Hydroxychloroquine should not be used to treat hospitalized COVID-19 patients, according to a new study published in JAMA.
“Hydroxychloroquine was adopted into routine care for hospitalized adults with COVID-19 at many hospitals,” wrote lead author Wesley H. Self, MD, department of emergency medicine at Vanderbilt University Medical Center in Nashville, and colleagues. “However, lack of evidence on efficacy and safety led multiple groups, including the National Institutes of Health and Infectious Diseases Society of America, to recommend clinical trials to evaluate hydroxychloroquine as a potential treatment for patients with COVID-19. This trial—Outcomes Related to COVID-19 Treated With Hydroxychloroquine Among Inpatients With Symptomatic Disease (ORCHID)—was conducted to test the hypothesis that, compared with placebo, hydroxychloroquine improves clinical outcomes for adults hospitalized with COVID-19.”
The ORCHID trial included more than 400 hospitalized COVID-19 patients who were randomly chosen to receive either hydroxychloroquine or a placebo. The initial dose was administered within four hours of the randomization, and the hydroxychloroquine group received a total of 10 doses over five days. Each patient’s QTc interval
“Open-label, clinical use of hydroxychloroquine and chloroquine was not allowed during the five-day course of trial drug,” the authors wrote. “Treating clinicians determined all other aspects of patient care. Concomitant medications were recorded through hospital discharge.”
Fourteen days after treatment, the team observed, patient outcomes “did not significantly differ” between the two groups. Also, 28 days after randomization, almost the exact same number of patients had died—10.4% from the hydroxychloroquine group and 10.6% from the placebo group.
“These findings do not support the use of hydroxychloroquine for treatment of COVID-19 among hospitalized adults,” the authors wrote.
The research did have certain limitations. For instance, hydroxychloroquine was assessed as a treatment option on its own and not as a medication that is co-administered with other medications such as azithromycin. Also, the authors chose not to focus on long-term outcomes beyond 28 days.
Some context related to hydroxychloroquine
The latest studies surrounding hydroxychloroquine’s potential to treat COVID-19 have produced mixed results. The authors of a study published in the New England Journal of Medicine, for instance, said it is “not an effective treatment for patients hospitalized with COVID-19.” On the other hand, another recent study in the International Journal of Infectious Diseases suggested the medication can limit ICU admissions among COVID-19 patients.
More on the wild tale of hydroxychloroquine—a layered story that includes President Donald Trump, government whistleblowers and much more—can be read here.
The full study from JAMA is available here.
Michael has more than 16 years of experience as a professional writer and editor. He has written at length about cardiology, radiology, artificial intelligence and other key healthcare topics.