Early Hydroxychloroquine but not Chloroquine use reduces ICU
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The global push for the use of hydroxychloroquine (HCQ) and chloroquine (CQ) against COVID-19 resulted in an ongoing discussion about the effectivity and toxicity of these drugs. Recent studies report no effect of HCQ on 28 day-mortality. Researchers investigated the effect of HCQ and CQ in hospitalized patients on the non-ICU COVID-ward.

A nationwide, observational cohort study was performed in The Netherlands. Hospitals were given the opportunity to decide independently on the use of three different COVID-19 treatment strategies: HCQ or CQ, or no treatment. Researchers compared the outcome between these groups. The primary outcomes were 1) death on the COVID-19 ward, and 2) transfer to the ICU.

Results:
-- The analysis contained 1064 patients from 14 hospitals: 566 patients received treatment with either HCQ or CQ, and 498 patients received no treatment.
-- In a multivariate propensity matched weighted competing regression analysis, there was no significant effect of HCQ on mortality on the COVID-ward.
-- HCQ however was associated with a significant decreased risk of transfer to the ICU, when compared to controls.
-- This effect was not found in the CQ group and remained significant after competing risk analysis.

Conclusively, The results of this observational study demonstrate a lack of effect of HCQ on non-ICU mortality. However, it shows that the use of HCQ - but not CQ - is associated with 53% decreased risk of transfer of COVID-19 patients from the regular ward to the ICU. Recent prospective studies have reported on 28 days all-cause mortality only, therefore additional prospective data on the early effect of HCQ in preventing transfer to the ICU is still needed.

Source: https://www.ijidonline.com/article/S1201-9712(20)32175-5/fulltext?rss=yes
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