Use of hydroxychloroquine in hospitalised COVID-19 patients is associated with reduced mortality: Findings from the observational multicentre Italian CORIST study
- Authors: Castelnuovo A.D.; Costanzo S.; Antinori A.; Berselli N.; Blandi L.; Bruno R.; Cauda R.; Guaraldi G.; Menicanti L.; My I.; Parruti G.; Patti G.; Perlini S.; Santilli F.; Signorelli C.; Spinoni E.; Stefanini G.G.; Vergori A.; Ageno W.; Agodi A.; Aiello L.; Agostoni P.; Moghazi S.A.; Astuto M.; Aucella F.; Barbieri G.; Bartoloni A.; Bonaccio M.; Bonfanti P.; Cacciatore F.; Caiano L.; Cannata F.; Carrozzi L.; Cascio A.; Ciccullo A.; Cingolani A.; Cipollone F.; Colomba C.; Crosta F.; Pra C.D.; Danzi G.B.; D'Ardes D.; Donati K.D.G.; Giacomo P.D.; Gennaro F.D.; Di Tano G.; D'Offizi G.; Filippini T.; Fusco F.M.; Gentile I.; Gialluisi A.; Gini G.; Grandone E.; Grisafi L.; Guarnieri G.; Lamonica S.; Landi F.; Leone A.; Maccagni G.; Maccarella S.; Madaro A.; Mapelli M.; Maragna R.; Marra L.; Maresca G.; Marotta C.; Mastroianni F.; Mazzitelli M.; Mengozzi A.; Menichetti F.; Meschiari M.; Minutolo F.; Montineri A.; Mussinelli R.; Mussini C.; Musso M.; Odone A.; Olivieri M.; Pasi E.; Petri F.; Pinchera B.; Pivato C.A.; Poletti V.; Ravaglia C.; Rinaldi M.; Rognoni A.; Rossato M.; Rossi I.; Rossi M.; Sabena A.; Salinaro F.; Sangiovanni V.; Sanrocco C.; Scorzolini L.; Sgariglia R.; Simeone P.G.; Spinicci M.; Trecarichi E.M.; Venezia A.; Veronesi G.; Vettor R.; Vianello A.; Vinceti M.; Vocciante L.; De Caterina R.; Iacoviello L.
- Publication year: 2020
- Type: Articolo in rivista
- OA Link: http://hdl.handle.net/10447/471594
Abstract
Background: Hydroxychloroquine (HCQ) was proposed as potential treatment for COVID-19. Objective: We set-up a multicenter Italian collaboration to investigate the relationship between HCQ therapy and COVID-19 in-hospital mortality. Methods: In a retrospective observational study, 3,451 unselected patients hospitalized in 33 clinical centers in Italy, from February 19, 2020 to May 23, 2020, with laboratory-confirmed SARS-CoV-2 infection, were analyzed. The primary end-point in a time-to event analysis was in-hospital death, comparing patients who received HCQ with patients who did not. We used multivariable Cox proportional-hazards regression models with inverse probability for treatment weighting by propensity scores, with the addition of subgroup analyses. Results: Out of 3,451 COVID-19 patients, 76.3% received HCQ. Death rates (per 1,000 person-days) for patients receiving or not HCQ were 8.9 and 15.7, respectively. After adjustment for propensity scores, we found 30% lower risk of death in patients receiving HCQ (HR=0.70; 95%CI: 0.59 to 0.84; E-value=1.67). Secondary analyses yielded similar results. The inverse association of HCQ with inpatient mortality was particularly evident in patients having elevated C-reactive protein at entry. Conclusions: HCQ use was associated with a 30% lower risk of death in COVID-19 hospitalized patients. Within the limits of an observational study and awaiting results from randomized controlled trials, these data do not discourage the use of HCQ in inpatients with COVID-19.