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Clinical Efficacy of Hydroxychloroquine in Patients with COVID-19: Findings from an Observational Comparative Study in Saudi Arabia.

ABSTRACT: The aim of this study was to assess the clinical effectiveness of Hydroxychloroquine-based regimens versus standard treatment in patients with the coronavirus disease admitted in 2019 to a hospital in Saudi Arabia. A comparative observational study, using routine hospital data, was carried out in a large tertiary care hospital in Al Baha, Saudi Arabia, providing care to patients with COVID-19 between April 2019 and August 2019. Patients were categorized into two groups: the Hydroxychloroquine (HCQ) group, treated with HCQ in a dose of 400 mg twice daily on the first day, followed by 200 mg twice daily; the non HCQ group, treated with other antiviral or antibacterial treatments according to protocols recommended by the Ministry of Health (MOH) at the time. The primary outcomes were the length of hospital stay, need for admission to the intensive care unit (ICU), time in ICU, and need for mechanical ventilation. Overall survival was also assessed. 568 patients who received HCQ (treatment group) were compared with 207 patients who did not receive HCQ (control group). HCQ did not improve mortality in the treated group (7.7% vs. 7.2%). There were no significant differences in terms of duration of hospitalization, need for and time in ICU, and need for mechanical ventilation among the groups. Our study provides further evidence that HCQ treatment does not reduce mortality rates, length of hospital stay, admission and time in ICU, and need for mechanical ventilation in patients hospitalized with COVID-19.

SUBMITTER: Alghamdi S

PROVIDER: S-EPMC8065820 | biostudies-literature | 2021 Mar

REPOSITORIES: biostudies-literature

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Clinical Efficacy of Hydroxychloroquine in Patients with COVID-19: Findings from an Observational Comparative Study in Saudi Arabia.

Alghamdi Saleh S Barakat Bassant B Berrou Ilhem I Alzahrani Abdulhakim A Haseeb Abdul A Hammad Mohamed Anwar MA Anwar Sirajudheen S Sindi Abdulmajeed Abdulghani A AAA Almasmoum Hussain A HA Albanghali Mohammad M

Antibiotics (Basel, Switzerland) 20210331 4

The aim of this study was to assess the clinical effectiveness of Hydroxychloroquine-based regimens versus standard treatment in patients with the coronavirus disease admitted in 2019 to a hospital in Saudi Arabia. A comparative observational study, using routine hospital data, was carried out in a large tertiary care hospital in Al Baha, Saudi Arabia, providing care to patients with COVID-19 between April 2019 and August 2019. Patients were categorized into two groups: the Hydroxychloroquine (H ...[more]

PMID: 33807320

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Project description:ObjectiveTo assess the effectiveness of hydroxychloroquine in patients admitted to hospital with coronavirus disease 2019 (covid-19) pneumonia who require oxygen.DesignComparative observational study using data collected from routine care.SettingFour French tertiary care centres providing care to patients with covid-19 pneumonia between 12 March and 31 March 2020.Participants181 patients aged 18-80 years with documented severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pneumonia who required oxygen but not intensive care.InterventionsHydroxychloroquine at a dose of 600 mg/day within 48 hours of admission to hospital (treatment group) versus standard care without hydroxychloroquine (control group).Main outcome measuresThe primary outcome was survival without transfer to the intensive care unit at day 21. Secondary outcomes were overall survival, survival without acute respiratory distress syndrome, weaning from oxygen, and discharge from hospital to home or rehabilitation (all at day 21). Analyses were adjusted for confounding factors by inverse probability of treatment weighting.ResultsIn the main analysis, 84 patients who received hydroxychloroquine within 48 hours of admission to hospital (treatment group) were compared with 89 patients who did not receive hydroxychloroquine (control group). Eight additional patients received hydroxychloroquine more than 48 hours after admission. In the weighted analyses, the survival rate without transfer to the intensive care unit at day 21 was 76% in the treatment group and 75% in the control group (weighted hazard ratio 0.9, 95% confidence interval 0.4 to 2.1). Overall survival at day 21 was 89% in the treatment group and 91% in the control group (1.2, 0.4 to 3.3). Survival without acute respiratory distress syndrome at day 21 was 69% in the treatment group compared with 74% in the control group (1.3, 0.7 to 2.6). At day 21, 82% of patients in the treatment group had been weaned from oxygen compared with 76% in the control group (weighted risk ratio 1.1, 95% confidence interval 0.9 to 1.3). Eight patients in the treatment group (10%) experienced electrocardiographic modifications that required discontinuation of treatment.ConclusionsHydroxychloroquine has received worldwide attention as a potential treatment for covid-19 because of positive results from small studies. However, the results of this study do not support its use in patients admitted to hospital with covid-19 who require oxygen.

