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Low-dose hydroxychloroquine therapy and mortality in hospitalised patients with COVID-19 : a nationwide observational study of 8075 participants

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Abstract
Hydroxychloroquine (HCQ) has been largely used and investigated as therapy for COVID-19 across various settings at a total dose usually ranging from 2400 mg to 9600 mg. In Belgium, off-label use of low-dose HCQ (total 2400 mg over 5 days) was recommended for hospitalised patients with COVID-19. We conducted a retrospective analysis of in-hospital mortality in the Belgian national COVID-19 hospital surveillance data. Patients treated either with HCQ monotherapy and supportive care (HCQ group) were compared with patients treated with supportive care only (no-HCQ group) using a competing risks proportional hazards regression with discharge alive as competing risk, adjusted for demographic and clinical features with robust standard errors. Of 8075 patients with complete discharge data on 24 May 2020 and diagnosed before 1 May 2020, 4542 received HCQ in monotherapy and 3533 were in the no-HCQ group. Death was reported in 804/4542 (17.7%) and 957/3533 (27.1%), respectively. In the multivariable analysis, mortality was lower in the HCQ group compared with the no-HCQ group [adjusted hazard ratio (aHR) = 0.684, 95% confidence interval (CI) 0.617-0.758]. Compared with the no-HCQ group, mortality in the HCQ group was reduced both in patients diagnosed <= 5 days (n = 3975) and >5 days (n = 3487) after symptom onset [aHR = 0.701 (95% CI 0.617-0.796) and aHR = 0.647 (95% CI 0.525-0.797), respectively]. Compared with supportive care only, low-dose HCQ monotherapy was independently associated with lower mortality in hospitalised patients with COVID-19 diagnosed and treated early or later after symptom onset. (C) 2020 Elsevier Ltd and International Society of Antimicrobial Chemotherapy. All rights reserved.
Keywords
Microbiology (medical), Pharmacology (medical), Infectious Diseases, General Medicine, Hydroxychloroquine, COVID-19, SARS-CoV-2, Mortality, Observational study, AZITHROMYCIN, CORONAVIRUS

