Compassionate use of hydroxychloroquine in clinical practice for patients with mild to severe Covid-19 in a French university hospital.
Identifieur interne : 001376 ( Main/Corpus ); précédent : 001375; suivant : 001377Compassionate use of hydroxychloroquine in clinical practice for patients with mild to severe Covid-19 in a French university hospital.
Auteurs : Olivier Paccoud ; Florence Tubach ; Amandine Baptiste ; Alexandre Bleibtreu ; David Hajage ; Gentiane Monsel ; Gianpiero Tebano ; David Boutolleau ; Elise Klement ; Nagisa Godefroy ; Romain Palich ; Oula Itani ; Antoine Fayssal ; Marc-Antoine Valantin ; Roland Tubiana ; Sonia Burrel ; Vincent Calvez ; Eric Caumes ; Anne-Geneviève Marcelin ; Valérie PourcherSource :
- Clinical infectious diseases : an official publication of the Infectious Diseases Society of America [ 1537-6591 ] ; 2020.
Abstract
BACKGROUND
Data from non-randomized studies have suggested that hydroxychloroquine could be an effective therapeutic agent against Covid-19.
METHODS
We conducted an observational, retrospective cohort study involving hospitalized adult patients with confirmed, mild to severe Covid-19 in a French university hospital. Patients who received hydroxychloroquine (200mg tid dosage for 10 days) on a compassionate basis in addition to SOCwere compared to patients without contraindications to hydroxychloroquine who received SOCalone. A propensity score-weighted analysis was performed to control for confounders: age, sex, time between symptom onset and admission ≤ 7 days, Charlson comorbidity index, medical history of arterial hypertension, and obesity, NEWS2 score at admission, and pneumonia severity. The primary endpoint was time to unfavorable outcome, defined as: death, admission to an intensive care unit, or decision to withdraw or withhold life-sustaining treatments, whichever came first.
RESULTS
Data from 89 patients with laboratory-confirmed Covid-19 were analyzed, 84 of whom were considered in the primary analysis; 38 patients treated with hydroxychloroquine and 46 patients treated with SOCalone. At admission, the mean age of patients was 66 years, the median Charlson comorbidity index was 3, and the median NEWS2 severity score was 3. After propensity score weighting, treatment with hydroxycholoroquine was not associated with a significantly reduced risk of unfavorable outcome (HR 0.90 [0.38; 2.1], p = 0.81). Overall survival was not significantly different between the two groups (HR 0.89 [0.23; 3.47], p = 1).
CONCLUSION
In hospitalized adults with Covid-19, no significant reduction of the risk of unfavorable outcomes was observed with hydroxychloroquine in comparison to standard of care. Unmeasured confounders may however have persisted despite careful propensity-weighted analysis and the study might be underpowered. Ongoing controlled trials in patients with varying degrees of initial severity on a larger scale will help determine whether there is a place for hydroxychloroquine in the treatment of Covid-19.
DOI: 10.1093/cid/ciaa791
PubMed: 32556143
PubMed Central: PMC7337663
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Compassionate use of hydroxychloroquine in clinical practice for patients with mild to severe Covid-19 in a French university hospital.</title><author><name sortKey="Paccoud, Olivier" sort="Paccoud, Olivier" uniqKey="Paccoud O" first="Olivier" last="Paccoud">Olivier Paccoud</name><affiliation><nlm:affiliation>Assistance Publique - Hôpitaux de Paris, Hôpitaux Universitaires Pitié-Salpêtrière Charles Foix, Service de Maladies infectieuses et Tropicales, 75013, Paris, France.</nlm:affiliation></affiliation></author><author><name sortKey="Tubach, Florence" sort="Tubach, Florence" uniqKey="Tubach F" first="Florence" last="Tubach">Florence Tubach</name><affiliation><nlm:affiliation>Sorbonne Université, INSERM UMR 1136, Département de Santé Publique, Unité de Recherche Clinique Pitié Salpêtrière - Charles Foix, Centre de Pharmaco-épidémiologie de l'AP-HP, Hôpitaux Universitaires Pitié-Salpêtrière Charles Foix, Paris, France.</nlm:affiliation></affiliation></author><author><name sortKey="Baptiste, Amandine" sort="Baptiste, Amandine" uniqKey="Baptiste A" first="Amandine" last="Baptiste">Amandine Baptiste</name><affiliation><nlm:affiliation>Sorbonne Université, INSERM UMR 1136, Département de Santé Publique, Unité de Recherche Clinique Pitié Salpêtrière - Charles Foix, Centre de Pharmaco-épidémiologie de l'AP-HP, Hôpitaux Universitaires Pitié-Salpêtrière Charles Foix, Paris, France.