Hydroxychloroquine for Early Treatment of Adults With Mild Coronavirus Disease 2019: A Randomized, Controlled Trial.


Journal

Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
ISSN: 1537-6591
Titre abrégé: Clin Infect Dis
Pays: United States
ID NLM: 9203213

Informations de publication

Date de publication:
06 12 2021
Historique:
received: 25 06 2020
pubmed: 17 7 2020
medline: 15 12 2021
entrez: 17 7 2020
Statut: ppublish

Résumé

No effective treatments for coronavirus disease 2019 (COVID-19) exist. We aimed to determine whether early treatment with hydroxychloroquine (HCQ) would be efficacious for outpatients with COVID-19. Multicenter open-label, randomized, controlled trial conducted in Catalonia, Spain, between 17 March and 26 May 2020. Patients recently diagnosed with <5-day of symptom onset were assigned to receive HCQ (800 mg on day 1 followed by 400 mg once daily for 6 days) or usual care. Outcomes were reduction of viral load in nasopharyngeal swabs up to 7 days after treatment start, disease progression up to 28 days, and time to complete resolution of symptoms. Adverse events were assessed up to 28 days. A total of 293 patients were eligible for intention-to-treat analysis: 157 in the control arm and 136 in the intervention arm. The mean age was 41.6 years (SD, 12.6), mean viral load at baseline was 7.90 log10 copies/mL (SD, 1.82), and median time from symptom onset to randomization was 3 days. No differences were found in the mean reduction of viral load at day 3 (-1.41 vs -1.41 log10 copies/mL in the control and intervention arm, respectively) or at day 7 (-3.37 vs -3.44). Treatment did not reduce risk of hospitalization (7.1% control vs 5.9% intervention) nor shorten the time to complete resolution of symptoms (12 days, control vs 10 days, intervention). No relevant adverse events were reported. In patients with mild COVID-19, no benefit was observed with HCQ beyond the usual care.

Sections du résumé

BACKGROUND
No effective treatments for coronavirus disease 2019 (COVID-19) exist. We aimed to determine whether early treatment with hydroxychloroquine (HCQ) would be efficacious for outpatients with COVID-19.
METHODS
Multicenter open-label, randomized, controlled trial conducted in Catalonia, Spain, between 17 March and 26 May 2020. Patients recently diagnosed with <5-day of symptom onset were assigned to receive HCQ (800 mg on day 1 followed by 400 mg once daily for 6 days) or usual care. Outcomes were reduction of viral load in nasopharyngeal swabs up to 7 days after treatment start, disease progression up to 28 days, and time to complete resolution of symptoms. Adverse events were assessed up to 28 days.
RESULTS
A total of 293 patients were eligible for intention-to-treat analysis: 157 in the control arm and 136 in the intervention arm. The mean age was 41.6 years (SD, 12.6), mean viral load at baseline was 7.90 log10 copies/mL (SD, 1.82), and median time from symptom onset to randomization was 3 days. No differences were found in the mean reduction of viral load at day 3 (-1.41 vs -1.41 log10 copies/mL in the control and intervention arm, respectively) or at day 7 (-3.37 vs -3.44). Treatment did not reduce risk of hospitalization (7.1% control vs 5.9% intervention) nor shorten the time to complete resolution of symptoms (12 days, control vs 10 days, intervention). No relevant adverse events were reported.
CONCLUSIONS
In patients with mild COVID-19, no benefit was observed with HCQ beyond the usual care.

Identifiants

pubmed: 32674126
pii: 5872589
doi: 10.1093/cid/ciaa1009
pmc: PMC7454406
doi:

Substances chimiques

Hydroxychloroquine 4QWG6N8QKH

Types de publication

Journal Article Multicenter Study Randomized Controlled Trial Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

e4073-e4081

Subventions

Organisme : JoEmCorono
Organisme : Laboratorios Rubió
Organisme : Laboratorios Gebro Pharma
Organisme : Zurich Seguros
Organisme : SYNLAB Barcelona
Organisme : Generalitat de Catalunya
Organisme : Foundation Dorneur

Informations de copyright

© The Author(s) 2020. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.

Auteurs

Oriol Mitjà (O)

Fight AIDS and Infectious Diseases Foundation, Badalona, Spain.
Hospital Universitari Germans Trias i Pujol and Universitat Autònoma de Barcelona, Badalona, Spain.
Lihir Medical Centre-International SOS, Lihir Island, Papua New Guinea.

Marc Corbacho-Monné (M)

Fight AIDS and Infectious Diseases Foundation, Badalona, Spain.
Facultat de Medicina, Universitat de Barcelona, Barcelona, Spain.

Maria Ubals (M)

Hospital Universitari Germans Trias i Pujol and Universitat Autònoma de Barcelona, Badalona, Spain.
Facultat de Medicina, Universitat de Barcelona, Barcelona, Spain.

Cristian Tebé (C)

Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Spain.

Judith Peñafiel (J)

Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Spain.

Aurelio Tobias (A)

Institute of Environmental Assessment and Water Research (IDAEA), Spanish Council for Scientific Research (CSIC), Barcelona, Spain.

Ester Ballana (E)

IrsiCaixa AIDS Research Institute, Germans Trias i Pujol Research Institute (IGTP), Badalona, Spain.

Andrea Alemany (A)

Fight AIDS and Infectious Diseases Foundation, Badalona, Spain.

Núria Riera-Martí (N)

Fight AIDS and Infectious Diseases Foundation, Badalona, Spain.

