged (MeSH), Pandemics (MeSH), Pneumonia, Viral (drug therapy), Pneumonia, Viral (mortality), Pneumonia, Viral (virology), Retrospective Studies (MeSH), SARS-CoV-2 (MeSH), Treatment Outcome (MeSH), Young Adult (MeSH).
MESH :
- chemical , antagonists & inhibitors : Interleukin-6.
- chemical , pharmacology : Antibodies, Monoclonal, Humanized.
- chemical , therapeutic use : Antibodies, Monoclonal, Humanized, Antimalarials, Azithromycin, Hydroxychloroquine.
- drug therapy : Coronavirus Infections, Pneumonia, Viral.
- mortality : Coronavirus Infections, Pneumonia, Viral.
- virology : Coronavirus Infections, Pneumonia, Viral.
- Adolescent, Adult, Aged, Aged, 80 and over, Betacoronavirus, COVID-19, Child, Child, Preschool, Drug Therapy, Combination, Female, Follow-Up Studies, Hospitalization, Humans, Infant, Infant, Newborn, Intensive Care Units, Kaplan-Meier Estimate, Male, Middle Aged, Pandemics, Retrospective Studies, SARS-CoV-2, Treatment Outcome, Young Adult.

Abstract

Hydroxychloroquine has been touted as a potential COVID-19 treatment. Tocilizumab, an inhibitor of IL-6, has also been proposed as a treatment of critically ill patients. In this retrospective observational cohort study drawn from electronic health records we sought to describe the association between mortality and hydroxychloroquine or tocilizumab therapy among hospitalized COVID-19 patients. Patients were hospitalized at a 13-hospital network spanning New Jersey USA between March 1, 2020 and April 22, 2020 with positive polymerase chain reaction results for SARS-CoV-2. Follow up was through May 5, 2020. Among 2512 hospitalized patients with COVID-19 there have been 547 deaths (22%), 1539 (61%) discharges and 426 (17%) remain hospitalized. 1914 (76%) received at least one dose of hydroxychloroquine and 1473 (59%) received hydroxychloroquine with azithromycin. After adjusting for imbalances via propensity modeling, compared to receiving neither drug, there were no significant differences in associated mortality for patients receiving any hydroxychloroquine during the hospitalization (HR, 0.99 [95% CI, 0.80-1.22]), hydroxychloroquine alone (HR, 1.02 [95% CI, 0.83-1.27]), or hydroxychloroquine with azithromycin (HR, 0.98 [95% CI, 0.75-1.28]). The 30-day unadjusted mortality for patients receiving hydroxychloroquine alone, azithromycin alone, the combination or neither drug was 25%, 20%, 18%, and 20%, respectively. Among 547 evaluable ICU patients, including 134 receiving tocilizumab in the ICU, an exploratory analysis found a trend towards an improved survival association with tocilizumab treatment (adjusted HR, 0.76 [95% CI, 0.57-1.00]), with 30 day unadjusted mortality with and without tocilizumab of 46% versus 56%. This observational cohort study suggests hydroxychloroquine, either alone or in combination with azithromycin, was not associated with a survival benefit among hospitalized COVID-19 patients. Tocilizumab demonstrated a trend association towards reduced mortality among ICU patients. Our findings are limited to hospitalized patients and must be interpreted with caution while awaiting results of randomized trials. Trial Registration: Clinicaltrials.gov Identifier: NCT04347993.

DOI: 10.1371/journal.pone.0237693
PubMed: 32790733
PubMed Central: PMC7425928

Links to Exploration step

pubmed:32790733

Le document en format XML

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<author><name sortKey="Ip, Andrew" sort="Ip, Andrew" uniqKey="Ip A" first="Andrew" last="Ip">Andrew Ip</name>
<affiliation><nlm:affiliation>Division of Outcomes and Value Research, John Theurer Cancer Center at Hackensack University Medical Center, Hackensack, New Jersey, United States of America.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Berry, Donald A" sort="Berry, Donald A" uniqKey="Berry D" first="Donald A" last="Berry">Donald A. Berry</name>
<affiliation><nlm:affiliation>Berry Consultants LLC, Austin, Texas, United States of America.</nlm:affiliation>
</affiliation>
<affiliation><nlm:affiliation>M.D. Anderson Cancer Center of the University of Texas, Houston, Texas, United States of America.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Hansen, Eric" sort="Hansen, Eric" uniqKey="Hansen E" first="Eric" last="Hansen">Eric Hansen</name>
<affiliation><nlm:affiliation>COTA, Boston, Massachusetts, United States of America.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Goy, Andre H" sort="Goy, Andre H" uniqKey="Goy A" first="Andre H" last="Goy">Andre H. Goy</name>
<affiliation><nlm:affiliation>John Theurer Cancer Center at Hackensack University Medical Center, Hackensack, New Jersey, United States of America.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Pecora, Andrew L" sort="Pecora, Andrew L" uniqKey="Pecora A" first="Andrew L" last="Pecora">Andrew L. Pecora</name>
<affiliation><nlm:affiliation>John Theurer Cancer Center at Hackensack University Medical Center, Hackensack, New Jersey, United States of America.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Sinclaire, Brittany A" sort="Sinclaire, Brittany A" uniqKey="Sinclaire B" first="Brittany A" last="Sinclaire">Brittany A. Sinclaire</name>
<affiliation><nlm:affiliation>John Theurer Cancer Center at Hackensack University Medical Center, Hackensack, New Jersey, United States of America.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Bednarz, Urszula" sort="Bednarz, Urszula" uniqKey="Bednarz U" first="Urszula" last="Bednarz">Urszula Bednarz</name>
<affiliation><nlm:affiliation>John Theurer Cancer Center at Hackensack University Medical Center, Hackensack, New Jersey, United States of America.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Marafelias, Michael" sort="Marafelias, Michael" uniqKey="Marafelias M" first="Michael" last="Marafelias">Michael Marafelias</name>
<affiliation><nlm:affiliation>John Theurer Cancer Center at Hackensack University Medical Center, Hackensack, New Jersey, United States of America.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Berry, Scott M" sort="Berry, Scott M" uniqKey="Berry S" first="Scott M" last="Berry">Scott M. Berry</name>
