Hydroxychloroquine is associated with reducing ICU admissions among hospitalized COVID-19 patients, according to new findings published in the International Journal of Infectious Diseases. Chloroquine, however, was not found to have such an effect.
Hydroxychloroquine and chloroquine are antimalarial drugs that have been at the center of dozens of controversies and debates since the beginning of the COVID-19 pandemic. Early evidence suggested one, or even both, of the drugs may be a game-changer in the treatment of COVID-19. However, details related to poor cardiovascular outcomes such as arrhythmias—and some other concerning findings—led many medical professionals to urge extreme caution.
More on the wild tale of hydroxychloroquine—a layered story that includes President Donald Trump, government whistleblowers and much more—can be read here.
This latest study included data from more than 1,000 adult COVID-19 patients who received treatment at one of 14 hospitals in the Netherlands from Feb. 28 to April 1.
“Based on the available evidence present at the start of the outbreak, a Dutch treatment guideline was developed,” wrote first author A.J.J. Lammers, MD, PhD, of Isla Hospital in Zwolle, the Netherlands, and colleagues. “Off-label use of both hydroxychloroquine and chloroquine was given as a treatment option; however, the guidelines did not endorse either treatment in particular. Consequently, hospitals decided independently on a treatment protocol with either hydroxychloroquine or chloroquine, or to give no treatment. This policy created a unique situation for comparing the efficacy of hydroxychloroquine and chloroquine with no treatment in hospitalized non-ICU patients with a reduction of potential bias by indication.”
Overall, the study revealed that the medications were not related to any significant changes to patient mortality. Hydroxychloroquine, however, was associated with a 53% reduction of being transferred to the ICU. Patients treated with chloroquine did not experience the same effect.
“This finding suggests that starting early treatment with hydroxychloroquine (within one day of admission) on the regular COVID-ward might prevent progression to critical respiratory illness,” the authors wrote. “This is consistent with the suggestion that hydroxychloroquine treatment reduces the risk of disease progression more effectively earlier in the course of the disease. This holds true for many other viral infections such as influenza and herpes simplex, where treatment must be initiated soon after onset of symptoms in order to confer benefit. However, treatment with hydroxychloroquine before onset of symptoms did not prevent COVID-19, as was demonstrated in a randomized controlled trial investigating post-exposure use of hydroxychloroquine.”
Read the full analysis here.