Effectiveness of Hydroxychloroquine for Treating COVID-19: A Meta-analysis (original) (raw)
Pathogens and Global Health
COVID-19 has quickly become a public health problem worldwide, and treatment for this new disease is needed. Hydroxychloroquine is an antimalarial that in vitro studies have shown action against SARS-CoV-2, which is why it has been the target of clinical studies with conflicting results. Therefore, the aim of this systematic review was to assess the association of hydroxychloroquine use with the virological cure, clinical recovery, mortality, and development of adverse effects in patients with COVID-19. PubMed, Cochrane Library, and Lilacs were searched until 7 January 2021, for randomized clinical trials with COVID-19 patients treated with hydroxychloroquine or chloroquine. Of the 130 studies found, 12 met the inclusion criteria. Compared to the patient's control group, the risk ratio (RR) for the virological cure and clinical recovery with hydroxychloroquine or chloroquine use was 1.04 (95%CI 0.91-1.17) and 1.03 (95%CI 0.92-1.13), respectively. Hydroxychloroquine (with or without azithromycin) was also not associated with mortality (RR = 1.09, 95%CI 0.98-1.20). Treatment with hydroxychloroquine was associated with any adverse effects (RR = 1.50, 95%CI 1.18-1.81). Hydroxychloroquine or chloroquine use did not have a significant effect on virological cure, the time of clinical recovery, and improvement in survival in COVID-19 patients. However, patients who used hydroxychloroquine showed an increase in adverse effects.
2020
The COVID-19 Pandemic has literally left the world breathless in the chase for Pharmacotherapy. With the vaccine approval likely more than a year away and novel drugs in early clinical trials, repurposing of existing drugs takes the center stage. A potential drug discussed both in geopolitical and global scientific community is hydroxychloroquine (HCQ). We intend to systematically weigh and analyze the existing evidence of HCQ in the light of published and pre-print data available so far. Methods: PubMed Ovid MEDLINE, EMBASE, Google scholar databases and official clinical trial Registries of the United States, China, WHO ICTRP were electronically searched for studies for the use of HCQ in patients with COVID-19. Pre-proof article repositories like MedRxiv, BioRxiv, and ChemRxiv were also included in the search. The literature was critically appraised. Results: Total 71 articles were available as of 15 th April of which articles of relevance (three invitro studies, two open label non-randomized trials, two open label randomized control trials, one follow-up study, three reviews, ten short communications) and 88 clinical trials registered in three clinical trial registries were analyzed. HCQ seems to be efficient in inhibiting of SARS-CoV-2 in in-vitro cell lines; there is lack of strong evidence from human studies. Conclusions: The in-vitro cell culture based data of viral inhibition does not suffice for the use of hydroxychloroquine in the patients with COVID-19. Currently literature shows inadequate, low level evidence in human studies. Scarcity of safety and efficacy data warrants medical communities, health care agencies and governments across the world against the widespread use of HCQ in COVID-19 prophylaxis and treatment, until robust evidence becomes available.
Status of chloroquine and hydroxychloroquine in COVID-19 infection
International Journal of Basic & Clinical Pharmacology, 2020
COVID-19 causing virus is a single stranded RNA virus which has spread across the globe causing human respiratory tract infection. The novel virus which started from Wuhan was named as Wuhan coronavirus or 2019 novel corona virus (2019-nCov) by the Chinese researchers. The international committee on taxonomy of viruses named the virus as SARS-CoV-2 and the disease as COVID-19. There is preliminary in vitro evidence of the ability of CQ and HCQ to inhibit SARS-CoV-2 activity. Various small group clinical studies conducted in china indicated efficacy of chloroquine and hydroxychloroquine in Covid-19 cases but results were inconclusive. Based on these studies national agencies in various countries issued guidelines mentioning that chloroquine and Hydroxychloroquine are only to be used in clinical trials or emergency use programs. However, USFDA does not recommend use of both these drugs for treatment of COVID-19 cases. Chloroquine and hydroxychloroquine are known to produce dose depend...
Chloroquine and hydroxychloroquine as potential therapies against COVID-19
2020
The desperate search to find effective treatments for coronavirus disease 2019 (COVID-19), 2 generic drugs, used largely by rheumatologists and dermatologists to treat immune-mediated diseases, have entered the spotlight. The antimalarials hydroxychloroquine (HCQ) and chloroquine (CQ) have demonstrated antiviral activity against severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) in vitro and in small, poorly controlled or uncontrolled clinical studies (1-3). Normally, such research would be deemed hypothesis-generating at best. Here, we try to provide guidance regarding clinical decision making both for patients with COVID-19 and those with immune-mediated conditions, such as systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA), and strategies to mitigate further harm to these patients. Index terms-chloroquine clinical research clinical trials corona virus in COVID-19 disease & medicine hydroxychloroquine malaria nut shell SARS-CoV-2
Is hydroxychloroquine beneficial for COVID-19 patients?