</nlm:affiliation></affiliation></author><author><name sortKey="Bleibtreu, Alexandre" sort="Bleibtreu, Alexandre" uniqKey="Bleibtreu A" first="Alexandre" last="Bleibtreu">Alexandre Bleibtreu</name><affiliation><nlm:affiliation>Assistance Publique - Hôpitaux de Paris, Hôpitaux Universitaires Pitié-Salpêtrière Charles Foix, Service de Maladies infectieuses et Tropicales, 75013, Paris, France.</nlm:affiliation></affiliation></author><author><name sortKey="Hajage, David" sort="Hajage, David" uniqKey="Hajage D" first="David" last="Hajage">David Hajage</name><affiliation><nlm:affiliation>Sorbonne Université, INSERM UMR 1136, Département de Santé Publique, Unité de Recherche Clinique Pitié Salpêtrière - Charles Foix, Centre de Pharmaco-épidémiologie de l'AP-HP, Hôpitaux Universitaires Pitié-Salpêtrière Charles Foix, Paris, France.</nlm:affiliation></affiliation></author><author><name sortKey="Monsel, Gentiane" sort="Monsel, Gentiane" uniqKey="Monsel G" first="Gentiane" last="Monsel">Gentiane Monsel</name><affiliation><nlm:affiliation>Assistance Publique - Hôpitaux de Paris, Hôpitaux Universitaires Pitié-Salpêtrière Charles Foix, Service de Maladies infectieuses et Tropicales, 75013, Paris, France.</nlm:affiliation></affiliation></author><author><name sortKey="Tebano, Gianpiero" sort="Tebano, Gianpiero" uniqKey="Tebano G" first="Gianpiero" last="Tebano">Gianpiero Tebano</name><affiliation><nlm:affiliation>Assistance Publique - Hôpitaux de Paris, Hôpitaux Universitaires Pitié-Salpêtrière Charles Foix, Service de Maladies infectieuses et Tropicales, 75013, Paris, France.</nlm:affiliation></affiliation></author><author><name sortKey="Boutolleau, David" sort="Boutolleau, David" uniqKey="Boutolleau D" first="David" last="Boutolleau">David Boutolleau</name><affiliation><nlm:affiliation>Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, AP-HP, Hôpitaux Universitaires Pitié-Salpêtrière - Charles Foix, laboratoire de virologie, Paris, France.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Sorbonne Université, INSERM 1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Paris, France.</nlm:affiliation></affiliation></author><author><name sortKey="Klement, Elise" sort="Klement, Elise" uniqKey="Klement E" first="Elise" last="Klement">Elise Klement</name><affiliation><nlm:affiliation>Assistance Publique - Hôpitaux de Paris, Hôpitaux Universitaires Pitié-Salpêtrière Charles Foix, Service de Maladies infectieuses et Tropicales, 75013, Paris, France.</nlm:affiliation></affiliation></author><author><name sortKey="Godefroy, Nagisa" sort="Godefroy, Nagisa" uniqKey="Godefroy N" first="Nagisa" last="Godefroy">Nagisa Godefroy</name><affiliation><nlm:affiliation>Assistance Publique - Hôpitaux de Paris, Hôpitaux Universitaires Pitié-Salpêtrière Charles Foix, Service de Maladies infectieuses et Tropicales, 75013, Paris, France.</nlm:affiliation></affiliation></author><author><name sortKey="Palich, Romain" sort="Palich, Romain" uniqKey="Palich R" first="Romain" last="Palich">Romain Palich</name><affiliation><nlm:affiliation>Assistance Publique - Hôpitaux de Paris, Hôpitaux Universitaires Pitié-Salpêtrière Charles Foix, Service de Maladies infectieuses et Tropicales, 75013, Paris, France.</nlm:affiliation></affiliation></author><author><name sortKey="Itani, Oula" sort="Itani, Oula" uniqKey="Itani O" first="Oula" last="Itani">Oula Itani</name><affiliation><nlm:affiliation>Assistance Publique - Hôpitaux de Paris, Hôpitaux Universitaires Pitié-Salpêtrière Charles Foix, Service de Maladies infectieuses et Tropicales, 75013, Paris, France.</nlm:affiliation></affiliation></author><author><name sortKey="Fayssal, Antoine" sort="Fayssal, Antoine" uniqKey="Fayssal A" first="Antoine" last="Fayssal">Antoine Fayssal</name><affiliation><nlm:affiliation>Assistance Publique - Hôpitaux de Paris, Hôpitaux Universitaires Pitié-Salpêtrière Charles Foix, Service de Maladies infectieuses et Tropicales, 75013, Paris, France.</nlm:affiliation></affiliation></author><author><name sortKey="Valantin, Marc Antoine" sort="Valantin, Marc Antoine" uniqKey="Valantin M" first="Marc-Antoine" last="Valantin">Marc-Antoine Valantin</name><affiliation><nlm:affiliation>Assistance Publique - Hôpitaux de Paris, Hôpitaux Universitaires Pitié-Salpêtrière Charles Foix, Service de Maladies infectieuses et Tropicales, 75013, Paris, France.