Comparing the impact of Hydroxychloroquine based regimens and standard treatment on COVID-19 patient outcomes: A retrospective cohort study.
Identifieur interne : 001533 ( Main/Exploration ); précédent : 001532; suivant : 001534Comparing the impact of Hydroxychloroquine based regimens and standard treatment on COVID-19 patient outcomes: A retrospective cohort study.
Auteurs : Saja H. Almazrou [Arabie saoudite] ; Ziyad S. Almalki [Arabie saoudite] ; Abdullah S. Alanazi [Arabie saoudite] ; Abdulhadi M. Alqahtani [Arabie saoudite] ; Saleh M. Alghamd [Arabie saoudite]Source :
- Saudi pharmaceutical journal : SPJ : the official publication of the Saudi Pharmaceutical Society [ 1319-0164 ] ; 2020.
Abstract
Background
Pharmacological treatments including antivirals (Lopinavir/Ritonavir), Immuno-modulatory and anti-inflammatory drugs including, Tocilizumab and Hydroxychloroquine (HCQ) has been widely investigated as a treatment for COVID-19.Despite the ongoing controversies, HCQ was recommended for managing mild to moderate cases in Saudi Arabia . However, to our knowledge, no previous studies have been conducted in Saudi Arabia to assess its effectiveness.
Methods
A hospital-based retrospective cohort study involving 161 patients with COVID-19 was conducted from March 1 to May 20, 2020. The study was conducted at Prince Mohammed bin Abdul Aziz Hospital (PMAH).The population included hospitalized adults (age ≥ 18 years) with laboratory-confirmed COVID-19. Each eligible patient was followed from the time of admission until the time of discharge. Patients were classified into two groups according to treatment type: in the HCQ group, patients were treated with HCQ; in the SC group, patients were treated with other antiviral or antibacterial treatments according to Ministry of Health (MOH) protocols.The outcomes were hospitalization days, ICU admission, and the need for mechanical ventilation.We estimated the differences in hospital length of stay and time in the ICU between the HCQ group and the standard care (SC) group using a multivariate generalized linear regression. The differences in ICU admission and mechanical ventilation were compared via logistic regression. All models were adjusted for age and gender variables.
Results
A total of 161 patients fulfilled the inclusion criteria. Approximately 59% (n = 95) received HCQ-based treatment, and 41% (n = 66) received SC. Length of hospital stay and time in ICU in for patients who received HCQ based treatment was shorter than those who received SC. Similarly, there was less need for ICU admission and mechanical ventilation among patients who received HCQ based treatment compared with SC, (8.6% vs. 10.7 and 3.1% vs. 9.1%). However, the regression analysis showed no significant difference between the two groups in terms of patient outcomes.
Conclusion
HCQ had a modest effect on hospital length stay and days in ICU compared with SC. However, these results need to be interpreted with caution. Larger observational studies and RCTs that evaluate the efficacy of HCQ in COVID-19 patients in the Saudi population are urgently needed.
DOI: 10.1016/j.jsps.2020.09.019
PubMed: 33020690
PubMed Central: PMC7527306
Affiliations:
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Almazrou</name><affiliation wicri:level="1"><nlm:affiliation>Clinical Pharmacy Department, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia.</nlm:affiliation><country xml:lang="fr">Arabie saoudite</country><wicri:regionArea>Clinical Pharmacy Department, College of Pharmacy, King Saud University, Riyadh</wicri:regionArea><wicri:noRegion>Riyadh</wicri:noRegion></affiliation></author><author><name sortKey="Almalki, Ziyad S" sort="Almalki, Ziyad S" uniqKey="Almalki Z" first="Ziyad S" last="Almalki">Ziyad S. Almalki</name><affiliation wicri:level="1"><nlm:affiliation>Clinical Pharmacy Department, College of Pharmacy, Prince Sattam bin Abdulaziz University, Al-Kharj, Riyadh, Saudi Arabia.</nlm:affiliation><country xml:lang="fr">Arabie saoudite</country><wicri:regionArea>Clinical Pharmacy Department, College of Pharmacy, Prince Sattam bin Abdulaziz University, Al-Kharj, Riyadh</wicri:regionArea><wicri:noRegion>Riyadh</wicri:noRegion></affiliation></author><author><name sortKey="Alanazi, Abdullah S" sort="Alanazi, Abdullah S" uniqKey="Alanazi A" first="Abdullah S" last="Alanazi">Abdullah S. Alanazi</name><affiliation wicri:level="1"><nlm:affiliation>Clinical Pharmacy Department, College of Pharmacy, Jouf University, Al-Jouf, Saudi Arabia.</nlm:affiliation><country xml:lang="fr">Arabie saoudite</country><wicri:regionArea>Clinical Pharmacy Department, College of Pharmacy, Jouf University, Al-Jouf</wicri:regionArea><wicri:noRegion>Al-Jouf</wicri:noRegion></affiliation></author><author><name sortKey="Alqahtani, Abdulhadi M" sort="Alqahtani, Abdulhadi M" uniqKey="Alqahtani A" first="Abdulhadi M" last="Alqahtani">Abdulhadi M. Alqahtani</name><affiliation wicri:level="1"><nlm:affiliation>Clinical Research Department, Research Center, King Fahad Medical City, Riyadh, Saudi Arabia.