Use of hydroxychloroquine in hospitalised COVID-19 patients is associated with reduced mortality: Findings from the observational multicentre Italian CORIST study

被引：75

作者：

Di Castelnuovo, Augusto ^{[1
]}

Costanzo, Simona ^{[2
]}

Antinori, Andrea ^{[3
]}

Berselli, Nausicaa ^{[4
]}

Blandi, Lorenzo ^{[3
]}

Bruno, Raffaele ^{[6
,7
]}

Cauda, Roberto ^{[8
,9
]}

Guaraldi, Giovanni ^{[10
]}

Menicanti, Lorenzo ^{[5
]}

My, Ilaria ^{[11
]}

Parrut, Giustino ^{[9
]}

Patti, Giuseppe ^{[13
]}

Perlini, Stefano ^{[14
,15
]}

Santilli, Francesca ^{[16
,17
]}

Signorelli, Carlo ^{[18
]}

Spinoni, Enrico ^{[13
]}

Stefanini, Giulio G. ^{[11
]}

Vergori, Alessandra ^{[19
]}

Ageno, Walter ^{[20
]}

Agodi, Antonella ^{[21
,22
]}

Aiello, Luca ^{[23
]}

Agostoni, Piergiuseppe ^{[24
,25
]}

Al Moghazi, Samir ^{[26
]}

Astutot, Marinella ^{[21
,22
]}

Aucella, Filippo ^{[27
]}

Barbieri, Greta ^{[28
,29
]}

Bartoloni, Alessandro ^{[30
]}

Bonaccio, Marialaura ^{[2
]}

Bonfanti, Paolo ^{[31
,32
]}

Cacciatore, Francesco ^{[33
]}

Caiano, Lucia ^{[20
]}

Cannata, Francesco ^{[11
]}

Carrozzi, Laura ^{[29
,34
]}

Cascio, Antonio ^{[35
]}

Ciccullo, Arturo ^{[8
]}

Cingolani, Antonella ^{[8
,9
]}

Cipollone, Francesco ^{[16
,17
]}

Colomba, Claudia ^{[35
]}

Crosta, Francesca ^{[12
]}

Dal Praag, Chiara ^{[36
]}

Danzi, Gian Battista ^{[37
]}

D'Ardes, Damiano ^{[16
,17
]}

Donati, Katleen de Gaetano ^{[8
]}

Del Giacomo, Paola ^{[8
]}

Di Gennaro, Francesco ^{[38
]}

Di Tano, Giuseppe ^{[37
]}

D'OFFizi, Giampiero ^{[39
]}

Filippini, Tommaso ^{[4
]}

Fusco, Francesco Maria ^{[40
]}

Gentile, Ivan ^{[41
]}

机构：

[1] Mediterranea Cardioctr, Naples, Italy

[2] IRCCS Neuromed, Dept Epidemiol & Prevent, Pozzilli, IS, Italy

[3] IRCCS, Natl Inst Infect Dis Spallanzani, UOC Immunodeficienze Virali, Rome, Italy

[4] Univ Modena & Reggio Emilia, Dept Biomed Metab & Neural Sci, Sect Publ Hlth, Modena, Italy

[5] IRCCS Policlin San Donato, San Donato Milanese, Italy

[6] Fdn IRCCS Policlin San Matteo, Div Infect Dis 1, Pavia, Italy

[7] Univ Pavia, Dept Clin Surg Diagnost & Paediat Sci, Pavia, Italy

[8] Fdn Policlin Univ A Gemelli IRCCS, Rome, Italy

[9] Univ Cattolica Sacro Cuore, Dipartimento Sicurezza & Bioet, Sede Roma, Rome, Italy

[10] Univ Modena & Reggio Emilia, Dept Surg, Infect Dis Unit, Modena, Italy

[11] Humanitas Clin & Res Hosp IRCCS, Rozzano Milano, Italy

[12] Azienda Sanitaria Locale AUSL Pescara, Dept Infect Dis, Pescara, Italy

[13] Univ Piemonte Orientale, Maggiore della Carita Hosp, Novara, Italy

[14] IRCCS Policlin San Matteo Fdn, Emergency Dept, Pavia, Italy

[15] Univ Pavia, Dept Internal Med, Pavia, Italy

[16] SS Annunziata Hosp, Dept Med & Aging, Clin Med, Chieti, Italy

[17] Univ G dAnnunzio, Chieti, Italy

[18] Univ Vita Salute San Raffaele, Sch Med, Milan, Italy

[19] Natl Inst Infect Dis Lazzaro Spallanzani IRCCS, HIV AIDS Dept, Rome, Italy

[20] Univ Insubria, Dept Med & Surg, Varese, Italy

[21] Univ Catania, Dept Med & Surg Sci & Adv Technol GF Ingrassia, Catania, Italy

