Chloroquine and Hydroxychloroquine for the Treatment of COVID-19: a Systematic Review and Meta-analysis
- PDF / 954,216 Bytes
- 7 Pages / 595.276 x 790.866 pts Page_size
- 69 Downloads / 215 Views
Department of Neurology, All India Institute of Medical Sciences, New Delhi, India; 2Department of Community Medicine, NDMC Medical College, New Delhi, India; 3Clinical Hematology, All India Institute of Medical Sciences, New Delhi, India; 4Medical Oncology, All India Institute of Medical Sciences, New Delhi, India; 5Pulmonary Medicine, Critical Care and Sleep Disorders, All India Institute of Medical Sciences, New Delhi, India; 6Medicine, All India Institute of Medical Sciences, New Delhi, India; 7Pharmacology, All India Institute of Medical Sciences, New Delhi, India; 8 Gastroenterology and Human Nutrition Unit, All India Institute of Medical Sciences, New Delhi, India.
BACKGROUND: There is no effective therapy for COVID19. Hydroxychloroquine (HCQ) and chloroquine (CQ) have been used for its treatment but their safety and efficacy remain uncertain. OBJECTIVE: We performed a systematic review to synthesize the available data on the efficacy and safety of CQ and HCQ for the treatment of COVID-19. METHODS: Two reviewers searched for published and pre-published relevant articles between December 2019 and 8 June 2020. The data from the selected studies were abstracted and analyzed for efficacy and safety outcomes. Critical appraisal of the evidence was done by Cochrane risk of bias tool and Newcastle Ottawa Scale. The quality of evidence was graded as per the GRADE approach. RESULTS: We reviewed 12 observational and 3 randomized trials which included 10,659 patients of whom 5713 received CQ/HCQ and 4966 received only standard of care. The efficacy of CQ/HCQ for COVID-19 was inconsistent across the studies. Meta-analysis of included studies revealed no significant reduction in mortality with HCQ use [RR 0.98 95% CI 0.66–1.46], time to fever resolution (mean difference − 0.54 days (− 1.19–011)) or clinical deterioration/development of ARDS with HCQ [RR 0.90 95% CI 0.47–1.71]. There was a higher risk of ECG abnormalities/arrhythmia with HCQ/CQ [RR 1.46 95% CI 1.04 to 2.06]. The quality of evidence was graded as very low for these outcomes. AUTHORS’ CONCLUSION: The available evidence suggests that CQ or HCQ does not improve clinical outcomes in COVID-19. Well-designed randomized trials are required for assessing the efficacy and safety of HCQ and CQ for COVID-19. KEY WORDS: Chloroquine; hydroxychloroquine; COVID-19; SARS-CoV-2; meta-analysis.
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s11606-020-06146-w) contains supplementary material, which is available to authorized users. Received July 6, 2020 Accepted August 12, 2020
J Gen Intern Med DOI: 10.1007/s11606-020-06146-w © Society of General Internal Medicine 2020
BACKGROUND
A novel coronavirus-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is responsible for the coronavirus disease 2019 (COVID-19). The World Health Organization (WHO) declared COVID-19 as a global pandemic on 11 March 2020. As of 8 June, more than 7.1 million people have been infected, and 406,959 have died due to COVID-19.1 In the absen
Data Loading...
