References
Zhang JJ, Dong X, Liu GH, Gao YD. Risk and protective factors for COVID-19 morbidity, severity, and mortality. Clin Rev Allergy Immunol 2023; 64(1): 90–107
Chen C, He W, Wang DW. Wuhan 3 years after the outbreak of the pandemic-cardiological insights and perspectives. Herz 2023; 48(3): 173–179
Hashem AM, Alghamdi BS, Algaissi AA, Alshehri FS, Bukhari A, Alfaleh MA, Memish ZA. Therapeutic use of chloroquine and hydroxychloroquine in COVID-19 and other viral infections: a narrative review. Travel Med Infect Dis 2020; 35: 101735
Schrezenmeier E, Dörner T. Mechanisms of action of hydroxychloroquine and chloroquine: implications for rheumatology. Nat Rev Rheumatol 2020; 16(3): 155–166
Yao X, Ye F, Zhang M, Cui C, Huang B, Niu P, Liu X, Zhao L, Dong E, Song C, Zhan S, Lu R, Li H, Tan W, Liu D. In vitro antiviral activity and projection of optimized dosing design of hydroxychloroquine for the treatment of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Clin Infect Dis 2020; 71(15): 732–739
Yu B, Li C, Chen P, Zhou N, Wang L, Li J, Jiang H, Wang DW. Low dose of hydroxychloroquine reduces fatality of critically ill patients with COVID-19. Sci China Life Sci 2020; 63(10): 1515–1521
Ip A, Ahn J, Zhou Y, Goy AH, Hansen E, Pecora AL, Sinclaire BA, Bednarz U, Marafelias M, Sawczuk IS, Underwood JP III, Walker DM, Prasad R, Sweeney RL, Ponce MG, La Capra S, Cunningham FJ, Calise AG, Pulver BL, Ruocco D, Mojares GE, Eagan MP, Ziontz KL, Mastrokyriakos P, Goldberg SL. Hydroxychloroquine in the treatment of outpatients with mildly symptomatic COVID-19: a multi-center observational study. BMC Infect Dis 2021; 21(1): 72
Singh B, Ryan H, Kredo T, Chaplin M, Fletcher T. Chloroquine or hydroxychloroquine for prevention and treatment of COVID-19. Cochrane Database Syst Rev 2021; 2(2): Cd013587
RECOVERY Collaborative Group; Horby P, Mafham M, Linsell L, Bell JL, Staplin N, Emberson JR, Wiselka M, Ustianowski A, Elmahi E, Prudon B, Whitehouse T, Felton T, Williams J, Faccenda J, Underwood J, Baillie JK, Chappell LC, Faust SN, Jaki T, Jeffery K, Lim WS, Montgomery A, Rowan K, Tarning J, Watson JA, White NJ, Juszczak E, Haynes R, Landray MJ. Effect of hydroxychloroquine in hospitalized patients with Covid-19. N Engl J Med 2020; 383(21): 2030–2040
Accinelli RA, Ynga-Meléndez GJ, León-Abarca JA, López LM, Madrid-Cisneros JC, Mendoza-Saldaña JD. Hydroxychloroquine / azithromycin in COVID-19: the association between time to treatment and case fatality rate. Travel Med Infect Dis 2021; 44: 102163
Gavriatopoulou M, Ntanasis-Stathopoulos I, Korompoki E, Fotiou D, Migkou M, Tzanninis IG, Psaltopoulou T, Kastritis E, Terpos E, Dimopoulos MA. Emerging treatment strategies for COVID-19 infection. Clin Exp Med 2021; 21(2): 167–179
Omma A, Erden A, Apaydin H, Aslan M, Çamli H, Şahiner ES, Güven SC, Armaǧan B, Karaahmetoǧlu S, Ates I, Kucuksahin O. Hydroxychloroquine shortened hospital stay and reduced intensive care unit admissions in hospitalized COVID-19 patients. J Infect Dev Ctries 2022; 16(1): 25–31
