Does Hydroxychloroquine, as President Trump has indicated, actually improve outcome in mild to moderate COVID-19 disease?
Finally, a trial which looks at treatment for COVID-19 in mild to moderate COVID-19 patients. It was published in the New England Journal of Medicine by Alexandre Cavalcanti and others.
They conducted a multicentre, randomised, open-label, three group control trial involving hospitalised patients with suspected or confirmed COVID-19 who were receiving either no supplemental oxygen or a maximum of 4 litres per minute of supplemental oxygen.
Patients were randomly assigned to standard care, standard care plus hydroxychloroquine at a dose of 400 mg twice daily, or standard care plus hydroxychloroquine at a dose of 400 mg twice daily and azithromycin at 500 mg once daily for seven days. The outcomes were measured at 15 days.
A total of 667 patients underwent randomisation, 504 of these patients had confirmed COVID-19. They found that prolongation of the corrected QT interval and elevation of liver enzyme levels were more frequent in patients receiving hydroxychloroquine alone or with azithromycin than in those who were not receiving either agent.
They concluded that amongst patients hospitalised with mild to moderate COVID-19, the use of hydroxychloroquine, alone or with azithromycin, did not improve clinical status at 15 days as compared with standard care.
This is significant and confirms the advice by British regulatory bodies that hydroxychloroquine should not be used in patients with COVID-19 disease.
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