PLoS ONE (Jan 2021)

COVID-19 Evidence Accelerator: A parallel analysis to describe the use of Hydroxychloroquine with or without Azithromycin among hospitalized COVID-19 patients.

  • Mark Stewart,
  • Carla Rodriguez-Watson,
  • Adem Albayrak,
  • Julius Asubonteng,
  • Andrew Belli,
  • Thomas Brown,
  • Kelly Cho,
  • Ritankar Das,
  • Elizabeth Eldridge,
  • Nicolle Gatto,
  • Alice Gelman,
  • Hanna Gerlovin,
  • Stuart L Goldberg,
  • Eric Hansen,
  • Jonathan Hirsch,
  • Yuk-Lam Ho,
  • Andrew Ip,
  • Monika Izano,
  • Jason Jones,
  • Amy C Justice,
  • Reyna Klesh,
  • Seth Kuranz,
  • Carson Lam,
  • Qingqing Mao,
  • Samson Mataraso,
  • Robertino Mera,
  • Daniel C Posner,
  • Jeremy A Rassen,
  • Anna Siefkas,
  • Andrew Schrag,
  • Georgia Tourassi,
  • Andrew Weckstein,
  • Frank Wolf,
  • Amar Bhat,
  • Susan Winckler,
  • Ellen V Sigal,
  • Jeff Allen

DOI
https://doi.org/10.1371/journal.pone.0248128
Journal volume & issue
Vol. 16, no. 3
p. e0248128

Abstract

Read online

BackgroundThe COVID-19 pandemic remains a significant global threat. However, despite urgent need, there remains uncertainty surrounding best practices for pharmaceutical interventions to treat COVID-19. In particular, conflicting evidence has emerged surrounding the use of hydroxychloroquine and azithromycin, alone or in combination, for COVID-19. The COVID-19 Evidence Accelerator convened by the Reagan-Udall Foundation for the FDA, in collaboration with Friends of Cancer Research, assembled experts from the health systems research, regulatory science, data science, and epidemiology to participate in a large parallel analysis of different data sets to further explore the effectiveness of these treatments.MethodsElectronic health record (EHR) and claims data were extracted from seven separate databases. Parallel analyses were undertaken on data extracted from each source. Each analysis examined time to mortality in hospitalized patients treated with hydroxychloroquine, azithromycin, and the two in combination as compared to patients not treated with either drug. Cox proportional hazards models were used, and propensity score methods were undertaken to adjust for confounding. Frequencies of adverse events in each treatment group were also examined.ResultsNeither hydroxychloroquine nor azithromycin, alone or in combination, were significantly associated with time to mortality among hospitalized COVID-19 patients. No treatment groups appeared to have an elevated risk of adverse events.ConclusionAdministration of hydroxychloroquine, azithromycin, and their combination appeared to have no effect on time to mortality in hospitalized COVID-19 patients. Continued research is needed to clarify best practices surrounding treatment of COVID-19.