Efficacy of early hydroxychloroquine treatment in preventing COVID-19 pneumonia aggravation, the experience from Shanghai, China.
Identifieur interne : 000516 ( Main/Exploration ); précédent : 000515; suivant : 000517Efficacy of early hydroxychloroquine treatment in preventing COVID-19 pneumonia aggravation, the experience from Shanghai, China.
Auteurs : Yi Su [République populaire de Chine] ; Yun Ling [République populaire de Chine] ; Yuyan Ma [République populaire de Chine] ; Lili Tao [États-Unis] ; Qing Miao [République populaire de Chine] ; Qingfeng Shi [République populaire de Chine] ; Jue Pan [République populaire de Chine] ; Hongzhou Lu [République populaire de Chine] ; Bijie Hu [République populaire de Chine]Source :
- Bioscience trends [ 1881-7823 ] ; 2021.
Descripteurs français
- KwdFr :
- MESH :
- administration et posologie : Antipaludiques, Hydroxychloroquine.
- Adulte, Adulte d'âge moyen, Chine, Femelle, Humains, Mâle, Résultat thérapeutique, Sujet âgé, Études rétrospectives.
- Wicri :
- geographic : République populaire de Chine.
English descriptors
- KwdEn :
- MESH :
- chemical , administration & dosage : Antimalarials, Hydroxychloroquine.
- geographic : China.
- drug therapy : COVID-19.
- Adult, Aged, Female, Humans, Male, Middle Aged, Retrospective Studies, Treatment Outcome.
Abstract
The aim of this study is to assess the efficacy of multiple treatments, especially hydroxychloroquine, used in different disease stages of coronavirus disease 2019 (COVID-19). All consecutive patients with COVID-19 admitted to Shanghai Public Health Clinical Center (Shanghai, China) between January 20, 2020, and April 30, 2020, were enrolled, and their clinical data were retrospectively collected. Binary logistic regression was used to screen the factors associated with disease aggravation, and multivariable analyses with the Cox proportional hazards model were used to estimate the effects of prognostic factors on the improvement time and PCR conversion days in throat swabs and stool swabs. A total of 616 patients, including 50 (8.11%) severe and 18 (2.92%) critical patients, were enrolled in our retrospective cohort study. The early use of hydroxychloroquine was a protective factor associated with disease aggravation (95% CI: 0.040-0.575, p = 0.006). Clinical improvement by 20 days was significantly different between patients with hydroxychloroquine used early and those with hydroxychloroquine not used (p = 0.016, 95% CI: 1.052-1.647). The median time to clinical improvement was 6 days in the hydroxychloroquine used early group, compared with 9 days in the without hydroxychloroquine used group and 8 days in the with hydroxychloroquine not used early group (p < 0.001). Hydroxychloroquine used early was associated with earlier PCR conversion in both throat swabs (HR = 1.558, p = 0.001) and stool swabs (HR = 1.400, p = 0.028). The use of hydroxychloroquine at an early stage is a potential therapeutic strategy for treating patients before irreversible severe respiratory complications occur. The early use of hydroxychloroquine decreased the improvement time and the duration of COVID-19 detection in throat and stool swabs.