<affiliation><nlm:affiliation>Berry Consultants LLC, Austin, Texas, United States of America.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Berry, Nicholas S" sort="Berry, Nicholas S" uniqKey="Berry N" first="Nicholas S" last="Berry">Nicholas S. Berry</name>
<affiliation><nlm:affiliation>Berry Consultants LLC, Austin, Texas, United States of America.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Mathura, Shivam" sort="Mathura, Shivam" uniqKey="Mathura S" first="Shivam" last="Mathura">Shivam Mathura</name>
<affiliation><nlm:affiliation>COTA, Boston, Massachusetts, United States of America.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Sawczuk, Ihor S" sort="Sawczuk, Ihor S" uniqKey="Sawczuk I" first="Ihor S" last="Sawczuk">Ihor S. Sawczuk</name>
<affiliation><nlm:affiliation>Hackensack Meridian Health, Hackensack New Jersey and Hackensack Meridian School of Medicine, Nutley, New Jersey, United States of America.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Biran, Noa" sort="Biran, Noa" uniqKey="Biran N" first="Noa" last="Biran">Noa Biran</name>
<affiliation><nlm:affiliation>John Theurer Cancer Center at Hackensack University Medical Center, Hackensack, New Jersey, United States of America.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Go, Ronaldo C" sort="Go, Ronaldo C" uniqKey="Go R" first="Ronaldo C" last="Go">Ronaldo C. Go</name>
<affiliation><nlm:affiliation>Hackensack Meridian Health, Hackensack New Jersey and Hackensack Meridian School of Medicine, Nutley, New Jersey, United States of America.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Sperber, Steven" sort="Sperber, Steven" uniqKey="Sperber S" first="Steven" last="Sperber">Steven Sperber</name>
<affiliation><nlm:affiliation>Hackensack Meridian Health, Hackensack New Jersey and Hackensack Meridian School of Medicine, Nutley, New Jersey, United States of America.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Piwoz, Julia A" sort="Piwoz, Julia A" uniqKey="Piwoz J" first="Julia A" last="Piwoz">Julia A. Piwoz</name>
<affiliation><nlm:affiliation>Hackensack Meridian Health, Hackensack New Jersey and Hackensack Meridian School of Medicine, Nutley, New Jersey, United States of America.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Balani, Bindu" sort="Balani, Bindu" uniqKey="Balani B" first="Bindu" last="Balani">Bindu Balani</name>
<affiliation><nlm:affiliation>Hackensack Meridian Health, Hackensack New Jersey and Hackensack Meridian School of Medicine, Nutley, New Jersey, United States of America.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Cicogna, Cristina" sort="Cicogna, Cristina" uniqKey="Cicogna C" first="Cristina" last="Cicogna">Cristina Cicogna</name>
<affiliation><nlm:affiliation>Hackensack Meridian Health, Hackensack New Jersey and Hackensack Meridian School of Medicine, Nutley, New Jersey, United States of America.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Sebti, Rani" sort="Sebti, Rani" uniqKey="Sebti R" first="Rani" last="Sebti">Rani Sebti</name>
<affiliation><nlm:affiliation>Hackensack Meridian Health, Hackensack New Jersey and Hackensack Meridian School of Medicine, Nutley, New Jersey, United States of America.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Zuckerman, Jerry" sort="Zuckerman, Jerry" uniqKey="Zuckerman J" first="Jerry" last="Zuckerman">Jerry Zuckerman</name>
<affiliation><nlm:affiliation>Hackensack Meridian Health, Hackensack New Jersey and Hackensack Meridian School of Medicine, Nutley, New Jersey, United States of America.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Rose, Keith M" sort="Rose, Keith M" uniqKey="Rose K" first="Keith M" last="Rose">Keith M. Rose</name>
<affiliation><nlm:affiliation>Hackensack Meridian Health, Hackensack New Jersey and Hackensack Meridian School of Medicine, Nutley, New Jersey, United States of America.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Tank, Lisa" sort="Tank, Lisa" uniqKey="Tank L" first="Lisa" last="Tank">Lisa Tank</name>
<affiliation><nlm:affiliation>Hackensack Meridian Health, Hackensack New Jersey and Hackensack Meridian School of Medicine, Nutley, New Jersey, United States of America.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Jacobs, Laurie G" sort="Jacobs, Laurie G" uniqKey="Jacobs L" first="Laurie G" last="Jacobs">Laurie G. Jacobs</name>
<affiliation><nlm:affiliation>Hackensack Meridian Health, Hackensack New Jersey and Hackensack Meridian School of Medicine, Nutley, New Jersey, United States of America.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Korcak, Jason" sort="Korcak, Jason" uniqKey="Korcak J" first="Jason" last="Korcak">Jason Korcak</name>
<affiliation><nlm:affiliation>Hackensack Meridian Health, Hackensack New Jersey and Hackensack Meridian School of Medicine, Nutley, New Jersey, United States of America.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Timmapuri, Sarah L" sort="Timmapuri, Sarah L" uniqKey="Timmapuri S" first="Sarah L" last="Timmapuri">Sarah L. Timmapuri</name>
<affiliation><nlm:affiliation>Hackensack Meridian Health, Hackensack New Jersey and Hackensack Meridian School of Medicine, Nutley, New Jersey, United States of America.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Underwood, Joseph P" sort="Underwood, Joseph P" uniqKey="Underwood J" first="Joseph P" last="Underwood">Joseph P. Underwood</name>
<affiliation><nlm:affiliation>Hackensack Meridian Health, Hackensack New Jersey and Hackensack Meridian School of Medicine, Nutley, New Jersey, United States of America.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Sugalski, Gregory" sort="Sugalski, Gregory" uniqKey="Sugalski G" first="Gregory" last="Sugalski">Gregory Sugalski</name>
<affiliation><nlm:affiliation>Hackensack Meridian Health, Hackensack New Jersey and Hackensack Meridian School of Medicine, Nutley, New Jersey, United States of America.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Barsky, Carol" sort="Barsky, Carol" uniqKey="Barsky C" first="Carol" last="Barsky">Carol Barsky</name>
