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Med J Aust 2020; 213 (6): . || doi: 10.5694/mja2.50774
Published online: 21 September 2020

A meta‐analysis of published studies into the drug hydroxychloroquine shows that it does not lower mortality in COVID‐19 patients, and using it combined with the antibiotic azithromycin is associated with a 27% increased mortality. The authors found 29 articles that met their criteria, all but one of which involving hospitalised patients, and evaluated the effects of hydroxychloroquine with or without azithromycin. After excluding studies with a critical risk of bias, the meta‐analysis included 11 932 patients in the hydroxychloroquine group, 8081 in the hydroxychloroquine with azithromycin group, and 12 930 in the control group (who received neither drug). The results showed that hydroxychloroquine was not associated with mortality, either in all trials combined or in separate analyses of randomised controlled trials or observational studies. The relative risk of death for use of hydroxychloroquine was 17% lower than controls for all studies combined, but 9% higher in randomised controlled trials. In both cases, these results were not statistically significant. However, the combination of hydroxychloroquine and azithromycin in patients with COVID‐19 was associated with a statistically significant 27% increase in mortality compared with controls. The authors wrote: “These results confirm the preliminary findings of several observational studies which have shown that the combination of hydroxychloroquine and azithromycin might increase the risk of acute, life‐threatening cardiovascular events.”



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