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Accepted for/Published in: Journal of Medical Internet Research

Date Submitted: Jun 24, 2020
Open Peer Review Period: Jun 24, 2020 - Jul 17, 2020
Date Accepted: Aug 4, 2020
Date Submitted to PubMed: Aug 13, 2020
(closed for review but you can still tweet)

The final, peer-reviewed published version of this preprint can be found here:

Efficacy of Hydroxychloroquine and Tocilizumab in Patients With COVID-19: Single-Center Retrospective Chart Review

Roomi SS, Ullah W, Ahmed F, Sadiq U, Farooq S, Boigon M

Efficacy of Hydroxychloroquine and Tocilizumab in Patients With COVID-19: Single-Center Retrospective Chart Review

J Med Internet Res 2020;22(9):e21758

DOI: 10.2196/21758

PMID: 32784192

PMCID: 7470234

Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.

Efficacy of hydroxychloroquine and tocilizumab in patients with COVID-19: A single-center retrospective chart review

  • Sohaib Sanan Roomi; 
  • Waqas Ullah; 
  • Faizan Ahmed; 
  • Usama Sadiq; 
  • Soban Farooq; 
  • Margot Boigon

ABSTRACT

Background:

During the initial phases of the coronavirus disease 2019 (COVID-19)pandemic, there was an unfounded fervor surrounding the use of hydroxychloroquine (HCQ) and tocilizumab(TCZ): however, evidence on their efficacy and safety have been controversial.

Objective:

We hypothesize that HCQ and TCZ use would be associated with a reduction in end-points of in-hospital mortality, upgrade to intensive care unit, mechanical ventilation, or acute renal failure necessitating dialysis. The objective of the study is to validate our hypothesis.

Methods:

A retrospective cohort study was performed to determine the impact of HCQ and TCZ use on hard clinical outcomes during hospitalization. Independent t-test and multivariate logistic regression analysis were performed to calculate mean differences and adjusted odds ratios (aOR) with its 95% confidence interval (CI), respectively.

Results:

A total of 176 hospitalized patients with confirmed COVID-19 were included. Patients were divided into two comparison groups HCQ vs. no-HCQ (n=144 vs. 32) and TCZ vs. no-TCZ (n=32 vs. n-144), respectively. The mean age, baseline comorbidities and other medications used during hospitalization were comparable among all the groups. The unadjusted odds ratio for patients upgraded to a higher level of care (OR 2.6, 95% CI 1.19-5.69, p=0.003) and reduction in C-reactive protein(CRP) level at day 7 of hospitalization (21% vs. 56%, OR 0.21, 95% CI 0.08-0.55, p=0.002) were significantly higher in the TCZ group compared to the control group. There was no significant difference in the odds of in-hospital mortality, upgrade to intensive medical care, need for invasive mechanical ventilation (IVM), acute kidney failure (AKI) necessitating dialysis, or discharge from the hospital after recovery in both TCZ and HCQ groups compared to their respective control groups. Adjusted odds ratios controlled for baseline comorbidities and medications closely followed the unadjusted estimates.

Conclusions:

In this cohort of patients with COVID-19, neither TCZ nor HCQ offered a significant reduction in in-hospital mortality, upgrade to intensive medical care, invasive mechanical ventilation, or acute renal failure needing dialysis.


 Citation

Please cite as:

Roomi SS, Ullah W, Ahmed F, Sadiq U, Farooq S, Boigon M

Efficacy of hydroxychloroquine and tocilizumab in patients with COVID-19: A single-center retrospective chart review

JMIR Preprints. 24/06/2020:21758

DOI: 10.2196/preprints.21758

URL: https://preprints.jmir.org/preprint/21758

PMID: 32784192

PMCID: 7470234

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