DOI: 10.5582/bst.2020.03340
PubMed: 33342929
Affiliations:
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Shanghai</wicri:regionArea><wicri:noRegion>Shanghai</wicri:noRegion></affiliation></author><author><name sortKey="Ling, Yun" sort="Ling, Yun" uniqKey="Ling Y" first="Yun" last="Ling">Yun Ling</name><affiliation wicri:level="1"><nlm:affiliation>Department of Infectious Diseases, Shanghai Public Health Clinical Center, China.</nlm:affiliation><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Infectious Diseases, Shanghai Public Health Clinical Center</wicri:regionArea><wicri:noRegion>Shanghai Public Health Clinical Center</wicri:noRegion></affiliation></author><author><name sortKey="Ma, Yuyan" sort="Ma, Yuyan" uniqKey="Ma Y" first="Yuyan" last="Ma">Yuyan Ma</name><affiliation wicri:level="1"><nlm:affiliation>Department of Infectious Diseases, Zhongshan Hospital Fudan University, Shanghai, China.</nlm:affiliation><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Infectious Diseases, Zhongshan Hospital Fudan University, Shanghai</wicri:regionArea><wicri:noRegion>Shanghai</wicri:noRegion></affiliation></author><author><name sortKey="Tao, Lili" sort="Tao, Lili" uniqKey="Tao L" first="Lili" last="Tao">Lili Tao</name><affiliation wicri:level="2"><nlm:affiliation>UT Southwestern Medical Center, Department of Immunology, Texas, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>UT Southwestern Medical Center, Department of Immunology, Texas</wicri:regionArea><placeName><region type="state">Texas</region></placeName></affiliation></author><author><name sortKey="Miao, Qing" sort="Miao, Qing" uniqKey="Miao Q" first="Qing" last="Miao">Qing Miao</name><affiliation wicri:level="1"><nlm:affiliation>Department of Infectious Diseases, Zhongshan Hospital Fudan University, Shanghai, China.</nlm:affiliation><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Infectious Diseases, Zhongshan Hospital Fudan University, Shanghai</wicri:regionArea><wicri:noRegion>Shanghai</wicri:noRegion></affiliation></author><author><name sortKey="Shi, Qingfeng" sort="Shi, Qingfeng" uniqKey="Shi Q" first="Qingfeng" last="Shi">Qingfeng Shi</name><affiliation wicri:level="1"><nlm:affiliation>Department of Infectious Control, Zhongshan Hospital Fudan University, Shanghai, China.</nlm:affiliation><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Infectious Control, Zhongshan Hospital Fudan University, Shanghai</wicri:regionArea><wicri:noRegion>Shanghai</wicri:noRegion></affiliation></author><author><name sortKey="Pan, Jue" sort="Pan, Jue" uniqKey="Pan J" first="Jue" last="Pan">Jue Pan</name><affiliation wicri:level="1"><nlm:affiliation>Department of Infectious Diseases, Zhongshan Hospital Fudan University, Shanghai, China.</nlm:affiliation><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Infectious Diseases, Zhongshan Hospital Fudan University, Shanghai</wicri:regionArea><wicri:noRegion>Shanghai</wicri:noRegion></affiliation></author><author><name sortKey="Lu, Hongzhou" sort="Lu, Hongzhou" uniqKey="Lu H" first="Hongzhou" last="Lu">Hongzhou Lu</name><affiliation wicri:level="1"><nlm:affiliation>Department of Infectious Diseases, Shanghai Public Health Clinical Center, China.</nlm:affiliation><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Infectious Diseases, Shanghai Public Health Clinical Center</wicri:regionArea><wicri:noRegion>Shanghai Public Health Clinical Center</wicri:noRegion></affiliation></author><author><name sortKey="Hu, Bijie" sort="Hu, Bijie" uniqKey="Hu B" first="Bijie" last="Hu">Bijie Hu</name><affiliation wicri:level="1"><nlm:affiliation>Department of Infectious Diseases, Zhongshan Hospital Fudan University, Shanghai, China.