Prospective Cohort Study
Study population and setting
This study included 1376 adults admitted to New York–Presbyterian Hospital (NYP)–Columbia University Irving Medical Center (CUIMC) who had any positive SARS-CoV-2 test during admission from March 7 to April 8, 2020. Exclusion criteria included intubation, death, or transfer within 24 hours of admission. 811 (58.9%) patients received hydroxychloroquine. A multivariable cox model with inverse probability weighting according to the propensity score was used to assess the primary outcome (a composite of intubation or death) in patients who received hydroxychloroquine compared to patients who did not.
Summary of Main Findings
Hydroxychloroquine was not significantly associated with intubation or death (hazard ratio, 1.04, 95% CI: 0.82 to 1.32). Multiple sensitivity analyses found similar results.
This study had a relatively large sample size compared to other hydroxychloroquine studies, adjustment for confounding variables including comorbidities known to increase risk of poor prognosis in COVID-19.
Participants were not randomized to treatment groups. The study occurred in a single academic hospital center in an urban location, and may not be applicable in other settings. Missing data for some variables and potential for inaccuracies in the electronic health records may bias results. Residual confounding remains possible.
This was a relatively large observational study on the clinical utility of hydroxycholoroquine with rigorous adjustment for confounding.