Story at a glance

  • A new study illustrates lackluster results when coronavirus patients receive hydroxychloroquine as a treatment.
  • The anti-malarial drug was touted by President Trump as a potential cure.

In the battle for a potent treatment for the coronavirus, a new study casts doubt on a familiar name: hydroxychloroquine.

A new observational analysis published in the New England Journal of Medicine suggests that the anti-malaria drug once promoted by President Trump may not be the best treatment option for coronavirus patients, though the researchers say more studies are needed.

Conducted at the New York–Presbyterian Hospital (NYP)–Columbia University Irving Medical Center (CUIMC), researchers examined 1,446 patients, 70 of whom were discharged, had passed away or were intubated too early in the study. This left a sample of 1,376 patients in the analysis.

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Guidelines suggested that hydroxychloroquine be used as a therapeutic option for patients with COVID-19 who presented with “moderate-to-severe” respiratory infections, which the study defined as a blood oxygen level of less than 94 percent while patients breathed ambient air. 

The sample of patients was given a 600 mg dose of hydroxychloroquine twice on day one of the study, followed by 400 mg once daily for a median of five days. 

Of the 1,376 patients, 811 received hydroxychloroquine, with 45.8 percent in the emergency department treated within 24 hours of the study baseline, and 85.9 percent in 48 hours. A corresponding 565 patients in the study did not receive the medicine. 

Over the median follow-up time of about 22.5 days, 180 patients required intubation and 232 patients died, 66 after receiving intubation. 

There were 1,025 patients who survived and were discharged, and 119 remained hospitalized. 

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The report authors conclude that in an adjusted comparison, there was “no significant association between hydroxychloroquine use and intubation or death." To summarize, hydroxychloroquine was largely ineffective. 

As an observational study, it comes with inherent limitations. Although researchers used a regression model to control for confounding variables like age, weight, preexisting conditions, and race, missing data and a wide confidence interval should be taken into account. 

This is something the authors note in the report’s conclusion, writing, “The study results should not be taken to rule out either benefit or harm of hydroxychloroquine treatment, given the observational design and the 95 % confidence interval, but the results do not support the use of hydroxychloroquine at present, outside randomized clinical trials testing its efficacy.”

The Food and Drug Administration (FDA) issued a warning about using hydroxychloroquine outside of clinical trials in April due to occurrences of heart arrhythmia. The FDA has, however, allowed hydroxychloroquine to be used for emergency usage for COVID-19 treatment for adults and children weighing more than 110 pounds, along with guidelines for administering health care providers.  


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Published on May 08, 2020