</nlm:affiliation></affiliation></author><author><name sortKey="Tubiana, Roland" sort="Tubiana, Roland" uniqKey="Tubiana R" first="Roland" last="Tubiana">Roland Tubiana</name><affiliation><nlm:affiliation>Assistance Publique - Hôpitaux de Paris, Hôpitaux Universitaires Pitié-Salpêtrière Charles Foix, Service de Maladies infectieuses et Tropicales, 75013, Paris, France.</nlm:affiliation></affiliation></author><author><name sortKey="Burrel, Sonia" sort="Burrel, Sonia" uniqKey="Burrel S" first="Sonia" last="Burrel">Sonia Burrel</name><affiliation><nlm:affiliation>Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, AP-HP, Hôpitaux Universitaires Pitié-Salpêtrière - Charles Foix, laboratoire de virologie, Paris, France.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Sorbonne Université, INSERM 1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Paris, France.</nlm:affiliation></affiliation></author><author><name sortKey="Calvez, Vincent" sort="Calvez, Vincent" uniqKey="Calvez V" first="Vincent" last="Calvez">Vincent Calvez</name><affiliation><nlm:affiliation>Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, AP-HP, Hôpitaux Universitaires Pitié-Salpêtrière - Charles Foix, laboratoire de virologie, Paris, France.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Sorbonne Université, INSERM 1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Paris, France.</nlm:affiliation></affiliation></author><author><name sortKey="Caumes, Eric" sort="Caumes, Eric" uniqKey="Caumes E" first="Eric" last="Caumes">Eric Caumes</name><affiliation><nlm:affiliation>Assistance Publique - Hôpitaux de Paris, Hôpitaux Universitaires Pitié-Salpêtrière Charles Foix, Service de Maladies infectieuses et Tropicales, 75013, Paris, France.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Sorbonne Université, INSERM 1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Paris, France.</nlm:affiliation></affiliation></author><author><name sortKey="Marcelin, Anne Genevieve" sort="Marcelin, Anne Genevieve" uniqKey="Marcelin A" first="Anne-Geneviève" last="Marcelin">Anne-Geneviève Marcelin</name><affiliation><nlm:affiliation>Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, AP-HP, Hôpitaux Universitaires Pitié-Salpêtrière - Charles Foix, laboratoire de virologie, Paris, France.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Sorbonne Université, INSERM 1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Paris, France.</nlm:affiliation></affiliation></author><author><name sortKey="Pourcher, Valerie" sort="Pourcher, Valerie" uniqKey="Pourcher V" first="Valérie" last="Pourcher">Valérie Pourcher</name><affiliation><nlm:affiliation>Assistance Publique - Hôpitaux de Paris, Hôpitaux Universitaires Pitié-Salpêtrière Charles Foix, Service de Maladies infectieuses et Tropicales, 75013, Paris, France.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Sorbonne Université, INSERM 1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Paris, France.</nlm:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2020">2020</date><idno type="RBID">pubmed:32556143</idno><idno type="pmid">32556143</idno><idno type="doi">10.1093/cid/ciaa791</idno><idno type="pmc">PMC7337663</idno><idno type="wicri:Area/Main/Corpus">001376</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Corpus" wicri:corpus="PubMed">001376</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Compassionate use of hydroxychloroquine in clinical practice for patients with mild to severe Covid-19 in a French university hospital.</title><author><name sortKey="Paccoud, Olivier" sort="Paccoud, Olivier" uniqKey="Paccoud O" first="Olivier" last="Paccoud">Olivier Paccoud</name><affiliation><nlm:affiliation>Assistance Publique - Hôpitaux de Paris, Hôpitaux Universitaires Pitié-Salpêtrière Charles Foix, Service de Maladies infectieuses et Tropicales, 75013, Paris, France.</nlm:affiliation></affiliation></author><author><name sortKey="Tubach, Florence" sort="Tubach, Florence" uniqKey="Tubach F" first="Florence" last="Tubach">Florence Tubach</name><affiliation><nlm:affiliation>Sorbonne Université, INSERM UMR 1136, Département de Santé Publique, Unité de Recherche Clinique Pitié Salpêtrière - Charles Foix, Centre de Pharmaco-épidémiologie de l'AP-HP, Hôpitaux Universitaires Pitié-Salpêtrière Charles Foix, Paris, France.