<affiliation><nlm:affiliation>Hackensack Meridian Health, Hackensack New Jersey and Hackensack Meridian School of Medicine, Nutley, New Jersey, United States of America.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Varga, Daniel W" sort="Varga, Daniel W" uniqKey="Varga D" first="Daniel W" last="Varga">Daniel W. Varga</name>
<affiliation><nlm:affiliation>Hackensack Meridian Health, Hackensack New Jersey and Hackensack Meridian School of Medicine, Nutley, New Jersey, United States of America.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Asif, Arif" sort="Asif, Arif" uniqKey="Asif A" first="Arif" last="Asif">Arif Asif</name>
<affiliation><nlm:affiliation>Hackensack Meridian Health, Hackensack New Jersey and Hackensack Meridian School of Medicine, Nutley, New Jersey, United States of America.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Landolfi, Joseph C" sort="Landolfi, Joseph C" uniqKey="Landolfi J" first="Joseph C" last="Landolfi">Joseph C. Landolfi</name>
<affiliation><nlm:affiliation>Hackensack Meridian Health, Hackensack New Jersey and Hackensack Meridian School of Medicine, Nutley, New Jersey, United States of America.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Goldberg, Stuart L" sort="Goldberg, Stuart L" uniqKey="Goldberg S" first="Stuart L" last="Goldberg">Stuart L. Goldberg</name>
<affiliation><nlm:affiliation>Division of Outcomes and Value Research, John Theurer Cancer Center at Hackensack University Medical Center, Hackensack, New Jersey, United States of America.</nlm:affiliation>
</affiliation>
</author>
</titleStmt>
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<date when="2020">2020</date>
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<idno type="pmid">32790733</idno>
<idno type="doi">10.1371/journal.pone.0237693</idno>
<idno type="pmc">PMC7425928</idno>
<idno type="wicri:Area/Main/Corpus">000E96</idno>
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<sourceDesc><biblStruct><analytic><title xml:lang="en">Hydroxychloroquine and tocilizumab therapy in COVID-19 patients-An observational study.</title>
<author><name sortKey="Ip, Andrew" sort="Ip, Andrew" uniqKey="Ip A" first="Andrew" last="Ip">Andrew Ip</name>
<affiliation><nlm:affiliation>Division of Outcomes and Value Research, John Theurer Cancer Center at Hackensack University Medical Center, Hackensack, New Jersey, United States of America.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Berry, Donald A" sort="Berry, Donald A" uniqKey="Berry D" first="Donald A" last="Berry">Donald A. Berry</name>
<affiliation><nlm:affiliation>Berry Consultants LLC, Austin, Texas, United States of America.</nlm:affiliation>
</affiliation>
<affiliation><nlm:affiliation>M.D. Anderson Cancer Center of the University of Texas, Houston, Texas, United States of America.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Hansen, Eric" sort="Hansen, Eric" uniqKey="Hansen E" first="Eric" last="Hansen">Eric Hansen</name>
<affiliation><nlm:affiliation>COTA, Boston, Massachusetts, United States of America.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Goy, Andre H" sort="Goy, Andre H" uniqKey="Goy A" first="Andre H" last="Goy">Andre H. Goy</name>
<affiliation><nlm:affiliation>John Theurer Cancer Center at Hackensack University Medical Center, Hackensack, New Jersey, United States of America.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Pecora, Andrew L" sort="Pecora, Andrew L" uniqKey="Pecora A" first="Andrew L" last="Pecora">Andrew L. Pecora</name>
<affiliation><nlm:affiliation>John Theurer Cancer Center at Hackensack University Medical Center, Hackensack, New Jersey, United States of America.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Sinclaire, Brittany A" sort="Sinclaire, Brittany A" uniqKey="Sinclaire B" first="Brittany A" last="Sinclaire">Brittany A. Sinclaire</name>
<affiliation><nlm:affiliation>John Theurer Cancer Center at Hackensack University Medical Center, Hackensack, New Jersey, United States of America.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Bednarz, Urszula" sort="Bednarz, Urszula" uniqKey="Bednarz U" first="Urszula" last="Bednarz">Urszula Bednarz</name>
<affiliation><nlm:affiliation>John Theurer Cancer Center at Hackensack University Medical Center, Hackensack, New Jersey, United States of America.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Marafelias, Michael" sort="Marafelias, Michael" uniqKey="Marafelias M" first="Michael" last="Marafelias">Michael Marafelias</name>
<affiliation><nlm:affiliation>John Theurer Cancer Center at Hackensack University Medical Center, Hackensack, New Jersey, United States of America.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Berry, Scott M" sort="Berry, Scott M" uniqKey="Berry S" first="Scott M" last="Berry">Scott M. Berry</name>
<affiliation><nlm:affiliation>Berry Consultants LLC, Austin, Texas, United States of America.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Berry, Nicholas S" sort="Berry, Nicholas S" uniqKey="Berry N" first="Nicholas S" last="Berry">Nicholas S. Berry</name>
<affiliation><nlm:affiliation>Berry Consultants LLC, Austin, Texas, United States of America.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Mathura, Shivam" sort="Mathura, Shivam" uniqKey="Mathura S" first="Shivam" last="Mathura">Shivam Mathura</name>
<affiliation><nlm:affiliation>COTA, Boston, Massachusetts, United States of America.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Sawczuk, Ihor S" sort="Sawczuk, Ihor S" uniqKey="Sawczuk I" first="Ihor S" last="Sawczuk">Ihor S. Sawczuk</name>
<affiliation><nlm:affiliation>Hackensack Meridian Health, Hackensack New Jersey and Hackensack Meridian School of Medicine, Nutley, New Jersey, United States of America.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Biran, Noa" sort="Biran, Noa" uniqKey="Biran N" first="Noa" last="Biran">Noa Biran</name>
