1. Effect of Hydroxychloroquine in Hospitalized Patients with Covid-19
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Susara Blunden, Alexander Mentzer, Tom Dymond, Robert Heyderman, Stacy Todd, Richard Haynes, Ahmad Abu-Arafeh, William Ricketts, Simon Drysdale, Danyal Jajbhay, Grant D. Stewart, Andrew Ustianowski, Jane Blazeby, Ashton Barnett-Vanes, Nicholas Kametas, Elizabeth Bancroft, Ankur Gupta-Wright, Hanif Esmail, Gerard McKnight, Catherine Harwood, Joe Fawke, Vivien Price, Tuck-Kay Loke, Kieran Nunn, Mili Estee Torok, Wei Shen Lim, Vishal Dey, Brendan Payne, Alexander Stockdale, Charles Christoph Roehr, Dominic Crocombe, Imogen Skene, Martin Landray, Anna Bibby, Jamie Brannigan, Padmasayee Papineni, Søren Kudsk-Iversen, Kathryn Puxty, Katrina Cathie, Maheshi Nirmala Ramasamy, Alan Montgomery, Louis Grandjean, Xin Hui Chan, Ben Gibbison, Cielito Caneja, Dinesh Saralaya, Omer Elneima, Charles Reynard, Natalie Blencowe, Eleanor Mishra, Henry HL Wu, Roy Soiza, Patrick Lillie, Paul Pfeffer, Christian Alexander Linares, Simon Tso, Benjamin Caplin, Sarah Burge, Sakib Rokadiya, Brunskill Nigel, Joel Tarning, Manish Patel, Jamie Cooper, Lee Hoggett, Nazima Pathan, Alex Horsley, Saul Faust, Martin Llewelyn, Alex Scott, Kim Hinshaw, Giorgio Calisti, Effrossyni Gkrania-Klotsas, Shaman Jhanji, Ben Burton, Anna Daunt, Chetan Parmar, Chris Imray, Christopher Green, Jonathan Underwood, Mark Peters, James A Watson, Eoin O'Sullivan, Pallav Shah, Paul Dark, Luke Hodgson, Ryan Malcolm Hum, Varun Sarodaya, Pilar Rivera Ortega, Jonathan Emberson, Ben Shelley, Richard Adams, Joseph Barker, John Kenneth Baillie, Manu Vatish, Tony Whitehouse, University of St Andrews. School of Medicine, Group, RECOVERY Collaborative, Jaki, Thomas [0000-0002-1096-188X], and Apollo - University of Cambridge Repository
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Male ,medicine.medical_treatment ,030204 cardiovascular system & hematology ,Rate ratio ,law.invention ,Pneumonia, viral/drug therapy ,chloroquine ,0302 clinical medicine ,Randomized controlled trial ,law ,RA0421 ,RA0421 Public health. Hygiene. Preventive Medicine ,klorokin ,030212 general & internal medicine ,Treatment Failure ,Middle aged ,Coronavirus infections/drug therapy ,Aged, 80 and over ,Incidence (epidemiology) ,General Medicine ,3rd-DAS ,Middle Aged ,hidroksiklorokin ,Antiviral Agents/adverse effects ,Covid-19 -- drug therapy ,Hospitalization ,Doxycycline ,Hydroxychloroquine/adverse effects ,Original Article ,Female ,Coronavirus Infections ,covid-19 -- terapija z zdravili ,medicine.drug ,Hydroxychloroquine ,medicine.medical_specialty ,RM ,hydroxychloroquine ,Pneumonia, Viral ,Antiviral Agents ,03 medical and health sciences ,Betacoronavirus ,SDG 3 - Good Health and Well-being ,Internal medicine ,udc:616.9 ,medicine ,Humans ,Pandemics ,Aged ,Mechanical ventilation ,business.industry ,SARS-CoV-2 ,COVID-19 ,NIS ,Interim analysis ,Respiration, Artificial ,Confidence interval ,RM Therapeutics. Pharmacology ,COVID-19 Drug Treatment ,Treatment failure ,Relative risk ,Respiration, artificial ,business - Abstract
Supported by a grant (MC_PC_19056) to the University of Oxford from UK Research and Innovation and the NIHR and by core funding provided by NIHR Oxford Biomedical Research Centre, Wellcome, the Bill and Melinda Gates Foundation, the Department for International Development, Health Data Research UK, the Medical Research Council Population Health Research Unit, the NIHR Health Protection Unit in Emerging and Zoonotic Infections, and NIHR Clinical Trials Unit Support Funding. BACKGROUND: Hydroxychloroquine and chloroquine have been proposed as treatments for coronavirus disease 2019 (Covid-19) on the basis of in vitro activity and data from uncontrolled studies and small, randomized trials. METHODS: In this randomized, controlled, open-label platform trial comparing a range of possible treatments with usual care in patients hospitalized with Covid-19, we randomly assigned 1561 patients to receive hydroxychloroquine and 3155 to receive usual care. The primary outcome was 28-day mortality. RESULTS: The enrollment of patients in the hydroxychloroquine group was closed on June 5, 2020, after an interim analysis determined that there was a lack of efficacy. Death within 28 days occurred in 421 patients (27.0%) in the hydroxychloroquine group and in 790 (25.0%) in the usual-care group (rate ratio, 1.09; 95% confidence interval [CI], 0.97 to 1.23; P = 0.15). Consistent results were seen in all prespecified subgroups of patients. The results suggest that patients in the hydroxychloroquine group were less likely to be discharged from the hospital alive within 28 days than those in the usual-care group (59.6% vs. 62.9%; rate ratio, 0.90; 95% CI, 0.83 to 0.98). Among the patients who were not undergoing mechanical ventilation at baseline, those in the hydroxychloroquine group had a higher frequency of invasive mechanical ventilation or death (30.7% vs. 26.9%; risk ratio, 1.14; 95% CI, 1.03 to 1.27). There was a small numerical excess of cardiac deaths (0.4 percentage points) but no difference in the incidence of new major cardiac arrhythmia among the patients who received hydroxychloroquine. CONCLUSIONS: Among patients hospitalized with Covid-19, those who received hydroxychloroquine did not have a lower incidence of death at 28 days than those who received usual care. Publisher PDF
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- 2020
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