Efficacy of early hydroxychloroquine treatment in preventing COVID-19 pneumonia aggravation, the experience from Shanghai, China
et al., BioScience Trends,
This study includes vitamin C and HCQ
risk of progression, 135.3% higher, HR 2.35, p = 0.18, adjusted per study, binary logistic regression.
improvement time, 34.2% worse, relative time 1.34, p = 0.04, adjusted per study, inverted to make RR<1 favor treatment, Cox proportional hazards.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Su et al., 23 Dec 2020, retrospective, China, peer-reviewed, 9 authors, study period 20 January, 2020 - 30 April, 2020.
BioScience Trends Advance Publication
Efficacy of early hydroxychloroquine treatment in preventing
COVID-19 pneumonia aggravation, the experience from Shanghai,
Yi Su1, , Yun Ling2, , Yuyan Ma1, , Lili Tao3, Qing Miao1, Qingfeng Shi4, Jue Pan1,
Hongzhou Lu2,*, Bijie Hu1,*
Department of Infectious Diseases, Zhongshan Hospital Fudan University, Shanghai, China;
Department of Infectious Diseases, Shanghai Public Health Clinical Center, China;
UT Southwestern Medical Center, Department of Immunology, Texas, USA;
Department of Infectious Control, Zhongshan Hospital Fudan University, Shanghai, China.
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.
clinical management, treatment, hydroxychloroquine, COVID-19, SARS-CoV-2, coronavirus
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