<affiliation><nlm:affiliation>John Theurer Cancer Center at Hackensack University Medical Center, Hackensack, New Jersey, United States of America.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Go, Ronaldo C" sort="Go, Ronaldo C" uniqKey="Go R" first="Ronaldo C" last="Go">Ronaldo C. Go</name>
<affiliation><nlm:affiliation>Hackensack Meridian Health, Hackensack New Jersey and Hackensack Meridian School of Medicine, Nutley, New Jersey, United States of America.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Sperber, Steven" sort="Sperber, Steven" uniqKey="Sperber S" first="Steven" last="Sperber">Steven Sperber</name>
<affiliation><nlm:affiliation>Hackensack Meridian Health, Hackensack New Jersey and Hackensack Meridian School of Medicine, Nutley, New Jersey, United States of America.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Piwoz, Julia A" sort="Piwoz, Julia A" uniqKey="Piwoz J" first="Julia A" last="Piwoz">Julia A. Piwoz</name>
<affiliation><nlm:affiliation>Hackensack Meridian Health, Hackensack New Jersey and Hackensack Meridian School of Medicine, Nutley, New Jersey, United States of America.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Balani, Bindu" sort="Balani, Bindu" uniqKey="Balani B" first="Bindu" last="Balani">Bindu Balani</name>
<affiliation><nlm:affiliation>Hackensack Meridian Health, Hackensack New Jersey and Hackensack Meridian School of Medicine, Nutley, New Jersey, United States of America.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Cicogna, Cristina" sort="Cicogna, Cristina" uniqKey="Cicogna C" first="Cristina" last="Cicogna">Cristina Cicogna</name>
<affiliation><nlm:affiliation>Hackensack Meridian Health, Hackensack New Jersey and Hackensack Meridian School of Medicine, Nutley, New Jersey, United States of America.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Sebti, Rani" sort="Sebti, Rani" uniqKey="Sebti R" first="Rani" last="Sebti">Rani Sebti</name>
<affiliation><nlm:affiliation>Hackensack Meridian Health, Hackensack New Jersey and Hackensack Meridian School of Medicine, Nutley, New Jersey, United States of America.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Zuckerman, Jerry" sort="Zuckerman, Jerry" uniqKey="Zuckerman J" first="Jerry" last="Zuckerman">Jerry Zuckerman</name>
<affiliation><nlm:affiliation>Hackensack Meridian Health, Hackensack New Jersey and Hackensack Meridian School of Medicine, Nutley, New Jersey, United States of America.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Rose, Keith M" sort="Rose, Keith M" uniqKey="Rose K" first="Keith M" last="Rose">Keith M. Rose</name>
<affiliation><nlm:affiliation>Hackensack Meridian Health, Hackensack New Jersey and Hackensack Meridian School of Medicine, Nutley, New Jersey, United States of America.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Tank, Lisa" sort="Tank, Lisa" uniqKey="Tank L" first="Lisa" last="Tank">Lisa Tank</name>
<affiliation><nlm:affiliation>Hackensack Meridian Health, Hackensack New Jersey and Hackensack Meridian School of Medicine, Nutley, New Jersey, United States of America.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Jacobs, Laurie G" sort="Jacobs, Laurie G" uniqKey="Jacobs L" first="Laurie G" last="Jacobs">Laurie G. Jacobs</name>
<affiliation><nlm:affiliation>Hackensack Meridian Health, Hackensack New Jersey and Hackensack Meridian School of Medicine, Nutley, New Jersey, United States of America.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Korcak, Jason" sort="Korcak, Jason" uniqKey="Korcak J" first="Jason" last="Korcak">Jason Korcak</name>
<affiliation><nlm:affiliation>Hackensack Meridian Health, Hackensack New Jersey and Hackensack Meridian School of Medicine, Nutley, New Jersey, United States of America.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Timmapuri, Sarah L" sort="Timmapuri, Sarah L" uniqKey="Timmapuri S" first="Sarah L" last="Timmapuri">Sarah L. Timmapuri</name>
<affiliation><nlm:affiliation>Hackensack Meridian Health, Hackensack New Jersey and Hackensack Meridian School of Medicine, Nutley, New Jersey, United States of America.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Underwood, Joseph P" sort="Underwood, Joseph P" uniqKey="Underwood J" first="Joseph P" last="Underwood">Joseph P. Underwood</name>
<affiliation><nlm:affiliation>Hackensack Meridian Health, Hackensack New Jersey and Hackensack Meridian School of Medicine, Nutley, New Jersey, United States of America.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Sugalski, Gregory" sort="Sugalski, Gregory" uniqKey="Sugalski G" first="Gregory" last="Sugalski">Gregory Sugalski</name>
<affiliation><nlm:affiliation>Hackensack Meridian Health, Hackensack New Jersey and Hackensack Meridian School of Medicine, Nutley, New Jersey, United States of America.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Barsky, Carol" sort="Barsky, Carol" uniqKey="Barsky C" first="Carol" last="Barsky">Carol Barsky</name>
<affiliation><nlm:affiliation>Hackensack Meridian Health, Hackensack New Jersey and Hackensack Meridian School of Medicine, Nutley, New Jersey, United States of America.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Varga, Daniel W" sort="Varga, Daniel W" uniqKey="Varga D" first="Daniel W" last="Varga">Daniel W. Varga</name>
<affiliation><nlm:affiliation>Hackensack Meridian Health, Hackensack New Jersey and Hackensack Meridian School of Medicine, Nutley, New Jersey, United States of America.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Asif, Arif" sort="Asif, Arif" uniqKey="Asif A" first="Arif" last="Asif">Arif Asif</name>
<affiliation><nlm:affiliation>Hackensack Meridian Health, Hackensack New Jersey and Hackensack Meridian School of Medicine, Nutley, New Jersey, United States of America.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Landolfi, Joseph C" sort="Landolfi, Joseph C" uniqKey="Landolfi J" first="Joseph C" last="Landolfi">Joseph C. Landolfi</name>