</nlm:affiliation><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Infectious Diseases, Zhongshan Hospital Fudan University, Shanghai</wicri:regionArea><wicri:noRegion>Shanghai</wicri:noRegion></affiliation></author></analytic><series><title level="j">Bioscience trends</title><idno type="eISSN">1881-7823</idno><imprint><date when="2021" type="published">2021</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adult (MeSH)</term><term>Aged (MeSH)</term><term>Antimalarials (administration & dosage)</term><term>COVID-19 (drug therapy)</term><term>China (MeSH)</term><term>Female (MeSH)</term><term>Humans (MeSH)</term><term>Hydroxychloroquine (administration & dosage)</term><term>Male (MeSH)</term><term>Middle Aged (MeSH)</term><term>Retrospective Studies (MeSH)</term><term>Treatment Outcome (MeSH)</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Adulte (MeSH)</term><term>Adulte d'âge moyen (MeSH)</term><term>Antipaludiques (administration et posologie)</term><term>Chine (MeSH)</term><term>Femelle (MeSH)</term><term>Humains (MeSH)</term><term>Hydroxychloroquine (administration et posologie)</term><term>Mâle (MeSH)</term><term>Résultat thérapeutique (MeSH)</term><term>Sujet âgé (MeSH)</term><term>Études rétrospectives (MeSH)</term></keywords><keywords scheme="MESH" type="chemical" qualifier="administration & dosage" xml:lang="en"><term>Antimalarials</term><term>Hydroxychloroquine</term></keywords><keywords scheme="MESH" type="geographic" xml:lang="en"><term>China</term></keywords><keywords scheme="MESH" qualifier="administration et posologie" xml:lang="fr"><term>Antipaludiques</term><term>Hydroxychloroquine</term></keywords><keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>COVID-19</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adult</term><term>Aged</term><term>Female</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Retrospective Studies</term><term>Treatment Outcome</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Adulte</term><term>Adulte d'âge moyen</term><term>Chine</term><term>Femelle</term><term>Humains</term><term>Mâle</term><term>Résultat thérapeutique</term><term>Sujet âgé</term><term>Études rétrospectives</term></keywords><keywords scheme="Wicri" type="geographic" xml:lang="fr"><term>République populaire de Chine</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">The aim of this study is to assess the efficacy of multiple treatments, especially hydroxychloroquine, used in different disease stages of coronavirus disease 2019 (COVID-19). All consecutive patients with COVID-19 admitted to Shanghai Public Health Clinical Center (Shanghai, China) between January 20, 2020, and April 30, 2020, were enrolled, and their clinical data were retrospectively collected. Binary logistic regression was used to screen the factors associated with disease aggravation, and multivariable analyses with the Cox proportional hazards model were used to estimate the effects of prognostic factors on the improvement time and PCR conversion days in throat swabs and stool swabs. A total of 616 patients, including 50 (8.11%) severe and 18 (2.92%) critical patients, were enrolled in our retrospective cohort study. The early use of hydroxychloroquine was a protective factor associated with disease aggravation (95% CI: 0.040-0.575, p = 0.006). Clinical improvement by 20 days was significantly different between patients with hydroxychloroquine used early and those with hydroxychloroquine not used (p = 0.016, 95% CI: 1.052-1.647). The median time to clinical improvement was 6 days in the hydroxychloroquine used early group, compared with 9 days in the without hydroxychloroquine used group and 8 days in the with hydroxychloroquine not used early group (p < 0.001). Hydroxychloroquine used early was associated with earlier PCR conversion in both throat swabs (HR = 1.558, p = 0.001) and stool swabs (HR = 1.400, p = 0.028). The use of hydroxychloroquine at an early stage is a potential therapeutic strategy for treating patients before irreversible severe respiratory complications occur. The early use of hydroxychloroquine decreased the improvement time and the duration of COVID-19 detection in throat and stool swabs.</div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">33342929</PMID><DateCompleted><Year>2021</Year><Month>01</Month><Day>29</Day></DateCompleted><DateRevised><Year>2021</Year><Month>01</Month><Day>29</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1881-7823</ISSN><JournalIssue CitedMedium="Internet"><Volume>14</Volume><Issue>6</Issue><PubDate><Year>2021</Year><Month>Jan</Month><Day>23</Day></PubDate></JournalIssue><Title>Bioscience trends</Title><ISOAbbreviation>Biosci Trends</ISOAbbreviation></Journal><ArticleTitle>Efficacy of early hydroxychloroquine treatment in preventing COVID-19 pneumonia aggravation, the experience from Shanghai, China.