Hydroxychloroquine and chloroquine for treatment of coronavirus disease 19 (COVID-19) : a systematic review and meta-analysis of randomized and non-randomized controlled trials
2021 Journal of Thoracic Disease. All rights reserved..
BACKGROUND: Although the US government approved hydroxychloroquine (HCQ) and chloroquine (CQ) for hospitalized coronavirus disease 19 (COVID-19) patients, some studies denied efficacy of HCQ and CQ. We aimed to evaluate HCQ/CQ treatment for COVID-19.
METHODS: Five databases were searched on April 15, 2020, without publication date restriction. We followed both Preferred Reporting Items for Systematic Reviews and Meta-analyses and Meta-analysis of Observational Studies in Epidemiology statement reporting recommendations. A random-model meta-analysis was conducted to pool odds ratio (OR) and hazard ratio (HR). The quality of evidence for each outcome and the final recommendation was assessed using the GRADE guidelines of the American College of Chest Physicians.
RESULTS: We identified four randomized controlled trials (RCTs) and four observational studies with 2,063 COVID-19 cases. All-cause mortality was not affected by the administration of HCQ/CQ [OR: 1.05, 95% confidence interval (CI): 0.53-2.09, P=0.89]. No improvement of viral clearance was found neither by time-to-event analysis (HR: 1.19, 95% CI: 0.74-1.94, P=0.47) nor frequency on day 7 (OR: 1.47, 95% CI: 0.33-6.63, P=0.62). HCQ/CQ treatment increased the risk of the any adverse event with OR of 3.56 (95% CI: 1.62-7.83, P=0.002).
CONCLUSIONS: HCQ/CQ failed to decrease the all-cause mortality (very low quality evidence) and did not improve viral clearance (low or very low quality evidence) but increased the risk of any adverse event (moderate quality evidence). Routine administration of HCQ/CQ for COVID-19 patients is not recommended (weak recommendation, Grade 2C).
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2021 |
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| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:13 |
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| Enthalten in: |
Journal of thoracic disease - 13(2021), 1 vom: 15. Jan., Seite 202-212 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Ebina-Shibuya, Risa [VerfasserIn] |
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| Links: |
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| Themen: |
Aminoquinolines |
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| Anmerkungen: |
Date Revised 20.04.2022 published: Print Citation Status PubMed-not-MEDLINE |
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| doi: |
10.21037/jtd-20-2022 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM321293029 |
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| 245 | 1 | 0 | |a Hydroxychloroquine and chloroquine for treatment of coronavirus disease 19 (COVID-19) |b a systematic review and meta-analysis of randomized and non-randomized controlled trials |
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| 500 | |a Citation Status PubMed-not-MEDLINE | ||
| 520 | |a 2021 Journal of Thoracic Disease. All rights reserved. | ||
| 520 | |a BACKGROUND: Although the US government approved hydroxychloroquine (HCQ) and chloroquine (CQ) for hospitalized coronavirus disease 19 (COVID-19) patients, some studies denied efficacy of HCQ and CQ. We aimed to evaluate HCQ/CQ treatment for COVID-19 | ||
| 520 | |a METHODS: Five databases were searched on April 15, 2020, without publication date restriction. We followed both Preferred Reporting Items for Systematic Reviews and Meta-analyses and Meta-analysis of Observational Studies in Epidemiology statement reporting recommendations. A random-model meta-analysis was conducted to pool odds ratio (OR) and hazard ratio (HR). The quality of evidence for each outcome and the final recommendation was assessed using the GRADE guidelines of the American College of Chest Physicians | ||
| 520 | |a RESULTS: We identified four randomized controlled trials (RCTs) and four observational studies with 2,063 COVID-19 cases. All-cause mortality was not affected by the administration of HCQ/CQ [OR: 1.05, 95% confidence interval (CI): 0.53-2.09, P=0.89]. No improvement of viral clearance was found neither by time-to-event analysis (HR: 1.19, 95% CI: 0.74-1.94, P=0.47) nor frequency on day 7 (OR: 1.47, 95% CI: 0.33-6.63, P=0.62). HCQ/CQ treatment increased the risk of the any adverse event with OR of 3.56 (95% CI: 1.62-7.83, P=0.002) | ||
| 520 | |a CONCLUSIONS: HCQ/CQ failed to decrease the all-cause mortality (very low quality evidence) and did not improve viral clearance (low or very low quality evidence) but increased the risk of any adverse event (moderate quality evidence). Routine administration of HCQ/CQ for COVID-19 patients is not recommended (weak recommendation, Grade 2C) | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Virus diseases | |
| 650 | 4 | |a aminoquinolines | |
| 650 | 4 | |a coronavirus disease 19 (COVID-19) | |
| 650 | 4 | |a drug approval | |
| 650 | 4 | |a evidence-based medicine | |
| 650 | 4 | |a policy making | |
| 700 | 1 | |a Namkoong, Ho |e verfasserin |4 aut | |
| 700 | 1 | |a Horita, Nobuyuki |e verfasserin |4 aut | |
| 700 | 1 | |a Kato, Hideaki |e verfasserin |4 aut | |
| 700 | 1 | |a Hara, Yu |e verfasserin |4 aut | |
| 700 | 1 | |a Kobayashi, Nobuaki |e verfasserin |4 aut | |
| 700 | 1 | |a Kaneko, Takeshi |e verfasserin |4 aut | |
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