<affiliation><nlm:affiliation>Hackensack Meridian Health, Hackensack New Jersey and Hackensack Meridian School of Medicine, Nutley, New Jersey, United States of America.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Goldberg, Stuart L" sort="Goldberg, Stuart L" uniqKey="Goldberg S" first="Stuart L" last="Goldberg">Stuart L. Goldberg</name>
<affiliation><nlm:affiliation>Division of Outcomes and Value Research, John Theurer Cancer Center at Hackensack University Medical Center, Hackensack, New Jersey, United States of America.</nlm:affiliation>
</affiliation>
</author>
</analytic>
<series><title level="j">PloS one</title>
<idno type="eISSN">1932-6203</idno>
<imprint><date when="2020" type="published">2020</date>
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<profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adolescent (MeSH)</term>
<term>Adult (MeSH)</term>
<term>Aged (MeSH)</term>
<term>Aged, 80 and over (MeSH)</term>
<term>Antibodies, Monoclonal, Humanized (pharmacology)</term>
<term>Antibodies, Monoclonal, Humanized (therapeutic use)</term>
<term>Antimalarials (therapeutic use)</term>
<term>Azithromycin (therapeutic use)</term>
<term>Betacoronavirus (MeSH)</term>
<term>COVID-19 (MeSH)</term>
<term>Child (MeSH)</term>
<term>Child, Preschool (MeSH)</term>
<term>Coronavirus Infections (drug therapy)</term>
<term>Coronavirus Infections (mortality)</term>
<term>Coronavirus Infections (virology)</term>
<term>Drug Therapy, Combination (MeSH)</term>
<term>Female (MeSH)</term>
<term>Follow-Up Studies (MeSH)</term>
<term>Hospitalization (MeSH)</term>
<term>Humans (MeSH)</term>
<term>Hydroxychloroquine (therapeutic use)</term>
<term>Infant (MeSH)</term>
<term>Infant, Newborn (MeSH)</term>
<term>Intensive Care Units (MeSH)</term>
<term>Interleukin-6 (antagonists & inhibitors)</term>
<term>Kaplan-Meier Estimate (MeSH)</term>
<term>Male (MeSH)</term>
<term>Middle Aged (MeSH)</term>
<term>Pandemics (MeSH)</term>
<term>Pneumonia, Viral (drug therapy)</term>
<term>Pneumonia, Viral (mortality)</term>
<term>Pneumonia, Viral (virology)</term>
<term>Retrospective Studies (MeSH)</term>
<term>SARS-CoV-2 (MeSH)</term>
<term>Treatment Outcome (MeSH)</term>
<term>Young Adult (MeSH)</term>
</keywords>
<keywords scheme="MESH" type="chemical" qualifier="antagonists & inhibitors" xml:lang="en"><term>Interleukin-6</term>
</keywords>
<keywords scheme="MESH" type="chemical" qualifier="pharmacology" xml:lang="en"><term>Antibodies, Monoclonal, Humanized</term>
</keywords>
<keywords scheme="MESH" type="chemical" qualifier="therapeutic use" xml:lang="en"><term>Antibodies, Monoclonal, Humanized</term>
<term>Antimalarials</term>
<term>Azithromycin</term>
<term>Hydroxychloroquine</term>
</keywords>
<keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>Coronavirus Infections</term>
<term>Pneumonia, Viral</term>
</keywords>
<keywords scheme="MESH" qualifier="mortality" xml:lang="en"><term>Coronavirus Infections</term>
<term>Pneumonia, Viral</term>
</keywords>
<keywords scheme="MESH" qualifier="virology" xml:lang="en"><term>Coronavirus Infections</term>
<term>Pneumonia, Viral</term>
</keywords>
<keywords scheme="MESH" xml:lang="en"><term>Adolescent</term>
<term>Adult</term>
<term>Aged</term>
<term>Aged, 80 and over</term>
<term>Betacoronavirus</term>
<term>COVID-19</term>
<term>Child</term>
<term>Child, Preschool</term>
<term>Drug Therapy, Combination</term>
<term>Female</term>
<term>Follow-Up Studies</term>
<term>Hospitalization</term>
<term>Humans</term>
<term>Infant</term>
<term>Infant, Newborn</term>
<term>Intensive Care Units</term>
<term>Kaplan-Meier Estimate</term>
<term>Male</term>
<term>Middle Aged</term>
<term>Pandemics</term>
<term>Retrospective Studies</term>
<term>SARS-CoV-2</term>
<term>Treatment Outcome</term>
<term>Young Adult</term>
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<front><div type="abstract" xml:lang="en">Hydroxychloroquine has been touted as a potential COVID-19 treatment. Tocilizumab, an inhibitor of IL-6, has also been proposed as a treatment of critically ill patients. In this retrospective observational cohort study drawn from electronic health records we sought to describe the association between mortality and hydroxychloroquine or tocilizumab therapy among hospitalized COVID-19 patients. Patients were hospitalized at a 13-hospital network spanning New Jersey USA between March 1, 2020 and April 22, 2020 with positive polymerase chain reaction results for SARS-CoV-2. Follow up was through May 5, 2020. Among 2512 hospitalized patients with COVID-19 there have been 547 deaths (22%), 1539 (61%) discharges and 426 (17%) remain hospitalized. 1914 (76%) received at least one dose of hydroxychloroquine and 1473 (59%) received hydroxychloroquine with azithromycin. After adjusting for imbalances via propensity modeling, compared to receiving neither drug, there were no significant differences in associated mortality for patients receiving any hydroxychloroquine during the hospitalization (HR, 0.99 [95% CI, 0.80-1.22]), hydroxychloroquine alone (HR, 1.02 [95% CI, 0.83-1.27]), or hydroxychloroquine with azithromycin (HR, 0.98 [95% CI, 0.75-1.28]). The 30-day unadjusted mortality for patients receiving hydroxychloroquine alone, azithromycin alone, the combination or neither drug was 25%, 20%, 18%, and 20%, respectively. Among 547 evaluable ICU patients, including 134 receiving tocilizumab in the ICU, an exploratory analysis found a trend towards an improved survival association with tocilizumab treatment (adjusted HR, 0.76 [95% CI, 0.57-1.00]), with 30 day unadjusted mortality with and without tocilizumab of 46% versus 56%. This observational cohort study suggests hydroxychloroquine, either alone or in combination with azithromycin, was not associated with a survival benefit among hospitalized COVID-19 patients. Tocilizumab demonstrated a trend association towards reduced mortality among ICU patients. Our findings are limited to hospitalized patients and must be interpreted with caution while awaiting results of randomized trials. Trial Registration: Clinicaltrials.gov Identifier: NCT04347993.</div>