[22] AOU Policlin Vittorio Emanuele, Catania, Italy

[23] Osped Morgagni Pierantoni, UOC Anestesia & Rianimaz, Dipartimento Chirurg Gen, Forli, Italy

[24] Ctr Cardiol Monzino IRCCS, Milan, Italy

[25] Univ Milan, Dept Clin Sci & Community Hlth, Cardiovasc Sect, Milan, Italy

[26] IRCCS, Infez Sistem Immunodepresso, Natl Inst Infect Dis L Spallanzani, Rome, Italy

[27] Fdn IRCCS Casa Sollievo della Sofferenza, Foggia, Italy

[28] Azienda Osped Univ Pisana, Dept Clin & Expt Med, Pisa, Italy

[29] Univ Pisa, Pisa, Italy

[30] Univ Florence, Dept Expt & Clin Med, Florence, Italy

[31] ASST Monza, Osped San Gerardo, UOC Malattie Infett, Monza, Italy

[32] Univ Milano Bicocca, Sch Med & Surg, Milan, Italy

[33] Univ Naples Federico II, Dept Translat Med Sci, Naples, Italy

[34] Azienda Osped Univ Pisana, Cardiovasc & Thorac Dept, Pisa, Italy

[35] Univ Palermo, Dept Hlth Promot Mother & Child Care Internal Med, Infect & Trop Dis Unit, Palermo, Italy

[36] Univ Hosp Padova, Dept Med DIMED, Clin Med 3, Padua, Italy

[37] Osped Cremona, Dept Cardiol, Cremona, Italy

[38] IRCCS Neuromed, Med Direct, Pozzilli, IS, Italy

[39] IRCCS, Natl Inst Infect Dis L Spallanzani, UOC Malattie Infett Epatol, Rome, Italy

[40] Azienda Osped Colli, Osped Cotugno, UOC Infez Sistem & Immunodepresso, Naples, Italy

[41] Univ Naples Federico II, Dept Clin Med & Surg, Naples, Italy

[42] Univ Padua, Dept Cardiol Thorac & Vasc Sci, Resp Pathophysiol Div, Padua, Italy

[43] PO San Giuseppe Moscati, UOC Pneumol, Taranto, Italy

[44] ASST Milano Nord, Osped Edoardo Bassini, Cinisello Balsamo, Italy

[45] EE Osped Reg F Miulli, COVID 19 Unit, Acquaviva Delle Fonti, BA, Italy

[46] ASL Napoli 1 Ctr, PO S Maria di Loreto Nuovo, UOC Med, Naples, Italy

[47] Magna Graecia Univ Catanzaro, Dept Med & Surg Sci, Infect & Trop Dis Unit, Catanzaro, Italy

[48] Univ Pisa, Dipartimento Farm, Pisa, Italy

[49] AOU Policlin Vittorio Emanuele, UO C Malattie Infett & Tropicali, PO San Marco, Catania, Italy

[50] IRCCS, Natl Inst Infect Dis L Spallanzani, UOC Malattie Infett Apparat Resp, Rome, Italy

来源：

EUROPEAN JOURNAL OF INTERNAL MEDICINE | 2020年 / 82卷

关键词：

Hydroxychloroquine; COVID-19; Disease severity; Mortality; Inflammation; VIRAL-INFECTIONS; CHLOROQUINE; REPLICATION;

D O I：

10.1016/j.ejim.2020.08.019

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Background: Hydroxychloroquine (HCQ) was proposed as potential treatment for COVID-19. Objective: We set-up a multicenter Italian collaboration to investigate the relationship between HCQ therapy and COVID-19 in-hospital mortality. Methods: In a retrospective observational study, 3,451 unselected patients hospitalized in 33 clinical centers in Italy, from February 19, 2020 to May 23, 2020, with laboratory-confirmed SARS-CoV-2 infection, were analyzed. The primary end-point in a time-to event analysis was in-hospital death, comparing patients who received HCQ with patients who did not. We used multivariable Cox proportional-hazards regression models with inverse probability for treatment weighting by propensity scores, with the addition of subgroup analyses. Results: Out of 3,451 COVID-19 patients, 76.3% received HCQ. Death rates (per 1,000 person-days) for patients receiving or not HCQ were 8.9 and 15.7, respectively. After adjustment for propensity scores, we found 30% lower risk of death in patients receiving HCQ (HR= 0.70; 95%CI: 0.59 to 0.84; E-value=1.67). Secondary analyses yielded similar results. The inverse association of HCQ with inpatient mortality was particularly evident in patients having elevated C-reactive protein at entry. Conclusions: HCQ use was associated with a 30% lower risk of death in COVID-19 hospitalized patients. Within the limits of an observational study and awaiting results from randomized controlled trials, these data do not discourage the use of HCQ in inpatients with COVID-19.

引用

页码：1 / 10

页数：10

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