Factbox: US hospitals differ on best use of hydroxychloroquine for coronavirus

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(Reuters) – Major hospitals in New York, Louisiana and other regions hardest hit by the coronavirus epidemic regularly use hydroxychloroquine in patients hospitalized with COVID-19, although solid evidence of its effectiveness can be found in weeks or even months. a treatment for malaria and autoimmune diseases in use since the 1950s. Chloroquine, a related drug, has been used longer, but is considered less safe. Medications can have serious side effects, including vision loss, heart problems, or even death, if used incorrectly. Here are examples of how some hospitals use therapy:

NORTHWELL HEALTH, NEW YORK

The health care system at 23 hospitals began routine use of hydroxychloroquine in late March for patients admitted with a life-threatening respiratory illness caused by the virus, according to Dr. Kevin Tracey, director general of the Northwell research division. This was based on preliminary data that “it could be beneficial,” said pharmacy chief Onisis Stefas. Hydroxychloroquine is given to patients who have “really no other option” and who have not qualified for clinical trials of other potential treatments for coronaviruses, he said. Northwell also allows doctors to prescribe it together with the antibiotic azithromycin on a case-by-case basis, but this is not the standard of care.

NYU LANGONE HEALTH, NEW YORK

NYU has been giving the drug to patients since early March, according to rheumatologist Dr. Michael Belmont. Some New York University doctors also prescribe azithromycin in combination with hydroxychloroquine, although Belmont said the medical literature he saw was “insufficient to draw a conclusion that the combination is particularly effective” .

UNIVERSITY OF CALIFORNIA, LOS ANGELES MEDICAL CENTERUCLA has been advising physicians since mid-March to consider hydroxychloroquine for critically ill COVID-19 patients. “Our recommendation is based on limiting use, making it a Hail Mary-like treatment for very sick patients,” said infectious disease specialist Dr. Otto Yang.

UNIVERSITY OF WASHINGTON MEDICINE

The hospital system advises prescribing hydroxychloroquine to critically ill patients if they are not eligible for trials of remdesivir, an experimental antiviral therapy developed by Gilead Sciences Inc. Gilead earlier this month suspended access to compassionate remdesivir due to overwhelming demand. Health system treatment guidelines warn that the combination of azithromycin and hydroxychloroquine “has not been thoroughly studied; it is not known if it offers additional benefits. The combination can cause significant cardiac toxicity. “

OCHSNER MEDICAL CENTER, LOUISIAN The largest hospital system in Louisiana prescribes large-scale hydroxychloroquine, according to its chief physician, Dr. Robert Hart. “We have been using it for quite a while in the epidemic to see if it helps,” he said.

LAHEY HOSPITAL AND MEDICAL CENTER, MASSACHUSETTS

The hospital system began using hydroxychloroquine around March 27 for the treatment in hospital of COVID-19 patients whose oxygen levels fall below a certain level and who have risk factors for serious illness. System protocols take into account the patient’s heart history and do not recommend combining hydroxychloroquine with azithromycin due to the increased risk of heart problems.

Report by Michael Erman in New York and Deena Beasley in Los Angeles; Editing by Michele Gershberg and Bill Berkrot

Our standards:Principles of the Thomson Reuters Trust.

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