</nlm:affiliation></affiliation></author><author><name sortKey="Baptiste, Amandine" sort="Baptiste, Amandine" uniqKey="Baptiste A" first="Amandine" last="Baptiste">Amandine Baptiste</name><affiliation><nlm:affiliation>Sorbonne Université, INSERM UMR 1136, Département de Santé Publique, Unité de Recherche Clinique Pitié Salpêtrière - Charles Foix, Centre de Pharmaco-épidémiologie de l'AP-HP, Hôpitaux Universitaires Pitié-Salpêtrière Charles Foix, Paris, France.</nlm:affiliation></affiliation></author><author><name sortKey="Bleibtreu, Alexandre" sort="Bleibtreu, Alexandre" uniqKey="Bleibtreu A" first="Alexandre" last="Bleibtreu">Alexandre Bleibtreu</name><affiliation><nlm:affiliation>Assistance Publique - Hôpitaux de Paris, Hôpitaux Universitaires Pitié-Salpêtrière Charles Foix, Service de Maladies infectieuses et Tropicales, 75013, Paris, France.</nlm:affiliation></affiliation></author><author><name sortKey="Hajage, David" sort="Hajage, David" uniqKey="Hajage D" first="David" last="Hajage">David Hajage</name><affiliation><nlm:affiliation>Sorbonne Université, INSERM UMR 1136, Département de Santé Publique, Unité de Recherche Clinique Pitié Salpêtrière - Charles Foix, Centre de Pharmaco-épidémiologie de l'AP-HP, Hôpitaux Universitaires Pitié-Salpêtrière Charles Foix, Paris, France.</nlm:affiliation></affiliation></author><author><name sortKey="Monsel, Gentiane" sort="Monsel, Gentiane" uniqKey="Monsel G" first="Gentiane" last="Monsel">Gentiane Monsel</name><affiliation><nlm:affiliation>Assistance Publique - Hôpitaux de Paris, Hôpitaux Universitaires Pitié-Salpêtrière Charles Foix, Service de Maladies infectieuses et Tropicales, 75013, Paris, France.</nlm:affiliation></affiliation></author><author><name sortKey="Tebano, Gianpiero" sort="Tebano, Gianpiero" uniqKey="Tebano G" first="Gianpiero" last="Tebano">Gianpiero Tebano</name><affiliation><nlm:affiliation>Assistance Publique - Hôpitaux de Paris, Hôpitaux Universitaires Pitié-Salpêtrière Charles Foix, Service de Maladies infectieuses et Tropicales, 75013, Paris, France.</nlm:affiliation></affiliation></author><author><name sortKey="Boutolleau, David" sort="Boutolleau, David" uniqKey="Boutolleau D" first="David" last="Boutolleau">David Boutolleau</name><affiliation><nlm:affiliation>Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, AP-HP, Hôpitaux Universitaires Pitié-Salpêtrière - Charles Foix, laboratoire de virologie, Paris, France.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Sorbonne Université, INSERM 1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Paris, France.</nlm:affiliation></affiliation></author><author><name sortKey="Klement, Elise" sort="Klement, Elise" uniqKey="Klement E" first="Elise" last="Klement">Elise Klement</name><affiliation><nlm:affiliation>Assistance Publique - Hôpitaux de Paris, Hôpitaux Universitaires Pitié-Salpêtrière Charles Foix, Service de Maladies infectieuses et Tropicales, 75013, Paris, France.</nlm:affiliation></affiliation></author><author><name sortKey="Godefroy, Nagisa" sort="Godefroy, Nagisa" uniqKey="Godefroy N" first="Nagisa" last="Godefroy">Nagisa Godefroy</name><affiliation><nlm:affiliation>Assistance Publique - Hôpitaux de Paris, Hôpitaux Universitaires Pitié-Salpêtrière Charles Foix, Service de Maladies infectieuses et Tropicales, 75013, Paris, France.</nlm:affiliation></affiliation></author><author><name sortKey="Palich, Romain" sort="Palich, Romain" uniqKey="Palich R" first="Romain" last="Palich">Romain Palich</name><affiliation><nlm:affiliation>Assistance Publique - Hôpitaux de Paris, Hôpitaux Universitaires Pitié-Salpêtrière Charles Foix, Service de Maladies infectieuses et Tropicales, 75013, Paris, France.</nlm:affiliation></affiliation></author><author><name sortKey="Itani, Oula" sort="Itani, Oula" uniqKey="Itani O" first="Oula" last="Itani">Oula Itani</name><affiliation><nlm:affiliation>Assistance Publique - Hôpitaux de Paris, Hôpitaux Universitaires Pitié-Salpêtrière Charles Foix, Service de Maladies infectieuses et Tropicales, 75013, Paris, France.</nlm:affiliation></affiliation></author><author><name sortKey="Fayssal, Antoine" sort="Fayssal, Antoine" uniqKey="Fayssal A" first="Antoine" last="Fayssal">Antoine Fayssal</name><affiliation><nlm:affiliation>Assistance Publique - Hôpitaux de Paris, Hôpitaux Universitaires Pitié-Salpêtrière Charles Foix, Service de Maladies infectieuses et Tropicales, 75013, Paris, France.</nlm:affiliation></affiliation></author><author><name sortKey="Valantin, Marc Antoine" sort="Valantin, Marc Antoine" uniqKey="Valantin M" first="Marc-Antoine" last="Valantin">Marc-Antoine Valantin</name><affiliation><nlm:affiliation>Assistance Publique - Hôpitaux de Paris, Hôpitaux Universitaires Pitié-Salpêtrière Charles Foix, Service de Maladies infectieuses et Tropicales, 75013, Paris, France.