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MLA
Catteau, Lucy, et al. “Low-Dose Hydroxychloroquine Therapy and Mortality in Hospitalised Patients with COVID-19 : A Nationwide Observational Study of 8075 Participants.” INTERNATIONAL JOURNAL OF ANTIMICROBIAL AGENTS, vol. 56, no. 4, 2020, doi:10.1016/j.ijantimicag.2020.106144.
APA
Catteau, L., Dauby, N., Montourcy, M., Bottieau, E., Hautekiet, J., Goetghebeur, E., … Willems, E. (2020). Low-dose hydroxychloroquine therapy and mortality in hospitalised patients with COVID-19 : a nationwide observational study of 8075 participants. INTERNATIONAL JOURNAL OF ANTIMICROBIAL AGENTS, 56(4). https://doi.org/10.1016/j.ijantimicag.2020.106144
Chicago author-date
Catteau, Lucy, Nicolas Dauby, Marion Montourcy, Emmanuel Bottieau, Joris Hautekiet, Els Goetghebeur, Sabrina van Ierssel, et al. 2020. “Low-Dose Hydroxychloroquine Therapy and Mortality in Hospitalised Patients with COVID-19 : A Nationwide Observational Study of 8075 Participants.” INTERNATIONAL JOURNAL OF ANTIMICROBIAL AGENTS 56 (4). https://doi.org/10.1016/j.ijantimicag.2020.106144.
Chicago author-date (all authors)
Catteau, Lucy, Nicolas Dauby, Marion Montourcy, Emmanuel Bottieau, Joris Hautekiet, Els Goetghebeur, Sabrina van Ierssel, Els Duysburgh, Herman Van Oyen, Chloé Wyndham-Thomas, Dominique Van Beckhoven, Kristof Bafort, Leïla Belkhir, Nathalie Bossuyt, Philippe Caprasse, Vincent Colombie, Paul De Munter, Jessika Deblonde, Didier Delmarcelle, Mélanie Delvallee, Rémy Demeester, Thierry Dugernier, Xavier Holemans, Benjamin Kerzmann, Pierre Yves Machurot, Philippe Minette, Jean-Marc Minon, Saphia Mokrane, Catherine Nachtergal, Séverine Noirhomme, Denis Piérard, Camelia Rossi, Carole Schirvel, Erica Sermijn, Frank Staelens, Filip Triest, Nina Van Goethem, Jens Van Praet, Anke Vanhoenacker, Roeland Verstraete, and Elise Willems. 2020. “Low-Dose Hydroxychloroquine Therapy and Mortality in Hospitalised Patients with COVID-19 : A Nationwide Observational Study of 8075 Participants.” INTERNATIONAL JOURNAL OF ANTIMICROBIAL AGENTS 56 (4). doi:10.1016/j.ijantimicag.2020.106144.
Vancouver
1.
Catteau L, Dauby N, Montourcy M, Bottieau E, Hautekiet J, Goetghebeur E, et al. Low-dose hydroxychloroquine therapy and mortality in hospitalised patients with COVID-19 : a nationwide observational study of 8075 participants. INTERNATIONAL JOURNAL OF ANTIMICROBIAL AGENTS. 2020;56(4).
IEEE
[1]
L. Catteau et al., “Low-dose hydroxychloroquine therapy and mortality in hospitalised patients with COVID-19 : a nationwide observational study of 8075 participants,” INTERNATIONAL JOURNAL OF ANTIMICROBIAL AGENTS, vol. 56, no. 4, 2020.
@article{8680297,
  abstract     = {Hydroxychloroquine (HCQ) has been largely used and investigated as therapy for COVID-19 across various settings at a total dose usually ranging from 2400 mg to 9600 mg. In Belgium, off-label use of low-dose HCQ (total 2400 mg over 5 days) was recommended for hospitalised patients with COVID-19. We conducted a retrospective analysis of in-hospital mortality in the Belgian national COVID-19 hospital surveillance data. Patients treated either with HCQ monotherapy and supportive care (HCQ group) were compared with patients treated with supportive care only (no-HCQ group) using a competing risks proportional hazards regression with discharge alive as competing risk, adjusted for demographic and clinical features with robust standard errors. Of 8075 patients with complete discharge data on 24 May 2020 and diagnosed before 1 May 2020, 4542 received HCQ in monotherapy and 3533 were in the no-HCQ group. Death was reported in 804/4542 (17.7%) and 957/3533 (27.1%), respectively. In the multivariable analysis, mortality was lower in the HCQ group compared with the no-HCQ group [adjusted hazard ratio (aHR) = 0.684, 95% confidence interval (CI) 0.617-0.758]. Compared with the no-HCQ group, mortality in the HCQ group was reduced both in patients diagnosed <= 5 days (n = 3975) and >5 days (n = 3487) after symptom onset [aHR = 0.701 (95% CI 0.617-0.796) and aHR = 0.647 (95% CI 0.525-0.797), respectively]. Compared with supportive care only, low-dose HCQ monotherapy was independently associated with lower mortality in hospitalised patients with COVID-19 diagnosed and treated early or later after symptom onset. (C) 2020 Elsevier Ltd and International Society of Antimicrobial Chemotherapy. All rights reserved.},
  articleno    = {106144},
  author       = {Catteau, Lucy and Dauby, Nicolas and Montourcy, Marion and Bottieau, Emmanuel and Hautekiet, Joris and Goetghebeur, Els and van Ierssel, Sabrina and Duysburgh, Els and Van Oyen, Herman and Wyndham-Thomas, Chloé and Van Beckhoven, Dominique and Bafort, Kristof and Belkhir, Leïla and Bossuyt, Nathalie and Caprasse, Philippe and Colombie, Vincent and De Munter, Paul and Deblonde, Jessika and Delmarcelle, Didier and Delvallee, Mélanie and Demeester, Rémy and Dugernier, Thierry and Holemans, Xavier and Kerzmann, Benjamin and Yves Machurot, Pierre and Minette, Philippe and Minon, Jean-Marc and Mokrane, Saphia and Nachtergal, Catherine and Noirhomme, Séverine and Piérard, Denis and Rossi, Camelia and Schirvel, Carole and Sermijn, Erica and Staelens, Frank and Triest, Filip and Goethem, Nina Van and Van Praet, Jens and Vanhoenacker, Anke and Verstraete, Roeland and Willems, Elise},
  issn         = {0924-8579},
  journal      = {INTERNATIONAL JOURNAL OF ANTIMICROBIAL AGENTS},
  keywords     = {Microbiology (medical),Pharmacology (medical),Infectious Diseases,General Medicine,Hydroxychloroquine,COVID-19,SARS-CoV-2,Mortality,Observational study,AZITHROMYCIN,CORONAVIRUS},
  language     = {eng},
  number       = {4},
  pages        = {8},
  title        = {Low-dose hydroxychloroquine therapy and mortality in hospitalised patients with COVID-19 : a nationwide observational study of 8075 participants},
  url          = {http://dx.doi.org/10.1016/j.ijantimicag.2020.106144},
  volume       = {56},
  year         = {2020},
}

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