Background

Pharmacological treatments including antivirals (Lopinavir/Ritonavir), Immuno-modulatory and anti-inflammatory drugs including, Tocilizumab and Hydroxychloroquine (HCQ) has been widely investigated as a treatment for COVID-19.

Despite the ongoing controversies, HCQ was recommended for managing mild to moderate cases in Saudi Arabia . However, to our knowledge, no previous studies have been conducted in Saudi Arabia to assess its effectiveness.

Methods

A hospital-based retrospective cohort study involving 161 patients with COVID-19 was conducted from March 1 to May 20, 2020. The study was conducted at Prince Mohammed bin Abdul Aziz Hospital (PMAH).

The population included hospitalized adults (age ≥ 18 years) with laboratory-confirmed COVID-19. Each eligible patient was followed from the time of admission until the time of discharge. Patients were classified into two groups according to treatment type: in the HCQ group, patients were treated with HCQ; in the SC group, patients were treated with other antiviral or antibacterial treatments according to Ministry of Health (MOH) protocols.

The outcomes were hospitalization days, ICU admission, and the need for mechanical ventilation.

We estimated the differences in hospital length of stay and time in the ICU between the HCQ group and the standard care (SC) group using a multivariate generalized linear regression. The differences in ICU admission and mechanical ventilation were compared via logistic regression. All models were adjusted for age and gender variables.

Results

A total of 161 patients fulfilled the inclusion criteria. Approximately 59% (n = 95) received HCQ-based treatment, and 41% (n = 66) received SC. Length of hospital stay and time in ICU in for patients who received HCQ based treatment was shorter than those who received SC. Similarly, there was less need for ICU admission and mechanical ventilation among patients who received HCQ based treatment compared with SC, (8.6% vs. 10.7 and 3.1% vs. 9.1%). However, the regression analysis showed no significant difference between the two groups in terms of patient outcomes.

Conclusion

HCQ had a modest effect on hospital length stay and days in ICU compared with SC. However, these results need to be interpreted with caution. Larger observational studies and RCTs that evaluate the efficacy of HCQ in COVID-19 patients in the Saudi population are urgently needed.

中文翻译：

---

比较基于羟氯喹的治疗方案和标准治疗对 COVID-19 患者预后的影响：一项回顾性队列研究

 背景

药物治疗，包括抗病毒药物（洛匹那韦/利托那韦）、免疫调节药物和抗炎药物，包括托珠单抗和羟氯喹 (HCQ)，已被广泛研究作为 COVID-19 的治疗方法。

尽管存在持续争议，但在沙特阿拉伯仍建议使用 HCQ 来治疗轻度至中度病例。然而，据我们所知，沙特阿拉伯此前尚未进行过研究来评估其有效性。

 方法

2020 年 3 月 1 日至 5 月 20 日进行了一项以医院为基础的回顾性队列研究，涉及 161 名 COVID-19 患者。该研究在穆罕默德·本·阿卜杜勒·阿齐兹亲王医院 (PMAH) 进行。

人群包括经实验室确诊的 COVID-19 住院成人（年龄 ≥ 18 岁）。每个符合条件的患者从入院到出院都接受随访。根据治疗类型将患者分为两组：HCQ组患者接受HCQ治疗；HCQ组患者接受HCQ治疗。在 SC 组中，患者根据卫生部 (MOH) 方案接受其他抗病毒或抗菌治疗。

结果是住院天数、入住 ICU 以及机械通气的需要。

我们使用多元广义线性回归估计了 HCQ 组和标准护理 (SC) 组之间住院时间和 ICU 时间的差异。通过逻辑回归比较 ICU 入住和机械通气的差异。所有模型均针对年龄和性别变量进行了调整。

 结果

共有 161 名患者符合纳入标准。大约 59% (n = 95) 接受基于 HCQ 的治疗，41% (n = 66) 接受 SC 治疗。接受 HCQ 治疗的患者的住院时间和 ICU 时间比接受 SC 的患者短。同样，与 SC 相比，接受 HCQ 治疗的患者对入住 ICU 和机械通气的需求较少（8.6% vs. 10.7% 和 3.1% vs. 9.1%）。然而，回归分析显示两组患者的治疗结果没有显着差异。

 结论

与 SC 相比，HCQ 对住院时间和 ICU 天数影响不大。然而，这些结果需要谨慎解释。迫切需要进行更大规模的观察性研究和随机对照试验来评估 HCQ 对沙特人群中的 COVID-19 患者的疗效。