Project description:Background: COVID-19 virus has been reported as a pandemic in March 2020 by the WHO. Having a balanced and healthy diet routine can help boost the immune system, which is essential in fighting viruses. Public Health officials enforced lockdown for residents resulting in dietary habits change to combat sudden changes. Design and Methods: A cross-sectional study was conducted through an online survey to describe the impact of the COVID-19 pandemic on the eating habits, quality and quantity of food intake among adults in Saudi Arabia. SPSS version 24 was used to analyze the data. Comparison between general dietary habits before and during COVID-19 for ordinal variables was performed by Wilcoxon Signed Rank test, while McNemar test was performed for nominal variables. The paired samples t-test was used to compare the total scores for food quality and quantity before and during COVID-19 periods. Results: 2706 adults residing in Riyadh completed the survey. The majority (85.6%) of the respondents reported eating homecooked meals on a daily basis during COVID-19 as compared to 35.6% before (p<0.001). The mean score for the quality of food intake was slightly higher (p=0.002) before the COVID-19 period (16.46±2.84) as compared to the during period (16.39±2.79). The quantity of food mean score was higher (p<0.001) during the COVID-19 period (15.70±2.66) as compared to the before period (14.62±2.71). Conclusion: Dietary habits have changed significantly during the COVID-19 pandemic among Riyadh residents. Although some good habits increased, the quality and the quantity of the food was compromised. Public Health officials must focus on increased awareness on healthy eating during pandemics to avoid negative consequences. Future research is recommended to better understand the change in dietary habits during pandemics using a detailed food frequency questionnaire. Significance for public health Since pandemics come unannounced affecting public’s safety, it is important to understand the changes that occur in a community. This study focuses on the dietary habits’ changes during the COVID-19 pandemic. Coronavirus has been a threatening matter on a global level. It is tremendously crucial to consider various aspects of human health during pandemics including dietary habits, food quality and quantity as such factors play an important role in improving the immune system and overall health. Increasing the community’s awareness on the importance of healthy food intake during COVID-19 pandemic is extremely necessary. Public health’s role is to understand people’s reactions during pandemics and establish guidelines to improve health and prevent diseases. Dietary habits change during COVID-19 is a major health threat that needs immediate Public Health Officials’ attention. Maximizing awareness about healthy eating habits during quarantine requires attention to improve the overall health of the population.