</front>
</TEI>
<pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">32790733</PMID>
<DateCompleted><Year>2020</Year>
<Month>08</Month>
<Day>28</Day>
</DateCompleted>
<DateRevised><Year>2021</Year>
<Month>04</Month>
<Day>23</Day>
</DateRevised>
<Article PubModel="Electronic-eCollection"><Journal><ISSN IssnType="Electronic">1932-6203</ISSN>
<JournalIssue CitedMedium="Internet"><Volume>15</Volume>
<Issue>8</Issue>
<PubDate><Year>2020</Year>
</PubDate>
</JournalIssue>
<Title>PloS one</Title>
<ISOAbbreviation>PLoS One</ISOAbbreviation>
</Journal>
<ArticleTitle>Hydroxychloroquine and tocilizumab therapy in COVID-19 patients-An observational study.</ArticleTitle>
<Pagination><MedlinePgn>e0237693</MedlinePgn>
</Pagination>
<ELocationID EIdType="doi" ValidYN="Y">10.1371/journal.pone.0237693</ELocationID>
<Abstract><AbstractText>Hydroxychloroquine has been touted as a potential COVID-19 treatment. Tocilizumab, an inhibitor of IL-6, has also been proposed as a treatment of critically ill patients. In this retrospective observational cohort study drawn from electronic health records we sought to describe the association between mortality and hydroxychloroquine or tocilizumab therapy among hospitalized COVID-19 patients. Patients were hospitalized at a 13-hospital network spanning New Jersey USA between March 1, 2020 and April 22, 2020 with positive polymerase chain reaction results for SARS-CoV-2. Follow up was through May 5, 2020. Among 2512 hospitalized patients with COVID-19 there have been 547 deaths (22%), 1539 (61%) discharges and 426 (17%) remain hospitalized. 1914 (76%) received at least one dose of hydroxychloroquine and 1473 (59%) received hydroxychloroquine with azithromycin. After adjusting for imbalances via propensity modeling, compared to receiving neither drug, there were no significant differences in associated mortality for patients receiving any hydroxychloroquine during the hospitalization (HR, 0.99 [95% CI, 0.80-1.22]), hydroxychloroquine alone (HR, 1.02 [95% CI, 0.83-1.27]), or hydroxychloroquine with azithromycin (HR, 0.98 [95% CI, 0.75-1.28]). The 30-day unadjusted mortality for patients receiving hydroxychloroquine alone, azithromycin alone, the combination or neither drug was 25%, 20%, 18%, and 20%, respectively. Among 547 evaluable ICU patients, including 134 receiving tocilizumab in the ICU, an exploratory analysis found a trend towards an improved survival association with tocilizumab treatment (adjusted HR, 0.76 [95% CI, 0.57-1.00]), with 30 day unadjusted mortality with and without tocilizumab of 46% versus 56%. This observational cohort study suggests hydroxychloroquine, either alone or in combination with azithromycin, was not associated with a survival benefit among hospitalized COVID-19 patients. Tocilizumab demonstrated a trend association towards reduced mortality among ICU patients. Our findings are limited to hospitalized patients and must be interpreted with caution while awaiting results of randomized trials. Trial Registration: Clinicaltrials.gov Identifier: NCT04347993.</AbstractText>
</Abstract>
<AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Ip</LastName>
<ForeName>Andrew</ForeName>
<Initials>A</Initials>
<Identifier Source="ORCID">0000-0003-0456-5618</Identifier>
<AffiliationInfo><Affiliation>Division of Outcomes and Value Research, John Theurer Cancer Center at Hackensack University Medical Center, Hackensack, New Jersey, United States of America.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Berry</LastName>
<ForeName>Donald A</ForeName>
<Initials>DA</Initials>
<AffiliationInfo><Affiliation>Berry Consultants LLC, Austin, Texas, United States of America.</Affiliation>
</AffiliationInfo>
<AffiliationInfo><Affiliation>M.D. Anderson Cancer Center of the University of Texas, Houston, Texas, United States of America.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Hansen</LastName>
<ForeName>Eric</ForeName>
<Initials>E</Initials>
<AffiliationInfo><Affiliation>COTA, Boston, Massachusetts, United States of America.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Goy</LastName>
<ForeName>Andre H</ForeName>
<Initials>AH</Initials>
<AffiliationInfo><Affiliation>John Theurer Cancer Center at Hackensack University Medical Center, Hackensack, New Jersey, United States of America.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Pecora</LastName>
<ForeName>Andrew L</ForeName>
<Initials>AL</Initials>
<AffiliationInfo><Affiliation>John Theurer Cancer Center at Hackensack University Medical Center, Hackensack, New Jersey, United States of America.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Sinclaire</LastName>
<ForeName>Brittany A</ForeName>
<Initials>BA</Initials>
<AffiliationInfo><Affiliation>John Theurer Cancer Center at Hackensack University Medical Center, Hackensack, New Jersey, United States of America.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Bednarz</LastName>
<ForeName>Urszula</ForeName>
<Initials>U</Initials>
<AffiliationInfo><Affiliation>John Theurer Cancer Center at Hackensack University Medical Center, Hackensack, New Jersey, United States of America.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Marafelias</LastName>
<ForeName>Michael</ForeName>
<Initials>M</Initials>
<AffiliationInfo><Affiliation>John Theurer Cancer Center at Hackensack University Medical Center, Hackensack, New Jersey, United States of America.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Berry</LastName>
<ForeName>Scott M</ForeName>
<Initials>SM</Initials>
<AffiliationInfo><Affiliation>Berry Consultants LLC, Austin, Texas, United States of America.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Berry</LastName>
<ForeName>Nicholas S</ForeName>
<Initials>NS</Initials>
<AffiliationInfo><Affiliation>Berry Consultants LLC, Austin, Texas, United States of America.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Mathura</LastName>
<ForeName>Shivam</ForeName>
<Initials>S</Initials>
