Mehra (2020)
Hydroxychloroquine or chloroquine with or without a macrolide for treatment of COVID-19: a multinational registry analysis
https://doi.org/10.1016/S0140-6736(20)31180-6
https://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(20)31180-6.pdf
Comorbidities
Hyperlipidaemia (Present vs. Not present)
COVID-19 (ventricular arrhythmias)
Hazard ratio: 1.059 (0.938-1.195) Adjusted model

Multinational

Retrospective observational study

Registry

96032

Patients with COVID-19 were hospitalised during the study period and met the inclusion criteria. Of these, 14 888 patients were in the treatment groups (1868 received chloroquine, 3783 received chloroquine with a macrolide, 3016 received hydroxychloroquine, and 6221 received hydroxychloroquine with a macrolide) and 81144 patients were in the control group.

mean age 5.8 years, 46.3% women The study included patients hospitalised between Dec 20, 2019, and April 14, 2020, with a positive laboratory finding for SARS-CoV-2. Patients who received one of the treatments of interest within 48 h of diagnosis were included in one of four treatment groups (chloroquine alone, chloroquine with a macrolide, hydroxychloroquine alone, or hydroxychloroquine with a macrolide), and patients who received none of these treatments formed the control group. Patients for whom one of the treatments of interest was initiated more than 48 h after diagnosis or while they were on mechanical ventilation, as well as patients who received remdesivir, were excluded.

Total

4 Month


COVID-19 (ventricular arrhythmias)

1239

ventricular arrhythmias (defined as the first occurrence of a non-sustained [at least 6 sec] or sustained ventricular tachycardia or ventricular fibrillation) during hospitalisation.


Comorbidities

Hyperlipidaemia

Not present

Present


Hazard ratio

1.059 (0.938-1.195)

No

No

Yes

Cox proportional hazards regression analysis was done to evaluate the effect of age, sex, race or ethnicity (using white race as a reference group), comorbidities (BMI, presence of coronary artery disease, presence of congestive heart failure, history of cardiac arrhythmia, diabetes, or COPD, current smoker, history of hypertension, immunocompromised state, and history of hyperlipidaemia), medications (cardiac medications, antivirals, and the treatment regimens of interest), and severity of illness scores (qSOFA <1 and SPO2 <94%) on the risk of clinically significant ventricular arrhythmia (using the time from admission to first occurrence, or if the event did not occur, to the time of discharge) and mortality (using the time from admission to inpatient mortality or discharge). The propensity score was based on the following variables: age, BMI, gender, race or ethnicity, comorbidities, use of ACE inhibitors, use of statins, use of angiotensin receptor blockers, treatment with other antivirals, qSOFA score of less than 1, and SPO2 of less than 94% on room air. ' WHERE `risks`.`risk_adj_description` = 'Cox proportional hazards regression analysis was done to evaluate the effect of age, sex, race or ethnicity (using white race as a reference group), comorbidities (BMI, presence of coronary artery disease, presence of congestive heart failure, history of cardiac arrhythmia, diabetes, or COPD, current smoker, history of hypertension, immunocompromised state, and history of hyperlipidaemia), medications (cardiac medications, antivirals, and the treatment regimens of interest), and severity of illness scores (qSOFA <1 and SPO2 <94%) on the risk of clinically significant ventricular arrhythmia (using the time from admission to first occurrence, or if the event did not occur, to the time of discharge) and mortality (using the time from admission to inpatient mortality or discharge).


none

Good

No