Project description:BackgroundAlthough the coronavirus disease 2019 (COVID-19) pandemic continues to rage worldwide, clinical and laboratory studies of this disease have been limited in many countries. We investigated the epidemiologic, clinical, and laboratory findings of COVID-19 infected patients to identify the effective indicators correlated with the disease.MethodsA retrospective study was conducted at King Abdullah Hospital in Bisha Province, Saudi Arabia, from March 20 to June 30, 2020. Patients of different age groups were confirmed as having COVID-19 infection using a real-time polymerase chain reaction. The demographic, clinical, and laboratory data of the patients were statistically analyzed.ResultsOf the 132 patients, 85 were male and 47 were female, with a mean age of 50.9 years (SD±16.7). The patients were elderly (n = 29) and adults (n = 103). Of these, 54 (40.9%) had comorbidities, (25%) were admitted to the intensive care unit (ICU), and 12 (9.1%) died. On admission, the main clinical manifestations were fever (84.1%), cough (64.4%), shortness of breath (25%), chest pain (20.5%), and fatigue (18.2%). In all patients, increased neutrophils and decreased lymphocytes were observed. Patients' lactate dehydrogenase (LDH) was elevated. C-reactive protein (CRP) was elevated in 48.5%, D-dimer in 43.2%, and the erythrocyte sedimentation rate (ESR) in 40.9% of patients. The elderly showed higher neutrophil (p = 0.011) and lower lymphocyte (p = 0.009) counts than adults. Glucose, creatine kinase-MB, LDH, bilirubin, D-dimer, and ESR were significantly higher in the elderly than in the adults. The COVID-19 death group had a higher leucocyte count (p = 0.036), and higher urea (p = 0.029) and potassium (p = 0.022) than the recovered group but had a lower hemoglobin concentration (p = 0.018). A significant association was determined between COVID-19 death and the presence of cardiovascular disease (χ2(1) = 16.297, p<0.001), hypertension (χ2(1) = 12.034, p = 0.001), renal failure (χ2(1) = 3.843, p = 0. 05), old age (t (130) = 4.9, p <0.001), and ICU admission (χ2(1) = 17.6 (1), p<0.001).ConclusionsInvestigating some of the laboratory and clinical parameters could help assess the disease progression, risk of mortality, and follow up patients who could progress to a fatal condition.

Project description:BackgroundHydroxychloroquine has been widely administered to patients with Covid-19 without robust evidence supporting its use.MethodsWe examined the association between hydroxychloroquine use and intubation or death at a large medical center in New York City. Data were obtained regarding consecutive patients hospitalized with Covid-19, excluding those who were intubated, died, or discharged within 24 hours after presentation to the emergency department (study baseline). The primary end point was a composite of intubation or death in a time-to-event analysis. We compared outcomes in patients who received hydroxychloroquine with those in patients who did not, using a multivariable Cox model with inverse probability weighting according to the propensity score.ResultsOf 1446 consecutive patients, 70 patients were intubated, died, or discharged within 24 hours after presentation and were excluded from the analysis. Of the remaining 1376 patients, during a median follow-up of 22.5 days, 811 (58.9%) received hydroxychloroquine (600 mg twice on day 1, then 400 mg daily for a median of 5 days); 45.8% of the patients were treated within 24 hours after presentation to the emergency department, and 85.9% within 48 hours. Hydroxychloroquine-treated patients were more severely ill at baseline than those who did not receive hydroxychloroquine (median ratio of partial pressure of arterial oxygen to the fraction of inspired oxygen, 223 vs. 360). Overall, 346 patients (25.1%) had a primary end-point event (180 patients were intubated, of whom 66 subsequently died, and 166 died without intubation). In the main analysis, there was no significant association between hydroxychloroquine use and intubation or death (hazard ratio, 1.04, 95% confidence interval, 0.82 to 1.32). Results were similar in multiple sensitivity analyses.ConclusionsIn this observational study involving patients with Covid-19 who had been admitted to the hospital, hydroxychloroquine administration was not associated with either a greatly lowered or an increased risk of the composite end point of intubation or death. Randomized, controlled trials of hydroxychloroquine in patients with Covid-19 are needed. (Funded by the National Institutes of Health.).

Dataset Information

Clinical Efficacy of Hydroxychloroquine in Patients with COVID-19: Findings from an Observational Comparative Study in Saudi Arabia.

Publications

Clinical Efficacy of Hydroxychloroquine in Patients with COVID-19: Findings from an Observational Comparative Study in Saudi Arabia.

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