</nlm:affiliation></affiliation></author><author><name sortKey="Tubiana, Roland" sort="Tubiana, Roland" uniqKey="Tubiana R" first="Roland" last="Tubiana">Roland Tubiana</name><affiliation><nlm:affiliation>Assistance Publique - Hôpitaux de Paris, Hôpitaux Universitaires Pitié-Salpêtrière Charles Foix, Service de Maladies infectieuses et Tropicales, 75013, Paris, France.</nlm:affiliation></affiliation></author><author><name sortKey="Burrel, Sonia" sort="Burrel, Sonia" uniqKey="Burrel S" first="Sonia" last="Burrel">Sonia Burrel</name><affiliation><nlm:affiliation>Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, AP-HP, Hôpitaux Universitaires Pitié-Salpêtrière - Charles Foix, laboratoire de virologie, Paris, France.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Sorbonne Université, INSERM 1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Paris, France.</nlm:affiliation></affiliation></author><author><name sortKey="Calvez, Vincent" sort="Calvez, Vincent" uniqKey="Calvez V" first="Vincent" last="Calvez">Vincent Calvez</name><affiliation><nlm:affiliation>Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, AP-HP, Hôpitaux Universitaires Pitié-Salpêtrière - Charles Foix, laboratoire de virologie, Paris, France.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Sorbonne Université, INSERM 1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Paris, France.</nlm:affiliation></affiliation></author><author><name sortKey="Caumes, Eric" sort="Caumes, Eric" uniqKey="Caumes E" first="Eric" last="Caumes">Eric Caumes</name><affiliation><nlm:affiliation>Assistance Publique - Hôpitaux de Paris, Hôpitaux Universitaires Pitié-Salpêtrière Charles Foix, Service de Maladies infectieuses et Tropicales, 75013, Paris, France.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Sorbonne Université, INSERM 1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Paris, France.</nlm:affiliation></affiliation></author><author><name sortKey="Marcelin, Anne Genevieve" sort="Marcelin, Anne Genevieve" uniqKey="Marcelin A" first="Anne-Geneviève" last="Marcelin">Anne-Geneviève Marcelin</name><affiliation><nlm:affiliation>Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, AP-HP, Hôpitaux Universitaires Pitié-Salpêtrière - Charles Foix, laboratoire de virologie, Paris, France.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Sorbonne Université, INSERM 1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Paris, France.</nlm:affiliation></affiliation></author><author><name sortKey="Pourcher, Valerie" sort="Pourcher, Valerie" uniqKey="Pourcher V" first="Valérie" last="Pourcher">Valérie Pourcher</name><affiliation><nlm:affiliation>Assistance Publique - Hôpitaux de Paris, Hôpitaux Universitaires Pitié-Salpêtrière Charles Foix, Service de Maladies infectieuses et Tropicales, 75013, Paris, France.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Sorbonne Université, INSERM 1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Paris, France.</nlm:affiliation></affiliation></author></analytic><series><title level="j">Clinical infectious diseases : an official publication of the Infectious Diseases Society of America</title><idno type="eISSN">1537-6591</idno><imprint><date when="2020" type="published">2020</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>BACKGROUND</b></p><p>Data from non-randomized studies have suggested that hydroxychloroquine could be an effective therapeutic agent against Covid-19.</p></div><div type="abstract" xml:lang="en"><p><b>METHODS</b></p><p>We conducted an observational, retrospective cohort study involving hospitalized adult patients with confirmed, mild to severe Covid-19 in a French university hospital. Patients who received hydroxychloroquine (200mg tid dosage for 10 days) on a compassionate basis in addition to SOCwere compared to patients without contraindications to hydroxychloroquine who received SOCalone. A propensity score-weighted analysis was performed to control for confounders: age, sex, time between symptom onset and admission ≤ 7 days, Charlson comorbidity index, medical history of arterial hypertension, and obesity, NEWS2 score at admission, and pneumonia severity. The primary endpoint was time to unfavorable outcome, defined as: death, admission to an intensive care unit, or decision to withdraw or withhold life-sustaining treatments, whichever came first.