Publication: Effect of hydroxychloroquine in hospitalized patients with Covid-19
Issued Date
2020-11-19
Resource Type
ISSN
15334406
00284793
00284793
Other identifier(s)
2-s2.0-85096456735
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Mahidol University
Rights Holder(s)
SCOPUS
Bibliographic Citation
New England Journal of Medicine. Vol.383, No.21 (2020), 2030-2040
Suggested Citation
Peter Horby, Marion Mafham, Louise Linsell, Jennifer L. Bell, Natalie Staplin, Jonathan R. Emberson, Martin Wiselka, Andrew Ustianowski, Einas Elmahi, Benjamin Prudon, Tony Whitehouse, Timothy Felton, John Williams, Jakki Faccenda, Jonathan Underwood, J. Kenneth Baillie, Lucy C. Chappell, Saul N. Faust, Thomas Jaki, Katie Jeffery, Wei Shen Lim, Alan Montgomery, Kathryn Rowan, Joel Tarning, James A. Watson, Nicholas J. White, Edmund Juszczak, Richard Haynes, Martin J. Landray Effect of hydroxychloroquine in hospitalized patients with Covid-19. New England Journal of Medicine. Vol.383, No.21 (2020), 2030-2040. doi:10.1056/NEJMoa2022926 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/60551
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Title
Effect of hydroxychloroquine in hospitalized patients with Covid-19
Author(s)
Peter Horby
Marion Mafham
Louise Linsell
Jennifer L. Bell
Natalie Staplin
Jonathan R. Emberson
Martin Wiselka
Andrew Ustianowski
Einas Elmahi
Benjamin Prudon
Tony Whitehouse
Timothy Felton
John Williams
Jakki Faccenda
Jonathan Underwood
J. Kenneth Baillie
Lucy C. Chappell
Saul N. Faust
Thomas Jaki
Katie Jeffery
Wei Shen Lim
Alan Montgomery
Kathryn Rowan
Joel Tarning
James A. Watson
Nicholas J. White
Edmund Juszczak
Richard Haynes
Martin J. Landray
Marion Mafham
Louise Linsell
Jennifer L. Bell
Natalie Staplin
Jonathan R. Emberson
Martin Wiselka
Andrew Ustianowski
Einas Elmahi
Benjamin Prudon
Tony Whitehouse
Timothy Felton
John Williams
Jakki Faccenda
Jonathan Underwood
J. Kenneth Baillie
Lucy C. Chappell
Saul N. Faust
Thomas Jaki
Katie Jeffery
Wei Shen Lim
Alan Montgomery
Kathryn Rowan
Joel Tarning
James A. Watson
Nicholas J. White
Edmund Juszczak
Richard Haynes
Martin J. Landray
Other Contributor(s)
National Institute for Health Research
North West Anglia NHS Foundation Trust
Cardiff & Vale University Health Board
Manchester University NHS Foundation Trust
Department of Mathematics and Statistics, Lancaster University
University of Cambridge
The James Cook University Hospital
University Hospitals of Leicester NHS Trust
University of Oxford
University Hospitals Birmingham NHS Foundation Trust
University of Edinburgh, Roslin Institute
Nottingham University Hospitals NHS Trust
Northampton General Hospital
North Tees and Hartlepool NHS Foundation Trust
Medical Research Council
University of Nottingham
Mahidol University
King's College London
Nuffield Department of Medicine
North Manchester General Hospital
The University of Manchester
University of Oxford Medical Sciences Division
University Hospital Southampton NHS Foundation Trust
Intensive Care National Audit and Research Centre
North West Anglia NHS Foundation Trust
Cardiff & Vale University Health Board
Manchester University NHS Foundation Trust
Department of Mathematics and Statistics, Lancaster University
University of Cambridge
The James Cook University Hospital
University Hospitals of Leicester NHS Trust
University of Oxford
University Hospitals Birmingham NHS Foundation Trust
University of Edinburgh, Roslin Institute
Nottingham University Hospitals NHS Trust
Northampton General Hospital
North Tees and Hartlepool NHS Foundation Trust
Medical Research Council
University of Nottingham
Mahidol University
King's College London
Nuffield Department of Medicine
North Manchester General Hospital
The University of Manchester
University of Oxford Medical Sciences Division
University Hospital Southampton NHS Foundation Trust
Intensive Care National Audit and Research Centre
Abstract
Copyright © 2020 Massachusetts Medical Society. BACKGROUND Hydroxychloroquine and chloroquine have been proposed as treatments for coronavirus disease 2019 (Covid-19) on the basis of in vitro activity and data from uncontrolled studies and small, randomized trials. METHODS In this randomized, controlled, open-label platform trial comparing a range of possible treatments with usual care in patients hospitalized with Covid-19, we randomly assigned 1561 patients to receive hydroxychloroquine and 3155 to receive usual care. The primary outcome was 28-day mortality. RESULTS The enrollment of patients in the hydroxychloroquine group was closed on June 5, 2020, after an interim analysis determined that there was a lack of efficacy. Death within 28 days occurred in 421 patients (27.0%) in the hydroxychloroquine group and in 790 (25.0%) in the usual-care group (rate ratio, 1.09; 95% confidence interval [CI], 0.97 to 1.23; P = 0.15). Consistent results were seen in all prespecified subgroups of patients. The results suggest that patients in the hydroxychloroquine group were less likely to be discharged from the hospital alive within 28 days than those in the usual-care group (59.6% vs. 62.9%; rate ratio, 0.90; 95% CI, 0.83 to 0.98). Among the patients who were not undergoing mechanical ventilation at baseline, those in the hydroxychloroquine group had a higher frequency of invasive mechanical ventilation or death (30.7% vs. 26.9%; risk ratio, 1.14; 95% CI, 1.03 to 1.27). There was a small numerical excess of cardiac deaths (0.4 percentage points) but no difference in the incidence of new major cardiac arrhythmia among the patients who received hydroxychloroquine. CONCLUSIONS Among patients hospitalized with Covid-19, those who received hydroxychloroquine did not have a lower incidence of death at 28 days than those who received usual care.