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New Microbes and New Infections
Volume 55, October 2023, 101172
Original Article
Efficacy and safety of in-hospital treatment of Covid-19 infection with low-dose hydroxychloroquine and azithromycin in hospitalized patients: A retrospective controlled cohort study
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Gert Meeus a, Frauke Van Coile b, Hans Pottel c, Ann-Sophie Michel d, Ortwin Vergauwen d, Katy Verhelle b, Stoffel Lamote e, Mathias Leys f, Michaël Boudewijns g, Pieter Samaey h
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open access
Highlights
Objectives
In this study we evaluate the efficacy and safety of a treatment protocol with standard dose of hydroxychloroquine plus azithromycin in patients hospitalized with COVID-19 infection.
Methods
We conducted a retrospective analysis to compare the 28-day mortality rate in 352 patients treated with hydroxychloroquine with or without azithromycin (HCQ-group) in our hospital with a contemporary control group of 3533 patients receiving standard of care from the Belgian Collaborative Group on COVID-19 Hospital Surveillance.
Results
All patients who received at least one dose of treatment were included in the analysis. A statistically significant reduction in crude mortality rate at 28 days was observed in the HCQ-group compared to standard of care (16.8% vs 25.9%,p = 0.001).
Patients in the treatment group were on average younger (69,7 vs73,1 years, p = 0,0002), were less likely to smoke or to have malignancy and more likely to be male. Patients in the treatment group were more likely to be obese, immunocompromised or to have arterial hypertension, liver disease and lung disease.
After adjustment for these variables the OR for mortality was 0.635 (95%CI 0.464–0.875). Patients who did not receive HCQ had a 57% higher risk of mortality. A survival benefit in the treatment group was consistent across all age groups. 13 patients discontinued treatment due to side effects (4 with QTc-prolongation>60msec (1.1%) and 9 because of gastro-intestinal symptoms (2.55%)). No episodes of ventricular arrhythmia or torsade de pointes were recorded during treatment.
Conclusion
Treatment of COVID-19 using a combination of hydroxychloroquine plus azithromycin was safe and was associated with a statistically significant mortality benefit in the treatment of COVID-19 infection in hospitalized patients. Our findings do not support the current negative recommendations regarding this treatment.
Volume 55, October 2023, 101172
Original ArticleEfficacy and safety of in-hospital treatment of Covid-19 infection with low-dose hydroxychloroquine and azithromycin in hospitalized patients: A retrospective controlled cohort study
Author links open overlay panel
Gert Meeus a, Frauke Van Coile b, Hans Pottel c, Ann-Sophie Michel d, Ortwin Vergauwen d, Katy Verhelle b, Stoffel Lamote e, Mathias Leys f, Michaël Boudewijns g, Pieter Samaey h
Cite
Get rights and content
Under a Creative Commons license
open access
Highlights
- •
Retrospective study of 3885 patients (352 treatment, 3533 control). - •
Hydroxychloroquine and azithromycin versus standard of care. - •
OR for mortality in the treatment group was 0.635 vs controls. This survival benefit was consistent in all age groups. - •
No torsade de pointes or malignant ventricular arrhythmias observed during treatment.
Objectives
In this study we evaluate the efficacy and safety of a treatment protocol with standard dose of hydroxychloroquine plus azithromycin in patients hospitalized with COVID-19 infection.
Methods
We conducted a retrospective analysis to compare the 28-day mortality rate in 352 patients treated with hydroxychloroquine with or without azithromycin (HCQ-group) in our hospital with a contemporary control group of 3533 patients receiving standard of care from the Belgian Collaborative Group on COVID-19 Hospital Surveillance.
Results
All patients who received at least one dose of treatment were included in the analysis. A statistically significant reduction in crude mortality rate at 28 days was observed in the HCQ-group compared to standard of care (16.8% vs 25.9%,p = 0.001).
Patients in the treatment group were on average younger (69,7 vs73,1 years, p = 0,0002), were less likely to smoke or to have malignancy and more likely to be male. Patients in the treatment group were more likely to be obese, immunocompromised or to have arterial hypertension, liver disease and lung disease.
After adjustment for these variables the OR for mortality was 0.635 (95%CI 0.464–0.875). Patients who did not receive HCQ had a 57% higher risk of mortality. A survival benefit in the treatment group was consistent across all age groups. 13 patients discontinued treatment due to side effects (4 with QTc-prolongation>60msec (1.1%) and 9 because of gastro-intestinal symptoms (2.55%)). No episodes of ventricular arrhythmia or torsade de pointes were recorded during treatment.
Conclusion
Treatment of COVID-19 using a combination of hydroxychloroquine plus azithromycin was safe and was associated with a statistically significant mortality benefit in the treatment of COVID-19 infection in hospitalized patients. Our findings do not support the current negative recommendations regarding this treatment.