Di Castelnuovo A, Gialluisi A, Antinori A, Berselli N, Blandi L, Bonaccio M, Bruno R, Cauda R, Costanzo S, Guaraldi G, Menicanti L, Mennuni M, My I, Parruti G, Patti G, Perlini S, Santilli F, Signorelli C, Stefanini G, Vergori A, Ageno W, Agodi A, Agostoni P, Aiello L, Al Moghazi S, Arboretti R, Aucella F, Barbieri G, Barchitta M, Bonfanti P, Cacciatore F, Caiano L, Cannata F, Carrozzi L, Cascio A, Castiglione G, Ciccullo A, Cingolani A, Cipollone F, Colomba C, Colombo C, Crisetti A, Crosta F, Danzi GB, D’Ardes D, de Gaetano Donati K, Di Gennaro F, Di Tano G, D’Offizi G, Fusco FM, Gaudiosi C, Gentile I, Gianfagna F, Giuliano G, Graziani E, Guarnieri G, Langella V, Larizza G, Leone A, Maccagni G, Magni F, Maitan S, Mancarella S, Manuele R, Mapelli M, Maragna R, Marcucci R, Maresca G, Marongiu S, Marotta C, Marra L, Mastroianni F, Mengozzi A, Meschiari M, Milic J, Minutolo F, Mussinelli R, Mussini C, Musso M, Odone A, Olivieri M, Palimodde A, Pasi E, Pesavento R, Petri F, Pivato CA, Poletti V, Ravaglia C, Righetti G, Rognoni A, Rossato M, Rossi I, Rossi M, Sabena A, Salinaro F, Sangiovanni V, Sanrocco C, Schiano Moriello N, Scorzolini L, Sgariglia R, Simeone PG, Spinicci M, Tamburrini E, Torti C, Trecarichi EM, Vettor R, Vianello A, Vinceti M, Virdis A, De Caterina R, Iacoviello L. Disentangling the association of hydroxychloroquine treatment with mortality in Covid-19 hospitalized patients through hierarchical clustering. J Healthc Eng 2021; 2021: 5556207
Seligmann H. Balanced evaluation of preliminary data on a candidate COVID-19 hydroxychloroquine treatment. Int J Antimicrob Agents 2021; 57(3): 106292
Ferreira PMP, Sousa RWR, Ferreira JRO, Militão GCG, Bezerra DP. Chloroquine and hydroxychloroquine in antitumor therapies based on autophagy-related mechanisms. Pharmacol Res 2021; 168: 105582
Acknowledgements
The authors would like to thank all patients, their families, and all investigators involved in this study. The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article. This work was supported in part by the projects of National Natural Science Foundation of China (Nos. 82100526, 82241034, and 82330010) and National Key R&D Program of China (No. 2024YFC3044500).
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflicts of interest Wu He, Ke Xu, Yongcui Yan, Gen Li, Bo Yu, Junfang Wu, Kaineng Zhong, Da Zhou, and Dao Wen Wang declare no potential conflicts of interest with respect to the research, authorship, and/or publication of this article. Dao Wen Wang is a member of the Editorial Board of Frontiers of Medicine, who was excluded from the peer-review process and all editorial decisions related to the acceptance and publication of this article. Peer-review was handled independently by the other editors to minimise bias.
The study was approved by the Research Ethics Committee of Tongji Medical College (No. TJ-IRB20210138) and the study was performed in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards. Due to the retrospective nature of this study and the anonymity of its participants, the ethics committee waived the requirement for written informed consent.
Supplemental Material
Rights and permissions
About this article
Cite this article
He, W., Xu, K., Yan, Y. et al. Low dose of hydroxychloroquine is associated with reduced COVID-19 mortality: a multicenter study in China. Front. Med. (2025). https://doi.org/10.1007/s11684-025-1123-9
Received:
Accepted:
Published:
DOI: https://doi.org/10.1007/s11684-025-1123-9