Once Lauded, then Discredited, Hydroxychloroquine Might Help Fight COVID-19 After All—in Some Patients

Hydroxychloroquine has had its share of champions and naysayers since it was first proposed as a possible treatment for patients infected with COVID-19. Now a study presented at the Virtual Congress of the International Society on Thrombosis and Hemostasis in Cepagatti, Italy indicates the pendulum is settling somewhere in the middle of those two extremes. If the conclusions of the study are correct, hydroxychloroquine really can offer a benefit to some patients—and the authors of the study say there’s an algorithm that can help identify them. The primary endpoint was a composite outcome of ventilation or mortality in the subpopulation identified by the algorithm. The secondary endpoint was in-hospital mortality in the general COVID-19 population. The algorithm identified 43 (14.8%) patients most likely to respond well  to hydroxychloroquine—and the 26 patients who actually received it were less likely to experience mechanical ventilation or death. However, hydroxychloroquine was not associated with decreased risk of ventilation or mortality in the general population. While the predictive value of the algorithm requires further validation, the initial results offer hope that a precision-medicine approach could help lower the pandemic’s death rate.