</nlm:affiliation><country xml:lang="fr">Arabie saoudite</country><wicri:regionArea>Clinical Research Department, Research Center, King Fahad Medical City, Riyadh</wicri:regionArea><wicri:noRegion>Riyadh</wicri:noRegion></affiliation></author><author><name sortKey="Alghamd, Saleh M" sort="Alghamd, Saleh M" uniqKey="Alghamd S" first="Saleh M" last="Alghamd">Saleh M. Alghamd</name><affiliation wicri:level="1"><nlm:affiliation>Clinical Research Department, Research Center, King Fahad Medical City, Riyadh, Saudi Arabia.</nlm:affiliation><country xml:lang="fr">Arabie saoudite</country><wicri:regionArea>Clinical Research Department, Research Center, King Fahad Medical City, Riyadh</wicri:regionArea><wicri:noRegion>Riyadh</wicri:noRegion></affiliation></author></analytic><series><title level="j">Saudi pharmaceutical journal : SPJ : the official publication of the Saudi Pharmaceutical Society</title><idno type="ISSN">1319-0164</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>Pharmacological treatments including antivirals (Lopinavir/Ritonavir), Immuno-modulatory and anti-inflammatory drugs including, Tocilizumab and Hydroxychloroquine (HCQ) has been widely investigated as a treatment for COVID-19.Despite the ongoing controversies, HCQ was recommended for managing mild to moderate cases in Saudi Arabia . However, to our knowledge, no previous studies have been conducted in Saudi Arabia to assess its effectiveness.</p></div><div type="abstract" xml:lang="en"><p><b>Methods</b></p><p>A hospital-based retrospective cohort study involving 161 patients with COVID-19 was conducted from March 1 to May 20, 2020. The study was conducted at Prince Mohammed bin Abdul Aziz Hospital (PMAH).The population included hospitalized adults (age ≥ 18 years) with laboratory-confirmed COVID-19. Each eligible patient was followed from the time of admission until the time of discharge. Patients were classified into two groups according to treatment type: in the HCQ group, patients were treated with HCQ; in the SC group, patients were treated with other antiviral or antibacterial treatments according to Ministry of Health (MOH) protocols.The outcomes were hospitalization days, ICU admission, and the need for mechanical ventilation.We estimated the differences in hospital length of stay and time in the ICU between the HCQ group and the standard care (SC) group using a multivariate generalized linear regression. The differences in ICU admission and mechanical ventilation were compared via logistic regression. All models were adjusted for age and gender variables.</p></div><div type="abstract" xml:lang="en"><p><b>Results</b></p><p>A total of 161 patients fulfilled the inclusion criteria. Approximately 59% (n = 95) received HCQ-based treatment, and 41% (n = 66) received SC. Length of hospital stay and time in ICU in for patients who received HCQ based treatment was shorter than those who received SC. Similarly, there was less need for ICU admission and mechanical ventilation among patients who received HCQ based treatment compared with SC, (8.6% vs. 10.7 and 3.1% vs. 9.1%). However, the regression analysis showed no significant difference between the two groups in terms of patient outcomes.</p></div><div type="abstract" xml:lang="en"><p><b>Conclusion</b></p><p>HCQ had a modest effect on hospital length stay and days in ICU compared with SC. However, these results need to be interpreted with caution. Larger observational studies and RCTs that evaluate the efficacy of HCQ in COVID-19 patients in the Saudi population are urgently needed.</p></div></front></TEI><pubmed><MedlineCitation Status="PubMed-not-MEDLINE" Owner="NLM"><PMID Version="1">33020690</PMID><DateRevised><Year>2020</Year><Month>12</Month><Day>30</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Print">1319-0164</ISSN><JournalIssue CitedMedium="Print"><Volume>28</Volume><Issue>12</Issue><PubDate><Year>2020</Year><Month>Dec</Month></PubDate></JournalIssue><Title>Saudi pharmaceutical journal : SPJ : the official publication of the Saudi Pharmaceutical Society</Title><ISOAbbreviation>Saudi Pharm J</ISOAbbreviation></Journal><ArticleTitle>Comparing the impact of Hydroxychloroquine based regimens and standard treatment on COVID-19 patient outcomes: A retrospective cohort study.</ArticleTitle><Pagination><MedlinePgn>1877-1882</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1016/j.jsps.2020.09.019</ELocationID><Abstract><AbstractText Label="Background" NlmCategory="UNASSIGNED">Pharmacological treatments including antivirals (Lopinavir/Ritonavir), Immuno-modulatory and anti-inflammatory drugs including, Tocilizumab and Hydroxychloroquine (HCQ) has been widely investigated as a treatment for COVID-19.Despite the ongoing controversies, HCQ was recommended for managing mild to moderate cases in Saudi Arabia . However, to our knowledge, no previous studies have been conducted in Saudi Arabia to assess its effectiveness.