Hackensack Meridian Health on Wednesday said that through its observational database it found the touted malaria treatment, hydroxychloroquine, does not improve survival for hospitalized COVID-19 patients.
However, another drug, tocilizumab, appears to improve survival among critically ill intensive care unit patients. If confirmed, tocilizumab would become the first medication improving survival from COVID-19.
HMH came to this conclusion based on the HMH Universal Observational Database for COVID-19, or RECOVERY, which compiles outcomes from 13 Hackensack Meridian Health hospitals throughout New Jersey, and in this instance of more than 3,000 hospitalized COVID-19 patients. This database enhances the understanding of this disease and helps rapidly identify effective therapies.
These major findings were released Wednesday on the online platform medRxiv, which allows researchers to share critical scientific information prior to publication in peer-reviewed journals.
“I am so proud of our Hackensack Meridian Health clinical and research teams who are helping to tackle this unprecedented global challenge,” said HMH Chief Executive Officer Robert Garrett. “This groundbreaking study will help our hospitals, as well as hospitals throughout the world, better understand the effectiveness of certain forms of treatment and the impact of certain risk factors. Our researchers’ observations that tocilizumab may improve survival among the most critically ill could alter the course of the pandemic if confirmed in randomized trials – and Hackensack Meridian Health is participating in those randomized trials as well.”
The outcomes division of the John Theurer Cancer Center at Hackensack University Medical Center, under the leadership of Dr. Stuart Goldberg and Dr. Andrew Ip, created a database to guide the analysis of more than 3,000 patients admitted to Hackensack MeridianHealth facilities for urgent care.
Results from the study include:
- Among 2,512 hospitalized patients with COVID-19, 76 percent received at least one dose of hydroxychloroquine and 59 percent received hydroxychloroquine with azithromycin;
- After adjusting for imbalances via propensity modeling, compared to receiving no hydroxychloroquine, there were no significant differences in associated mortality for patients receiving any hydroxychloroquine during the hospital stay;
- Among 547 ICU patients, including 134 receiving Tocilizumab in the ICU, an exploratory analysis found a trend towards an improved survival rate: 56 percent who received the drug compared to 46 percent who did not receive the therapy, and a propensity adjusted
hazard ratio 0.76.
Using a national leader in real-world evidence analysis to assist, COTA Inc., the Hackensack Meridian JTCC team conducted propensity modeling to assess for potential effective therapeutic interventions. Researchers established an observational database through Epic – Hackensack Meridian’s electronic health records (EHR) system – and collected a random sampling of COVID-19
patients who received treatment at one of 13 hospitals across the network.
It’s important to note these findings are from an observational study. While randomized clinical trials (RCT) will ultimately determine the efficacy of these drugs, Hackensack Meridian’s real-world observational study offers the first useful early insights into effective treatment strategies.
Hackensack Meridian Health has been at the epicenter of the evolving COVID-19 crisis in New Jersey. To date, the network has cared for more than 10,000 patients with confirmed COVID-19 infections and has discharged more than 6,000 patients from network hospitals.