</p></div><div type="abstract" xml:lang="en"><p><b>RESULTS</b></p><p>Data from 89 patients with laboratory-confirmed Covid-19 were analyzed, 84 of whom were considered in the primary analysis; 38 patients treated with hydroxychloroquine and 46 patients treated with SOCalone. At admission, the mean age of patients was 66 years, the median Charlson comorbidity index was 3, and the median NEWS2 severity score was 3. After propensity score weighting, treatment with hydroxycholoroquine was not associated with a significantly reduced risk of unfavorable outcome (HR 0.90 [0.38; 2.1], p = 0.81). Overall survival was not significantly different between the two groups (HR 0.89 [0.23; 3.47], p = 1).</p></div><div type="abstract" xml:lang="en"><p><b>CONCLUSION</b></p><p>In hospitalized adults with Covid-19, no significant reduction of the risk of unfavorable outcomes was observed with hydroxychloroquine in comparison to standard of care. Unmeasured confounders may however have persisted despite careful propensity-weighted analysis and the study might be underpowered. Ongoing controlled trials in patients with varying degrees of initial severity on a larger scale will help determine whether there is a place for hydroxychloroquine in the treatment of Covid-19.</p></div></front></TEI><pubmed><MedlineCitation Status="Publisher" Owner="NLM"><PMID Version="1">32556143</PMID><DateRevised><Year>2021</Year><Month>05</Month><Day>19</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1537-6591</ISSN><JournalIssue CitedMedium="Internet"><PubDate><Year>2020</Year><Month>Jun</Month><Day>18</Day></PubDate></JournalIssue><Title>Clinical infectious diseases : an official publication of the Infectious Diseases Society of America</Title><ISOAbbreviation>Clin Infect Dis</ISOAbbreviation></Journal><ArticleTitle>Compassionate use of hydroxychloroquine in clinical practice for patients with mild to severe Covid-19 in a French university hospital.</ArticleTitle><ELocationID EIdType="pii" ValidYN="Y">ciaa791</ELocationID><ELocationID EIdType="doi" ValidYN="Y">10.1093/cid/ciaa791</ELocationID><Abstract><AbstractText Label="BACKGROUND" NlmCategory="BACKGROUND">Data from non-randomized studies have suggested that hydroxychloroquine could be an effective therapeutic agent against Covid-19.</AbstractText><AbstractText Label="METHODS" NlmCategory="METHODS">We conducted an observational, retrospective cohort study involving hospitalized adult patients with confirmed, mild to severe Covid-19 in a French university hospital. Patients who received hydroxychloroquine (200mg tid dosage for 10 days) on a compassionate basis in addition to SOCwere compared to patients without contraindications to hydroxychloroquine who received SOCalone. A propensity score-weighted analysis was performed to control for confounders: age, sex, time between symptom onset and admission ≤ 7 days, Charlson comorbidity index, medical history of arterial hypertension, and obesity, NEWS2 score at admission, and pneumonia severity. The primary endpoint was time to unfavorable outcome, defined as: death, admission to an intensive care unit, or decision to withdraw or withhold life-sustaining treatments, whichever came first.</AbstractText><AbstractText Label="RESULTS" NlmCategory="RESULTS">Data from 89 patients with laboratory-confirmed Covid-19 were analyzed, 84 of whom were considered in the primary analysis; 38 patients treated with hydroxychloroquine and 46 patients treated with SOCalone. At admission, the mean age of patients was 66 years, the median Charlson comorbidity index was 3, and the median NEWS2 severity score was 3. After propensity score weighting, treatment with hydroxycholoroquine was not associated with a significantly reduced risk of unfavorable outcome (HR 0.90 [0.38; 2.1], p = 0.81). Overall survival was not significantly different between the two groups (HR 0.89 [0.23; 3.47], p = 1).</AbstractText><AbstractText Label="CONCLUSION" NlmCategory="CONCLUSIONS">In hospitalized adults with Covid-19, no significant reduction of the risk of unfavorable outcomes was observed with hydroxychloroquine in comparison to standard of care. Unmeasured confounders may however have persisted despite careful propensity-weighted analysis and the study might be underpowered. Ongoing controlled trials in patients with varying degrees of initial severity on a larger scale will help determine whether there is a place for hydroxychloroquine in the treatment of Covid-19.