Use of Hydroxychloroquine in Patients with COVID-19: A Retrospective Observational Study

OBJECTIVE: There is no consensus on a certain drug therapy for COVID-19 infection. Growing reports argue about the potential benefits of hydroxychloroquine (HCQ) in reducing morbidity and mortality in patients hospitalized with COVID-19, but with inconsistent results.This study aimed to assess the potential benefits of HCQ on viral conversion, reducing the need for ICU or mechanical ventilation, and its impact on mortality.MATERIAL AND METHODS: This retrospective observational study was conducted enrolling confirmed SARS-CoV2 patients. They were subjected to plain CXR (HRCT of chest if needed), routine laboratory tests for COVID-19 (including CBC, CRP, LDH, D-Dimer, ferritin, and blood sugar), ECG, and blood gases. They were allocated to either HCQ or non-HCQ groups. Both groups were followed-up for symptoms resolution, need for ICU admission, non-invasive or invasive ventilation, duration till conversion, and mortality.RESULTS: A total of 202 patients with moderate COVID-19 were enrolled with a mean age of 55.05±10.15, out of whom 80% were male patients. The most common presenting symptom was fever (87.38% in the control group versus 92% in the HCQ group), followed by cough (82.52% versus 89.9%). In total, 24.27% of patients in the control group versus 28.3% in the HCQ group deteriorated and necessitated ICU admission (p=0.52), 13.6% of the control group versus 19.2% in the HCQ group required mechanical ventilation (p=0.28), and 69.9% of the control group versus 68.9% in the HCQ group converted negative on day 7 (p=0.85). No significant mortality difference between both groups was observed (4.9% versus 6.1%, p=0.47).CONCLUSION: This work did not support any benefits of using HCQ in patients with COVID-19, neither in reducing the need for ICU, mechanical ventilation, nor mortality


1. World Health Organization. Director-General’s remarks at the media briefing on 2019-nCoV on 11 February 2020. https://www.wt/dg/speeches/detail/who-director-general-sremarks-at-the-media-briefing-on-2019-ncov-on-11-february-2020 (Accessed on February 12, 2020).

2. Biot C, Daher W, Chavain N, et al. Design and synthesis of hydroxyferroquine derivatives with antimalarial and antiviral activities. J Med Chem 2006;49:2845-9. [Crossref]

3. Fox RI. Mechanism of action of hydroxychloroquine as an antirheumatic drug. Semin Arthritis Rheum 1993;23(2 Suppl 1):82- 91.

4. Devaux CA, Rolain JM, Colson P, Raoult D. New insights on the antiviral effects of chloroquine against coronavirus: what to expect for COVID-19? Int J Antimicrob Agents 2020;55:105938. [Crossref]

5. Fantini J, Di Scala C, Chahinian H, Yahi N. Structural and molecular modeling studies reveal a new mechanism of action of chloroquine and hydroxychloroquine against SARS-CoV-2 infection. Int J Antimicrob Agents 2020;55:105960. [Crossref]

6. Geleris J, Sun Y, Platt J, et al. Observational Study of Hydroxychloroquine in Hospitalized Patients with Covid-19. N Engl J Med 2020;382:2411-8. [Crossref]

7. He W, Chen L, Chen L, et al. COVID- 19 in persons with haematological cancers. Leukemia 2020;34:1637-45. [Crossref]

8. National Health Commission of China. The novel corona virus pneumonia diagnosis and treatment program, 7th version. China. 2020. 9294a7dfe4cef80dc7f5912eb1989.shtml. Accessed 04 Apr.

9. Gautret P, Lagier JC, Parola P, et al. Hydroxychloroquine and azithromycin as a treatment of COVID-19: Results of an openlabel non-randomized clinical trial. Int J Antimicrob Agents 2020;56:105949. [Crossref]

10. Yao X, Ye F, Zhang M, et al. In Vitro Antiviral Activity and Projection of Optimized Dosing Design of Hydroxychloroquine for the Treatment of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). Clin Infect Dis 2020;71:732-9. [Crossref]

11. Zhuang MW, Cheng Y, Zhang J, et al. Increasing host cellular receptor -angiotensin- converting enzyme 2 expression by coronavirus may Facilitate 2019-nCoV (or SARS-CoV-2) Infection. J Med Virol 2020;92:2693-1. [Crossref]

12. Wang M, Cao R, Zhang L, et al. Remdesivir and chloroquine effectively inhibit the recently emerged novel corona virus (2019- nCoV) in vitro. Cell Res 2020;30:269-71. [Crossref]

13. Gao J, Tian Z, Yang X. Breakthrough: Chloroquine phosphate has shown apparent efficacy in treatment of COVID-19 associated pneumonia in clinical studies. Biosci Trends 2020;14:72-3. [Crossref]

14. Gautret P, Lagier JC, Parola P, et al. Clinical and microbiological effect of a combination of hydroxychloroquine and azithromycin in 80 COVID-19 patients with at least a six-day follow up: A pilot observational study. Travel Med Infect Dis 2020;34:101663. [Crossref]

15. Tang W, Cao Z, Han M, et al. Hydroxychloroquine in patients with mainly mild to moderate coronavirus disease 2019: Open label, randomised controlled trial. BMJ 2020;369:m1849. [Crossref]

16. Chen J, Liu D, Liu L, et al. A pilot study of hydroxychloroquine in treatment of patients with common coronavirus disease-19 (COVID-19). Zhejiang Da Xue Xue Bao Yi Xue Ban 2020;49:215-9.

17. Rosenberg ES, Dufort EM, Udo T, et al. Association of Treatment with hydroxychloroquine or azithromycin with in-hospital mortality in patients with COVID-19 in New York State. JAMA 2020;323:2493-2. [Crossref]

18. Magagnoli J, Narendran S, Pereira F, et al. Outcomes of hydroxychloroquine usage in United States veterans hospitalized with Covid-19. medRxiv 2020;1:114-27. [Crossref]

Kaynak Göster