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A multinational registry analysis found no evidence of benefit of hydroxychloroquine or chloroquine when used either alone or with a macrolide.
- Using an international, observational registry across six continents, the study assessed 96,032 patients with COVID-19, of whom 14,888 were treated with hydroxychloroquine, chloroquine, or their combination with a macrolide.
- To minimize the effect of confounding factors, a propensity score matching analysis was done individually for each of the four treatment groups compared with a control group that received no form of that therapy. For each treatment group, a separate matched control was identified using exact and propensity-score matched criteria with a calliper of 0·001.
- After controlling for age, sex, race or ethnicity, underlying comorbidities, and disease severity at baseline, the use of all four regimens was associated increased risk for:
- De-novo ventricular arrhythmia in hospital: Compared with the control group (0·3%), hydroxychloroquine alone (6·1%; HR 2·369, 95% CI 1·935–2·900), hydroxychloroquine with a macrolide (8·1%; 5·106, 4·106–5·983), chloroquine alone (4·3%; 3·561, 2·760–4·596), and chloroquine with a macrolide (6·5%; 4·011, 3·344–4·812)
- In-hospital mortality: Compared with the control group (9·3%), hydroxychloroquine alone (18·0%; HR 1·335, 95% CI 1·223–1·457), hydroxychloroquine with a macrolide (23·8%; 1·447, 1·368–1·531), chloroquine alone (16·4%; 1·365, 1·218–1·531), and chloroquine with a macrolide (22·2%; 1·368, 1·273–1·469).
- Limitations: This study should be interpreted cautiously. Because this was an observational study design, there may have been unmeasured confounding factors