</ArticleTitle><Pagination><MedlinePgn>408-414</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.5582/bst.2020.03340</ELocationID><Abstract><AbstractText>The aim of this study is to assess the efficacy of multiple treatments, especially hydroxychloroquine, used in different disease stages of coronavirus disease 2019 (COVID-19). All consecutive patients with COVID-19 admitted to Shanghai Public Health Clinical Center (Shanghai, China) between January 20, 2020, and April 30, 2020, were enrolled, and their clinical data were retrospectively collected. Binary logistic regression was used to screen the factors associated with disease aggravation, and multivariable analyses with the Cox proportional hazards model were used to estimate the effects of prognostic factors on the improvement time and PCR conversion days in throat swabs and stool swabs. A total of 616 patients, including 50 (8.11%) severe and 18 (2.92%) critical patients, were enrolled in our retrospective cohort study. The early use of hydroxychloroquine was a protective factor associated with disease aggravation (95% CI: 0.040-0.575, p = 0.006). Clinical improvement by 20 days was significantly different between patients with hydroxychloroquine used early and those with hydroxychloroquine not used (p = 0.016, 95% CI: 1.052-1.647). The median time to clinical improvement was 6 days in the hydroxychloroquine used early group, compared with 9 days in the without hydroxychloroquine used group and 8 days in the with hydroxychloroquine not used early group (p < 0.001). Hydroxychloroquine used early was associated with earlier PCR conversion in both throat swabs (HR = 1.558, p = 0.001) and stool swabs (HR = 1.400, p = 0.028). The use of hydroxychloroquine at an early stage is a potential therapeutic strategy for treating patients before irreversible severe respiratory complications occur. The early use of hydroxychloroquine decreased the improvement time and the duration of COVID-19 detection in throat and stool swabs.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Su</LastName><ForeName>Yi</ForeName><Initials>Y</Initials><AffiliationInfo><Affiliation>Department of Infectious Diseases, Zhongshan Hospital Fudan University, Shanghai, China.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Ling</LastName><ForeName>Yun</ForeName><Initials>Y</Initials><AffiliationInfo><Affiliation>Department of Infectious Diseases, Shanghai Public Health Clinical Center, China.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Ma</LastName><ForeName>Yuyan</ForeName><Initials>Y</Initials><AffiliationInfo><Affiliation>Department of Infectious Diseases, Zhongshan Hospital Fudan University, Shanghai, China.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Tao</LastName><ForeName>Lili</ForeName><Initials>L</Initials><AffiliationInfo><Affiliation>UT Southwestern Medical Center, Department of Immunology, Texas, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Miao</LastName><ForeName>Qing</ForeName><Initials>Q</Initials><AffiliationInfo><Affiliation>Department of Infectious Diseases, Zhongshan Hospital Fudan University, Shanghai, China.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Shi</LastName><ForeName>Qingfeng</ForeName><Initials>Q</Initials><AffiliationInfo><Affiliation>Department of Infectious Control, Zhongshan Hospital Fudan University, Shanghai, China.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Pan</LastName><ForeName>Jue</ForeName><Initials>J</Initials><AffiliationInfo><Affiliation>Department of Infectious Diseases, Zhongshan Hospital Fudan University, Shanghai, China.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Lu</LastName><ForeName>Hongzhou</ForeName><Initials>H</Initials><AffiliationInfo><Affiliation>Department of Infectious Diseases, Shanghai Public Health Clinical Center, China.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Hu</LastName><ForeName>Bijie</ForeName><Initials>B</Initials><AffiliationInfo><Affiliation>Department of Infectious Diseases, Zhongshan Hospital Fudan University, Shanghai, China.