<AffiliationInfo><Affiliation>COTA, Boston, Massachusetts, United States of America.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Sawczuk</LastName>
<ForeName>Ihor S</ForeName>
<Initials>IS</Initials>
<AffiliationInfo><Affiliation>Hackensack Meridian Health, Hackensack New Jersey and Hackensack Meridian School of Medicine, Nutley, New Jersey, United States of America.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Biran</LastName>
<ForeName>Noa</ForeName>
<Initials>N</Initials>
<AffiliationInfo><Affiliation>John Theurer Cancer Center at Hackensack University Medical Center, Hackensack, New Jersey, United States of America.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Go</LastName>
<ForeName>Ronaldo C</ForeName>
<Initials>RC</Initials>
<Identifier Source="ORCID">0000-0001-6100-7773</Identifier>
<AffiliationInfo><Affiliation>Hackensack Meridian Health, Hackensack New Jersey and Hackensack Meridian School of Medicine, Nutley, New Jersey, United States of America.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Sperber</LastName>
<ForeName>Steven</ForeName>
<Initials>S</Initials>
<AffiliationInfo><Affiliation>Hackensack Meridian Health, Hackensack New Jersey and Hackensack Meridian School of Medicine, Nutley, New Jersey, United States of America.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Piwoz</LastName>
<ForeName>Julia A</ForeName>
<Initials>JA</Initials>
<AffiliationInfo><Affiliation>Hackensack Meridian Health, Hackensack New Jersey and Hackensack Meridian School of Medicine, Nutley, New Jersey, United States of America.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Balani</LastName>
<ForeName>Bindu</ForeName>
<Initials>B</Initials>
<AffiliationInfo><Affiliation>Hackensack Meridian Health, Hackensack New Jersey and Hackensack Meridian School of Medicine, Nutley, New Jersey, United States of America.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Cicogna</LastName>
<ForeName>Cristina</ForeName>
<Initials>C</Initials>
<AffiliationInfo><Affiliation>Hackensack Meridian Health, Hackensack New Jersey and Hackensack Meridian School of Medicine, Nutley, New Jersey, United States of America.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Sebti</LastName>
<ForeName>Rani</ForeName>
<Initials>R</Initials>
<AffiliationInfo><Affiliation>Hackensack Meridian Health, Hackensack New Jersey and Hackensack Meridian School of Medicine, Nutley, New Jersey, United States of America.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Zuckerman</LastName>
<ForeName>Jerry</ForeName>
<Initials>J</Initials>
<AffiliationInfo><Affiliation>Hackensack Meridian Health, Hackensack New Jersey and Hackensack Meridian School of Medicine, Nutley, New Jersey, United States of America.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Rose</LastName>
<ForeName>Keith M</ForeName>
<Initials>KM</Initials>
<AffiliationInfo><Affiliation>Hackensack Meridian Health, Hackensack New Jersey and Hackensack Meridian School of Medicine, Nutley, New Jersey, United States of America.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Tank</LastName>
<ForeName>Lisa</ForeName>
<Initials>L</Initials>
<AffiliationInfo><Affiliation>Hackensack Meridian Health, Hackensack New Jersey and Hackensack Meridian School of Medicine, Nutley, New Jersey, United States of America.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Jacobs</LastName>
<ForeName>Laurie G</ForeName>
<Initials>LG</Initials>
<AffiliationInfo><Affiliation>Hackensack Meridian Health, Hackensack New Jersey and Hackensack Meridian School of Medicine, Nutley, New Jersey, United States of America.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Korcak</LastName>
<ForeName>Jason</ForeName>
<Initials>J</Initials>
<AffiliationInfo><Affiliation>Hackensack Meridian Health, Hackensack New Jersey and Hackensack Meridian School of Medicine, Nutley, New Jersey, United States of America.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Timmapuri</LastName>
<ForeName>Sarah L</ForeName>
<Initials>SL</Initials>
<AffiliationInfo><Affiliation>Hackensack Meridian Health, Hackensack New Jersey and Hackensack Meridian School of Medicine, Nutley, New Jersey, United States of America.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Underwood</LastName>
<ForeName>Joseph P</ForeName>
<Initials>JP</Initials>
<AffiliationInfo><Affiliation>Hackensack Meridian Health, Hackensack New Jersey and Hackensack Meridian School of Medicine, Nutley, New Jersey, United States of America.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Sugalski</LastName>
<ForeName>Gregory</ForeName>
<Initials>G</Initials>
<AffiliationInfo><Affiliation>Hackensack Meridian Health, Hackensack New Jersey and Hackensack Meridian School of Medicine, Nutley, New Jersey, United States of America.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Barsky</LastName>
<ForeName>Carol</ForeName>
<Initials>C</Initials>
<AffiliationInfo><Affiliation>Hackensack Meridian Health, Hackensack New Jersey and Hackensack Meridian School of Medicine, Nutley, New Jersey, United States of America.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Varga</LastName>
<ForeName>Daniel W</ForeName>
<Initials>DW</Initials>
<AffiliationInfo><Affiliation>Hackensack Meridian Health, Hackensack New Jersey and Hackensack Meridian School of Medicine, Nutley, New Jersey, United States of America.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Asif</LastName>
<ForeName>Arif</ForeName>
<Initials>A</Initials>
<AffiliationInfo><Affiliation>Hackensack Meridian Health, Hackensack New Jersey and Hackensack Meridian School of Medicine, Nutley, New Jersey, United States of America.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Landolfi</LastName>
<ForeName>Joseph C</ForeName>
<Initials>JC</Initials>
<AffiliationInfo><Affiliation>Hackensack Meridian Health, Hackensack New Jersey and Hackensack Meridian School of Medicine, Nutley, New Jersey, United States of America.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Goldberg</LastName>