Cell Death & Disease
The outbreak of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was first reported in December 2019. As similar cases rapidly emerged around the world1–3, the World Health Organization (WHO) declared a public health emergency of international concern on January 30, 2020 and pronounced the rapidly spreading coronavirus outbreak as a pandemic on March 11, 20204. The virus has reached almost all countries of the globe. As of June 3, 2020, the accumulated confirmed cases reached 6,479,405 with more than 383,013 deaths worldwide. The urgent and emergency care of COVID-19 patients calls for effective drugs, in addition to the beneficial effects of remdesivir5, to control the disease and halt the pandemic.
CMAJ Open, 2021
E ighteen years ago, the severe acute respiratory syndrome (SARS) experience 1-5 highlighted limited knowledge of early treatments for novel pandemic respiratory viruses. With the emergence of SARS-CoV-2, early experience in Wuhan, 6 the Lombardy region of Italy 7,8 and New York City 9 demonstrated the need to suppress severe disease to prevent health system collapse. Hydroxychloroquine, derived from the centuries-old antimalarial medicine quinine, has broad antiviral effects and immunomodulatory properties, making it an attractive candidate to be repurposed for SARS-CoV-2 infection. The precise mechanisms of immunomodulation are uncertain, but the net result is inhibition of macrophage production of proinflammatory cytokines tumor necrosis factor (TNF)-α and Assessing the efficacy and safety of hydroxychloroquine as outpatient treatment of COVID-19: a randomized controlled trial
A Perspective Approach Of Hydroxychloroquine In The Treatment for Covid-19
American Journal of Pharmacy And Health Research, 2020
Hydroxychloroquine is used in the treatment of malaria due to its pharmacological activity and with minimal adverse effects. Hydroxychloroquine is used in treatment of the diseases like rheumatoid arthritis and lupus erythematosus. In some countries, it is also indicated in the prevention or treatment of malaria. It has been developed in the 1950s from chloroquine, an old anti-malarial drug. COVID-19 is a highly contagious disease, transmitted through respiratory droplets by affected person through sneezing, coughing, talking, which also spread by touching a contaminated surface or may object. The person infected with the disease shows flu-like symptoms such as fever, muscle pain, cough and sore throat in five to six days after infection, while some patients may remain asymptomatic carriers. The disease further develops severe pneumonia in the patients. The mortality rate is high in patients with underlying conditions and those aged 60 years and above. This review complies about the mechanism, precautions, toxicity, ongoing trials of hydroxychloroquine and their medicinal usage.
Hydroxychloroquine in COVID-19: therapeutic promises, current status, and environmental implications
Environmental Science and Pollution Research
The outbreak of novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has affected the entire world with its infectious spread and mortality rate. The severe cases of coronavirus disease 2019 (COVID-19) are characterized by hypoxia and acute respiratory distress syndrome. In the absence of any specific treatment, just the preventive and supportive care options are available. Therefore, much focus is given to assess the available therapeutic options not only to avoid acute respiratory failure and hypoxia but also to reduce the viral load to control the severity of the disease. The antimalarial drug hydroxychloroquine (HCQ) is among the much-discussed drugs for the treatment and management of COVID-19 patients. This article reviews the therapeutic potential of HCQ in the treatment of COVID-19 based on the available in vitro and clinical evidence, current status of registered HCQ-based clinical trials investigating therapeutic options for COVID-19, and environmental implications of HCQ.
Chloroquineand hydroxychloroquine in covid 19: asystematic review
2020
Since 100 years, current coronavirus pandemic (COVID - 19) caused by SARS - CoV - 2 is themost dangerous healthcare crisis and unprecedented in absense of prophylactic or therapeutic drugs. The world's major health systems have had no large - scale therapeutic choice and at an acceptable cost apart from Chloroquine (CQ) and its derivative hydroxychlo roquine (HCQ) to treat Covid - 19.These drugs have anti - inflammatory activity and are already used to treat rheumatoid arthritis, lupus. However, these drugs have raised a great worldwide controversy between the pros and cons of their uses to treat patients with Covid - 19 In these systematic review, we analyzed articles published until 28 august in pubmed, sciences direct and ClinicalTrials.gov by using these keywords: chloroquine and COVID - 19 or hydroxychloroquine and COVID - 19. these online preprint publicat ions have offered inconclusive preliminary results as well as clinical trials not yet finished. Although CQ / HCQ have...