</AbstractText><AbstractText Label="Methods" NlmCategory="UNASSIGNED">A hospital-based retrospective cohort study involving 161 patients with COVID-19 was conducted from March 1 to May 20, 2020. The study was conducted at Prince Mohammed bin Abdul Aziz Hospital (PMAH).The population included hospitalized adults (age ≥ 18 years) with laboratory-confirmed COVID-19. Each eligible patient was followed from the time of admission until the time of discharge. Patients were classified into two groups according to treatment type: in the HCQ group, patients were treated with HCQ; in the SC group, patients were treated with other antiviral or antibacterial treatments according to Ministry of Health (MOH) protocols.The outcomes were hospitalization days, ICU admission, and the need for mechanical ventilation.We estimated the differences in hospital length of stay and time in the ICU between the HCQ group and the standard care (SC) group using a multivariate generalized linear regression. The differences in ICU admission and mechanical ventilation were compared via logistic regression. All models were adjusted for age and gender variables.</AbstractText><AbstractText Label="Results" NlmCategory="UNASSIGNED">A total of 161 patients fulfilled the inclusion criteria. Approximately 59% (n = 95) received HCQ-based treatment, and 41% (n = 66) received SC. Length of hospital stay and time in ICU in for patients who received HCQ based treatment was shorter than those who received SC. Similarly, there was less need for ICU admission and mechanical ventilation among patients who received HCQ based treatment compared with SC, (8.6% vs. 10.7 and 3.1% vs. 9.1%). However, the regression analysis showed no significant difference between the two groups in terms of patient outcomes.</AbstractText><AbstractText Label="Conclusion" NlmCategory="UNASSIGNED">HCQ had a modest effect on hospital length stay and days in ICU compared with SC. However, these results need to be interpreted with caution. Larger observational studies and RCTs that evaluate the efficacy of HCQ in COVID-19 patients in the Saudi population are urgently needed.</AbstractText><CopyrightInformation>© 2020 The Author(s).</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Almazrou</LastName><ForeName>Saja H</ForeName><Initials>SH</Initials><AffiliationInfo><Affiliation>Clinical Pharmacy Department, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Almalki</LastName><ForeName>Ziyad S</ForeName><Initials>ZS</Initials><AffiliationInfo><Affiliation>Clinical Pharmacy Department, College of Pharmacy, Prince Sattam bin Abdulaziz University, Al-Kharj, Riyadh, Saudi Arabia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Alanazi</LastName><ForeName>Abdullah S</ForeName><Initials>AS</Initials><AffiliationInfo><Affiliation>Clinical Pharmacy Department, College of Pharmacy, Jouf University, Al-Jouf, Saudi Arabia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Alqahtani</LastName><ForeName>Abdulhadi M</ForeName><Initials>AM</Initials><AffiliationInfo><Affiliation>Clinical Research Department, Research Center, King Fahad Medical City, Riyadh, Saudi Arabia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Alghamd</LastName><ForeName>Saleh M</ForeName><Initials>SM</Initials><AffiliationInfo><Affiliation>Clinical Research Department, Research Center, King Fahad Medical City, Riyadh, Saudi Arabia.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2020</Year><Month>10</Month><Day>01</Day></ArticleDate></Article><MedlineJournalInfo><Country>Saudi Arabia</Country><MedlineTA>Saudi Pharm J</MedlineTA><NlmUniqueID>9705695</NlmUniqueID><ISSNLinking>1319-0164</ISSNLinking></MedlineJournalInfo><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">COVID-19</Keyword><Keyword MajorTopicYN="N">COVID-19, Coronavirus Disease 2019</Keyword><Keyword MajorTopicYN="N">Cohort study</Keyword><Keyword MajorTopicYN="N">Coronavirus disease</Keyword><Keyword MajorTopicYN="N">HCQ, Hydroxychloroquine</Keyword><Keyword MajorTopicYN="N">HESN, Health Electronic Surveillance Network</Keyword><Keyword MajorTopicYN="N">Hydroxychloroquine</Keyword><Keyword MajorTopicYN="N">ICU, intensive care unit</Keyword><Keyword MajorTopicYN="N">MOH, Ministry of Health</Keyword><Keyword MajorTopicYN="N">PMAH, Prince Mohammed bin Abdul Aziz Hospital</Keyword><Keyword MajorTopicYN="N">SC, Standard care</Keyword><Keyword MajorTopicYN="N">Saudi Arabia</Keyword><Keyword MajorTopicYN="N">WHO, World health organization</Keyword></KeywordList><CoiStatement>The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.</CoiStatement></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2020</Year><Month>07</Month><Day>04</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2020</Year><Month>09</Month><Day>27</Day></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2020</Year><Month>10</Month><Day>7</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2020</Year><Month>10</Month><Day>7</Day><Hour>6</Hour><Minute>1</Minute></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2020</Year><Month>10</Month><Day>6</Day><Hour>5</Hour><Minute>32</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">33020690</ArticleId><ArticleId IdType="doi">10.1016/j.jsps.2020.09.019</ArticleId><ArticleId IdType="pii">S1319-0164(20)30233-4</ArticleId><ArticleId IdType="pmc">PMC7527306</ArticleId></ArticleIdList><pmc-dir>pmcsd</pmc-dir>
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