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. JusticeReyna 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

Research output: Contribution to journalArticlepeer-review

8 Scopus citations

Abstract

Background The 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. Methods Electronic 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. Results Neither 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. Conclusion Administration 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.

Original languageEnglish
Article numbere0248128
JournalPLoS ONE
Volume16
Issue number3 March
DOIs
StatePublished - Mar 2021

Funding

Health catalyst provided support for this study in the form of salary for AA, EE, AG, and JJ. Gilead Sciences provided support for this study in the form of salary for JA and RM. COTA, Inc provided support for this study in the form of salary for AB, EH, and SG. Sypase provided support for this study in the form of salary for TB, MI, AS, FW and JH. Aetion, Inc. provided support for this study in the form of salary for NG, JR, and AW. TriNetX, LLC. provided support for this study in the form of salary for SK. Dascena provided support for this study in the form of salary for RD, CL, QM, SM, AS. HealthVerity provided support for this study in the form of salary for RK. The specific roles of these authors are articulated in the 'author contributions' section. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

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