Carla A Pérez (CA)

Fight AIDS and Infectious Diseases Foundation, Badalona, Spain.

Clara Suñer (C)

Fight AIDS and Infectious Diseases Foundation, Badalona, Spain.

Pep Laporte (P)

Fight AIDS and Infectious Diseases Foundation, Badalona, Spain.

Pol Admella (P)

Fight AIDS and Infectious Diseases Foundation, Badalona, Spain.

Jordi Mitjà (J)

Fight AIDS and Infectious Diseases Foundation, Badalona, Spain.

Mireia Clua (M)

Fight AIDS and Infectious Diseases Foundation, Badalona, Spain.

Laia Bertran (L)

Fight AIDS and Infectious Diseases Foundation, Badalona, Spain.

Maria Sarquella (M)

Fight AIDS and Infectious Diseases Foundation, Badalona, Spain.

Sergi Gavilán (S)

Fight AIDS and Infectious Diseases Foundation, Badalona, Spain.

Jordi Ara (J)

Hospital Universitari Germans Trias i Pujol and Universitat Autònoma de Barcelona, Badalona, Spain.

Josep M Argimon (JM)

Direcció-gerència, Institut Català de la Salut, Barcelona, Spain.

Jordi Casabona (J)

Centre of Epidemiological Studies of HIV/AIDS and STI of Catalonia (CEEISCAT), Catalan Institute of Oncology (ICO)-Departament de Salut, Generalitat de Catalunya, Barcelona, Spain.
Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.

Gabriel Cuatrecasas (G)

Equip d'atenció primària de Sarria, Barcelona, Spain.

Paz Cañadas (P)

SYNLAB, Barcelona, Spain.

Aleix Elizalde-Torrent (A)

IrsiCaixa AIDS Research Institute, Germans Trias i Pujol Research Institute (IGTP), Badalona, Spain.

Robert Fabregat (R)

Direcció General de Recerca i Innovació en Salut, Generalitat de Catalunya, Barcelona, Catalonia, Spain.

Magí Farré (M)

Hospital Universitari Germans Trias i Pujol and Universitat Autònoma de Barcelona, Badalona, Spain.

Anna Forcada (A)

Gerència territorial de Catalunya Central, Institut Català de la Salut, St Fruitós del Bages, Spain.

Gemma Flores-Mateo (G)

Xarxa Sanitària i Social Santa Tecla, Tarragona, Spain.

Esteve Muntada (E)

Centre of Epidemiological Studies of HIV/AIDS and STI of Catalonia (CEEISCAT), Catalan Institute of Oncology (ICO)-Departament de Salut, Generalitat de Catalunya, Barcelona, Spain.

Núria Nadal (N)

Gerència territorial de Barcelona, Institut Català de la Salut, Barcelona, Spain.

Silvia Narejos (S)

Entitat de Base Asociativa Centelles- Atenció Primària, Centelles, Spain.

Aroa Nieto (A)

Fight AIDS and Infectious Diseases Foundation, Badalona, Spain.

Nuria Prat (N)

Gerència territorial de Àmbit Metropolità nord, Institut Català de la Salut, Sabadell, Spain.

Jordi Puig (J)

Fight AIDS and Infectious Diseases Foundation, Badalona, Spain.

Carles Quiñones (C)

Hospital Universitari Germans Trias i Pujol and Universitat Autònoma de Barcelona, Badalona, Spain.

Juliana Reyes-Ureña (J)

Centre of Epidemiological Studies of HIV/AIDS and STI of Catalonia (CEEISCAT), Catalan Institute of Oncology (ICO)-Departament de Salut, Generalitat de Catalunya, Barcelona, Spain.
Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.

Ferran Ramírez-Viaplana (F)

Fight AIDS and Infectious Diseases Foundation, Badalona, Spain.

Lidia Ruiz (L)

IrsiCaixa AIDS Research Institute, Germans Trias i Pujol Research Institute (IGTP), Badalona, Spain.

Eva Riveira-Muñoz (E)

IrsiCaixa AIDS Research Institute, Germans Trias i Pujol Research Institute (IGTP), Badalona, Spain.

Alba Sierra (A)

Fight AIDS and Infectious Diseases Foundation, Badalona, Spain.

César Velasco (C)

Agència de Qualitat i Avaluació Sanitàries de Catalunya (AQuAS), Barcelona, Spain.

Rosa Maria Vivanco-Hidalgo (RM)

Agència de Qualitat i Avaluació Sanitàries de Catalunya (AQuAS), Barcelona, Spain.

Alexis Sentís (A)

Centre of Epidemiological Studies of HIV/AIDS and STI of Catalonia (CEEISCAT), Catalan Institute of Oncology (ICO)-Departament de Salut, Generalitat de Catalunya, Barcelona, Spain.

Camila G-Beiras (C)

Fight AIDS and Infectious Diseases Foundation, Badalona, Spain.

Bonaventura Clotet (B)

Fight AIDS and Infectious Diseases Foundation, Badalona, Spain.
IrsiCaixa AIDS Research Institute, Germans Trias i Pujol Research Institute (IGTP), Badalona, Spain.
Universitat de Vic-Universitat Central de Catalunya (UVIC-UCC), Vic, Spain.

Martí Vall-Mayans (M)

Fight AIDS and Infectious Diseases Foundation, Badalona, Spain.
Hospital Universitari Germans Trias i Pujol and Universitat Autònoma de Barcelona, Badalona, Spain.

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