COVID-19 Update for 6/8/2020

Hydroxychloroquine and Chloroquine
 
In 28-day, 150 patient, Chinese trial, the addition of hydroxychloroquine to standard of care treatment did not result in negative conversion of PCR viral tests compared to standard of care in patients hospitalized with mild to moderate COVID-19. Initiation of hydroxychloroquine was delayed with an average 16-days between symptom onset and drug administration. Standard of care included antivirals in half of patients. So, given the delayed initiation of the drug and high use of antivirals, it is difficult to use the information provided in this study.
 
In a 21-day, 173 patient French retrospective analysis, hydroxychloroquine given within 48 hours of hospital admission did not reduce ICU admission or death compared to standard of care (76% vs 75%). The analysts used propensity scores to control for potential confounding variables. The study was performed in hospitalized French patients with a moderate COVID-19 requiring oxygen. No patients in the study received antivirals or anti-inflammatory treatments, including NSAIDs, steroids or biologics such as tocilizumab.
 
Researchers at Oxford announced results from the hydroxychloroquine arm of the RECOVERY trial. The 11,000 patient RECOVERY trial has several arms testing lopinavir-ritonavir, dexamethasone, hydroxychloroquine, azithromycin, tocilizumab and convalescent plasma. An interim analysis of 4,674 patients enrolled in the hydroxychloroquine arm found no decrease in mortality at 28-days compared to supportive care (25.7% vs 23.5%). Due to the lack of benefit, the researchers discontinued enrollment in the hydroxychloroquine arm of the trial.