</AbstractText><CopyrightInformation>© The Author(s) 2020. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Paccoud</LastName><ForeName>Olivier</ForeName><Initials>O</Initials><AffiliationInfo><Affiliation>Assistance Publique - Hôpitaux de Paris, Hôpitaux Universitaires Pitié-Salpêtrière Charles Foix, Service de Maladies infectieuses et Tropicales, 75013, Paris, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Tubach</LastName><ForeName>Florence</ForeName><Initials>F</Initials><AffiliationInfo><Affiliation>Sorbonne Université, INSERM UMR 1136, Département de Santé Publique, Unité de Recherche Clinique Pitié Salpêtrière - Charles Foix, Centre de Pharmaco-épidémiologie de l'AP-HP, Hôpitaux Universitaires Pitié-Salpêtrière Charles Foix, Paris, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Baptiste</LastName><ForeName>Amandine</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>Sorbonne Université, INSERM UMR 1136, Département de Santé Publique, Unité de Recherche Clinique Pitié Salpêtrière - Charles Foix, Centre de Pharmaco-épidémiologie de l'AP-HP, Hôpitaux Universitaires Pitié-Salpêtrière Charles Foix, Paris, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Bleibtreu</LastName><ForeName>Alexandre</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>Assistance Publique - Hôpitaux de Paris, Hôpitaux Universitaires Pitié-Salpêtrière Charles Foix, Service de Maladies infectieuses et Tropicales, 75013, Paris, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Hajage</LastName><ForeName>David</ForeName><Initials>D</Initials><AffiliationInfo><Affiliation>Sorbonne Université, INSERM UMR 1136, Département de Santé Publique, Unité de Recherche Clinique Pitié Salpêtrière - Charles Foix, Centre de Pharmaco-épidémiologie de l'AP-HP, Hôpitaux Universitaires Pitié-Salpêtrière Charles Foix, Paris, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Monsel</LastName><ForeName>Gentiane</ForeName><Initials>G</Initials><AffiliationInfo><Affiliation>Assistance Publique - Hôpitaux de Paris, Hôpitaux Universitaires Pitié-Salpêtrière Charles Foix, Service de Maladies infectieuses et Tropicales, 75013, Paris, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Tebano</LastName><ForeName>Gianpiero</ForeName><Initials>G</Initials><AffiliationInfo><Affiliation>Assistance Publique - Hôpitaux de Paris, Hôpitaux Universitaires Pitié-Salpêtrière Charles Foix, Service de Maladies infectieuses et Tropicales, 75013, Paris, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Boutolleau</LastName><ForeName>David</ForeName><Initials>D</Initials><AffiliationInfo><Affiliation>Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, AP-HP, Hôpitaux Universitaires Pitié-Salpêtrière - Charles Foix, laboratoire de virologie, Paris, France.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Sorbonne Université, INSERM 1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Paris, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Klement</LastName><ForeName>Elise</ForeName><Initials>E</Initials><AffiliationInfo><Affiliation>Assistance Publique - Hôpitaux de Paris, Hôpitaux Universitaires Pitié-Salpêtrière Charles Foix, Service de Maladies infectieuses et Tropicales, 75013, Paris, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Godefroy</LastName><ForeName>Nagisa</ForeName><Initials>N</Initials><AffiliationInfo><Affiliation>Assistance Publique - Hôpitaux de Paris, Hôpitaux Universitaires Pitié-Salpêtrière Charles Foix, Service de Maladies infectieuses et Tropicales, 75013, Paris, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Palich</LastName><ForeName>Romain</ForeName><Initials>R</Initials><AffiliationInfo><Affiliation>Assistance Publique - Hôpitaux de Paris, Hôpitaux Universitaires Pitié-Salpêtrière Charles Foix, Service de Maladies infectieuses et Tropicales, 75013, Paris, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Itani</LastName><ForeName>Oula</ForeName><Initials>O</Initials><AffiliationInfo><Affiliation>Assistance Publique - Hôpitaux de Paris, Hôpitaux Universitaires Pitié-Salpêtrière Charles Foix, Service de Maladies infectieuses et Tropicales, 75013, Paris, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Fayssal</LastName><ForeName>Antoine</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>Assistance Publique - Hôpitaux de Paris, Hôpitaux Universitaires Pitié-Salpêtrière Charles