<ForeName>Stuart L</ForeName>
<Initials>SL</Initials>
<Identifier Source="ORCID">0000-0003-2175-4082</Identifier>
<AffiliationInfo><Affiliation>Division of Outcomes and Value Research, John Theurer Cancer Center at Hackensack University Medical Center, Hackensack, New Jersey, United States of America.</Affiliation>
</AffiliationInfo>
</Author>
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<Language>eng</Language>
<DataBankList CompleteYN="Y"><DataBank><DataBankName>ClinicalTrials.gov</DataBankName>
<AccessionNumberList><AccessionNumber>NCT04347993</AccessionNumber>
</AccessionNumberList>
</DataBank>
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<GrantList CompleteYN="Y"><Grant><GrantID>P30 CA016672</GrantID>
<Acronym>CA</Acronym>
<Agency>NCI NIH HHS</Agency>
<Country>United States</Country>
</Grant>
<Grant><GrantID>UL1 TR003167</GrantID>
<Acronym>TR</Acronym>
<Agency>NCATS NIH HHS</Agency>
<Country>United States</Country>
</Grant>
</GrantList>
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<PublicationType UI="D016448">Multicenter Study</PublicationType>
<PublicationType UI="D064888">Observational Study</PublicationType>
</PublicationTypeList>
<ArticleDate DateType="Electronic"><Year>2020</Year>
<Month>08</Month>
<Day>13</Day>
</ArticleDate>
</Article>
<MedlineJournalInfo><Country>United States</Country>
<MedlineTA>PLoS One</MedlineTA>
<NlmUniqueID>101285081</NlmUniqueID>
<ISSNLinking>1932-6203</ISSNLinking>
</MedlineJournalInfo>
<ChemicalList><Chemical><RegistryNumber>0</RegistryNumber>
<NameOfSubstance UI="D061067">Antibodies, Monoclonal, Humanized</NameOfSubstance>
</Chemical>
<Chemical><RegistryNumber>0</RegistryNumber>
<NameOfSubstance UI="D000962">Antimalarials</NameOfSubstance>
</Chemical>
<Chemical><RegistryNumber>0</RegistryNumber>
<NameOfSubstance UI="C508600">IL6 protein, human</NameOfSubstance>
</Chemical>
<Chemical><RegistryNumber>0</RegistryNumber>
<NameOfSubstance UI="D015850">Interleukin-6</NameOfSubstance>
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<Chemical><RegistryNumber>4QWG6N8QKH</RegistryNumber>
<NameOfSubstance UI="D006886">Hydroxychloroquine</NameOfSubstance>
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<Chemical><RegistryNumber>83905-01-5</RegistryNumber>
<NameOfSubstance UI="D017963">Azithromycin</NameOfSubstance>
</Chemical>
<Chemical><RegistryNumber>I031V2H011</RegistryNumber>
<NameOfSubstance UI="C502936">tocilizumab</NameOfSubstance>
</Chemical>
</ChemicalList>
<SupplMeshList><SupplMeshName Type="Protocol" UI="C000705127">COVID-19 drug treatment</SupplMeshName>
</SupplMeshList>
<CitationSubset>IM</CitationSubset>
<MeshHeadingList><MeshHeading><DescriptorName UI="D000293" MajorTopicYN="N">Adolescent</DescriptorName>
</MeshHeading>
<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="D061067" MajorTopicYN="N">Antibodies, Monoclonal, Humanized</DescriptorName>
<QualifierName UI="Q000494" MajorTopicYN="N">pharmacology</QualifierName>
<QualifierName UI="Q000627" MajorTopicYN="Y">therapeutic use</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D000962" MajorTopicYN="N">Antimalarials</DescriptorName>
<QualifierName UI="Q000627" MajorTopicYN="Y">therapeutic use</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D017963" MajorTopicYN="N">Azithromycin</DescriptorName>
<QualifierName UI="Q000627" MajorTopicYN="N">therapeutic use</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D000073640" MajorTopicYN="Y">Betacoronavirus</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D000086382" MajorTopicYN="N">COVID-19</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D002648" MajorTopicYN="N">Child</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D002675" MajorTopicYN="N">Child, Preschool</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D018352" MajorTopicYN="N">Coronavirus Infections</DescriptorName>
<QualifierName UI="Q000188" MajorTopicYN="Y">drug therapy</QualifierName>
<QualifierName UI="Q000401" MajorTopicYN="N">mortality</QualifierName>
<QualifierName UI="Q000821" MajorTopicYN="N">virology</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D004359" MajorTopicYN="N">Drug Therapy, Combination</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D005500" MajorTopicYN="N">Follow-Up Studies</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D006760" MajorTopicYN="N">Hospitalization</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D006886" MajorTopicYN="N">Hydroxychloroquine</DescriptorName>
<QualifierName UI="Q000627" MajorTopicYN="Y">therapeutic use</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D007223" MajorTopicYN="N">Infant</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D007231" MajorTopicYN="N">Infant, Newborn</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D007362" MajorTopicYN="N">Intensive Care Units</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D015850" MajorTopicYN="N">Interleukin-6</DescriptorName>
<QualifierName UI="Q000037" MajorTopicYN="N">antagonists & inhibitors</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D053208" MajorTopicYN="N">Kaplan-Meier Estimate</DescriptorName>
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<CoiStatement>I have read the journal’s policy and the authors of this manuscript have the following competing interests: DAB, SMB, and NSB are employed by Berry Consultants LLC which provided statistical support for the study. EH, AHG, ALP, SM, and SLG are employed or have ownership interest in COTA Inc which provided statistical support for the study. AHG discloses consulting fees from Physicians’ Education Resource, LLC for his contributions to COVID-19 and Cancer Care. This does not alter our adherence to PLOS ONE policies on sharing data and materials.</CoiStatement>
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Hydroxychloroquine and tocilizumab therapy in COVID-19 patients-An observational study.

Hydroxychloroquine and tocilizumab therapy in COVID-19 patients-An observational study.

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