Treating COVID-19 with hydroxychloroquine, with or without azithromycin, leads to more deaths

Treating the new coronavirus with hydroxychloroquine is associated with an increase in overall mortality, according to new research involving U.S. veterans. The combination of hydroxychloroquine and azithromycin also led to an increase in mortality.

Hydroxychloroquine, an antimalarial drug, has been repeatedly suggested by President Donald Trump and others as a safe COVID-19 treatment. Recent research, however, has noted that the medication—and similar drugs such as chloroquine—are associated with significant side effects, especially in terms of the patients’ cardiac health. In early April, the American Heart Association, American College of Cardiology and Heart Rhythm Society warned healthcare providers to use caution when considering hydroxychloroquine and azithromycin to treat COVID-19 if the patient has cardiovascular disease.

For this latest study, published on medRxiv and still awaiting a peer review, the researchers assessed data from 368 patients with confirmed cases of COVID-19. All patients were treated at medical centers affiliated with he U.S. Veterans Health Administration through April 11, 2020. Each patient was treated with hydroxychloroquine alone (97 patients), both hydroxychloroquine and azithromycin (113 patients) or no hydroxychloroquine at all (158 patients).

Overall, patients treated with hydroxychloroquine alone experienced a death rate of 27.8%. Patients treated with hydroxychloroquine and azithromycin had a death rate of 22.1%, and patients receiving neither treatment had a death rate of 11.4%. The risk of ventilation was similar for all three groups.

“In this study, we found no evidence that use of hydroxychloroquine, either with or without azithromycin, reduced the risk of mechanical ventilation in patients hospitalized with COVID-19,” wrote Joseph Magagnoli, MS, University of South Carolina, and colleagues. “An association of increased overall mortality was identified in patients treated with hydroxychloroquine alone. These findings highlight the importance of awaiting the results of ongoing prospective, randomized, controlled studies before widespread adoption of these drugs.”

NIH recommends against treatment with hydroxychloroquine, azithromycin

While anecdotal evidence and small studies have suggested the combination of hydroxychloroquine and azithromycin could treat COVID-19 patients, healthcare specialists have noted again and again that there is a lack of clinical data backing up such claims.

In fact, the COVID-19 Treatment Guidelines Panel formed by the National Institutes of Health (NIH) is now specifically recommending against the combination of hydroxychloroquine and azithromycin for patients suffering from this virus. The panel has also said “there are insufficient clinical data to recommend either for or against” the use of hydroxychloroquine or chloroquine alone for COVID-19 patients.

“Although reports have appeared in the medical literature and the lay press claiming successful treatment of patients with COVID-19 with a variety of agents, definitive clinical trial data are needed to identify optimal treatments for this disease,” according to the NIH-backed guidelines. “Recommended clinical management of patients with COVID-19 includes infection prevention and control measures and supportive care, including supplemental oxygen and mechanical ventilatory support when indicated.”