Foix, Service de Maladies infectieuses et Tropicales, 75013, Paris, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Valantin</LastName><ForeName>Marc-Antoine</ForeName><Initials>MA</Initials><AffiliationInfo><Affiliation>Assistance Publique - Hôpitaux de Paris, Hôpitaux Universitaires Pitié-Salpêtrière Charles Foix, Service de Maladies infectieuses et Tropicales, 75013, Paris, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Tubiana</LastName><ForeName>Roland</ForeName><Initials>R</Initials><AffiliationInfo><Affiliation>Assistance Publique - Hôpitaux de Paris, Hôpitaux Universitaires Pitié-Salpêtrière Charles Foix, Service de Maladies infectieuses et Tropicales, 75013, Paris, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Burrel</LastName><ForeName>Sonia</ForeName><Initials>S</Initials><AffiliationInfo><Affiliation>Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, AP-HP, Hôpitaux Universitaires Pitié-Salpêtrière - Charles Foix, laboratoire de virologie, Paris, France.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Sorbonne Université, INSERM 1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Paris, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Calvez</LastName><ForeName>Vincent</ForeName><Initials>V</Initials><AffiliationInfo><Affiliation>Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, AP-HP, Hôpitaux Universitaires Pitié-Salpêtrière - Charles Foix, laboratoire de virologie, Paris, France.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Sorbonne Université, INSERM 1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Paris, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Caumes</LastName><ForeName>Eric</ForeName><Initials>E</Initials><AffiliationInfo><Affiliation>Assistance Publique - Hôpitaux de Paris, Hôpitaux Universitaires Pitié-Salpêtrière Charles Foix, Service de Maladies infectieuses et Tropicales, 75013, Paris, France.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Sorbonne Université, INSERM 1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Paris, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Marcelin</LastName><ForeName>Anne-Geneviève</ForeName><Initials>AG</Initials><AffiliationInfo><Affiliation>Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, AP-HP, Hôpitaux Universitaires Pitié-Salpêtrière - Charles Foix, laboratoire de virologie, Paris, France.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Sorbonne Université, INSERM 1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Paris, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Pourcher</LastName><ForeName>Valérie</ForeName><Initials>V</Initials><AffiliationInfo><Affiliation>Assistance Publique - Hôpitaux de Paris, Hôpitaux Universitaires Pitié-Salpêtrière Charles Foix, Service de Maladies infectieuses et Tropicales, 75013, Paris, France.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Sorbonne Université, INSERM 1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Paris, France.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2020</Year><Month>06</Month><Day>18</Day></ArticleDate></Article><MedlineJournalInfo><Country>United States</Country><MedlineTA>Clin Infect Dis</MedlineTA><NlmUniqueID>9203213</NlmUniqueID><ISSNLinking>1058-4838</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><CommentsCorrectionsList><CommentsCorrections RefType="CommentIn"><RefSource>Clin Infect Dis. 2021 May 4;72(9):e440-e441</RefSource><PMID Version="1">32761119</PMID></CommentsCorrections><CommentsCorrections RefType="CommentIn"><RefSource>Clin Infect Dis. 2021 May 4;72(9):e439</RefSource><PMID Version="1">32761148</PMID></CommentsCorrections></CommentsCorrectionsList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2020</Year><Month>04</Month><Day>15</Day></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2020</Year><Month>6</Month><Day>20</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2020</Year><Month>6</Month><Day>20</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2020</Year><Month>6</Month><Day>20</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>aheadofprint</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">32556143</ArticleId><ArticleId IdType="pii">5859555</ArticleId><ArticleId IdType="doi">10.1093/cid/ciaa791</ArticleId><ArticleId IdType="pmc">PMC7337663</ArticleId></ArticleIdList></PubmedData></pubmed></record>Pour manipuler ce document sous Unix (Dilib)
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