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2020</Year><Month>12</Month><Day>18</Day></ArticleDate></Article><MedlineJournalInfo><Country>Japan</Country><MedlineTA>Biosci Trends</MedlineTA><NlmUniqueID>101502754</NlmUniqueID><ISSNLinking>1881-7815</ISSNLinking></MedlineJournalInfo><ChemicalList><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D000962">Antimalarials</NameOfSubstance></Chemical><Chemical><RegistryNumber>4QWG6N8QKH</RegistryNumber><NameOfSubstance UI="D006886">Hydroxychloroquine</NameOfSubstance></Chemical></ChemicalList><SupplMeshList><SupplMeshName Type="Protocol" UI="C000705127">COVID-19 drug treatment</SupplMeshName></SupplMeshList><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000328" MajorTopicYN="N">Adult</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000368" MajorTopicYN="N">Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000962" MajorTopicYN="N">Antimalarials</DescriptorName><QualifierName UI="Q000008" MajorTopicYN="Y">administration & dosage</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D000086382" MajorTopicYN="N">COVID-19</DescriptorName><QualifierName UI="Q000188" MajorTopicYN="Y">drug therapy</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D002681" MajorTopicYN="N" Type="Geographic">China</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006886" MajorTopicYN="N">Hydroxychloroquine</DescriptorName><QualifierName UI="Q000008" MajorTopicYN="Y">administration & dosage</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008875" MajorTopicYN="N">Middle Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D012189" MajorTopicYN="N">Retrospective Studies</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D016896" MajorTopicYN="N">Treatment Outcome</DescriptorName></MeshHeading></MeshHeadingList><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">COVID-19</Keyword><Keyword MajorTopicYN="N">SARS-CoV-2</Keyword><Keyword MajorTopicYN="N">clinical management</Keyword><Keyword MajorTopicYN="N">coronavirus</Keyword><Keyword MajorTopicYN="N">hydroxychloroquine</Keyword><Keyword MajorTopicYN="N">treatment</Keyword></KeywordList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="pubmed"><Year>2020</Year><Month>12</Month><Day>22</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2021</Year><Month>1</Month><Day>30</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2020</Year><Month>12</Month><Day>21</Day><Hour>6</Hour><Minute>2</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">33342929</ArticleId><ArticleId IdType="doi">10.5582/bst.2020.03340</ArticleId></ArticleIdList></PubmedData></pubmed><affiliations><list><country><li>République populaire de Chine</li><li>États-Unis</li></country><region><li>Texas</li></region></list><tree><country name="République populaire de Chine"><noRegion><name sortKey="Su, Yi" sort="Su, Yi" uniqKey="Su Y" first="Yi" last="Su">Yi Su</name></noRegion><name sortKey="Hu, Bijie" sort="Hu, Bijie" uniqKey="Hu B" first="Bijie" last="Hu">Bijie Hu</name><name sortKey="Ling, Yun" sort="Ling, Yun" uniqKey="Ling Y" first="Yun" last="Ling">Yun Ling</name><name sortKey="Lu, Hongzhou" sort="Lu, Hongzhou" uniqKey="Lu H" first="Hongzhou" last="Lu">Hongzhou Lu</name><name sortKey="Ma, Yuyan" sort="Ma, Yuyan" uniqKey="Ma Y" first="Yuyan" last="Ma">Yuyan Ma</name><name sortKey="Miao, Qing" sort="Miao, Qing" uniqKey="Miao Q" first="Qing" last="Miao">Qing Miao</name><name sortKey="Pan, Jue" sort="Pan, Jue" uniqKey="Pan J" first="Jue" last="Pan">Jue Pan</name><name sortKey="Shi, Qingfeng" sort="Shi, Qingfeng" uniqKey="Shi Q" first="Qingfeng" last="Shi">Qingfeng Shi</name></country><country name="États-Unis"><region name="Texas"><name sortKey="Tao, Lili" sort="Tao, Lili" uniqKey="Tao L" first="Lili" 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|clé= pubmed:33342929
|texte= Efficacy of early hydroxychloroquine treatment in preventing COVID-19 pneumonia aggravation, the experience from Shanghai, China.
}}
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| HfdSelect -Kh $EXPLOR_AREA/Data/Main/Exploration/biblio.hfd \
| NlmPubMed2Wicri -a CovidChloroV1
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