Is hydroxychloroquine bad for coronavirus patients? | Visualized Science

By Rebecca Israel, MS and Charles Li, MD

May 26, 2020

  • The FDA approved hydroxychloroquine for emergency use to treat coronavirus patients.

  • Early studies reported mixed results of the drug’s efficacy and safety.

  • A large-scale study found strong evidence that the drug is doing more harm than good.

COVID-19 & Hydroxychloroquine Study

If something is too good to be true, it probably is.

The media and politicians alike have tapped hydroxychloroquine as the saving grace of our current pandemic. This article will describe studies that are making doctors and policymakers think twice about scaling the drug.

What is Hydroxychloroquine?

Hydroxychloroquine Fact Sheet.

Multinational registry

The Lancet published an analysis of over 90 thousand hospitalized coronavirus patients. They compared a control group (people who did not receive HCQ) with patients who received four different HCQ-related treatments: chloroquine alone, chloroquine with a macrolide, hydroxychloroquine alone, or hydroxychloroquine with a macrolide.

The researchers wanted to know the rates of in-hospital deaths and abnormal heartbeats in the treatment groups compared to patients who did not receive any form of HCQ.

The Lancet Hydroxychloroquine Study Setup

Source: Hydroxychloroquine or chloroquine with or without a macrolide for treatment of COVID-19: a multinational registry analysis

The results are concerning. In every treatment group, patients were more likely to die compared to patients who received different treatments.

Patients in the treatment groups were roughly 2 to 5 times more likely to have an abnormal heartbeat than patients who received different treatments- creating a convincing link between the treatment and the symptom.

Hydroxychloroquine & Mortality Data from The Lancet
Hydroxychloroquine & heart health Data from The Lancet

We were unable to confirm a benefit of hydroxychloroquine or chloroquine, when used alone or with a macrolide, on in-hospital outcomes for COVID-19. Each of these drug regimens was associated with decreased in-hospital survival and an increased frequency of ventricular arrhythmias when used for treatment of COVID-19.

Mehra et al

This initial study provides some evidence that hydroxychloroquine may not be the silver bullet we've been looking for and may carry some risks.

The researchers used robust methods and provided actionable insights into hydroxychloroquine.

As a retrospective cohort study however, the data above is not as conclusive as data from a clinical trial. There are many factors that can affect the data including which patients were selected for HCQ.

In order to know for sure, we will need to wait for clinical trial data. Randomized Double-Blinded Controlled Trials are the gold standard in medical science for determining whether drugs are effective.

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