April 16, 2020 Hydroxychloroquine has been a highly controversial potential treatment for COVID-19. To date, available evidence has consisted of in vitro data as well as some heavily flawed studies from France. A new pre-print from China offers the most meaningful investigation of hydroxychloroquine to date.

design
Tang et al. is a multi-center, open-label RCT involving administration of hydroxychloroquine to 150 patients hospitalized with COVID-19. Sixteen government-designated COVID-19 treatment centers were involved. The dose of hydroxychloroquine used was 1,200 mg daily for three days, followed by 800 mg daily for 2-3 weeks. This is a huge dose of hydroxychloroquine (in comparison, the most commonly used regimen in the United States currently seems to be 800 mg on the first day followed by 400 mg daily for four days). Patients with severe renal or hepatic disease were excluded, to avoid potential drug accumulation.

subjects
Patients were fairly well-matched at baseline. Most patients had relatively mild disease (e.g., with a low rate of dyspnea or hypoxemia). Treatment was initiated late, an average of 16-17 days after disease onset:

Read Full Article: https://emcrit.org/pulmcrit/hydroxychloroquine-fail/


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