No benefit of hydroxychloroquine in COVID-19: Results of Systematic Review and Meta-Analysis of Randomized Controlled Trials”

Abstract

Background and aims Coronavirus pandemic is currently a global public health emergency with no definitive treatment guidelines. We conducted a systematic review and meta-analysis of the literature evaluating the efficacy of hydroxychloroquine and its related formulations in COVID-19 patients. Methods A systematic search of PubMed, Scopus, MedRxiv data and Cochrane Central Register of Clinical Trials for published articles that reported the outcomes of COVID-19 patients treated with hydroxychloroquine or its compounds was done. We identified 1071 published studies and 7 studies were included in the analysis. Results The study population consisted of a total of 4984 patients, of which 1721 (34.5%) received hydroxychloroquine or its congeners (HCQ group) while 3091 (62.01%) received standard of care or had included antiviral medication (control group). The pooled estimate of successful treatment in the hydroxychloroquine group and the control group was 77.45% and 77.87% respectively, which indicated similar clinical outcomes in patients treated with hydroxychloroquine compared to the control group. The odds ratio of a favourable outcome with hydroxychloroquine was 1.11 (95 CI 0.72 to 1.69) (p = 0.20). The pooled risk difference of favourable outcome with hydroxychloroquine versus control group was 0.00 (95 CI -0.03 to 0.03) which was statistically not significant (p = 0.10). Conclusions : The present evidence shows no benefit of hydroxychloroquine in patients affected by mild to moderate COVID-19 disease. However, now several trials on HCQ are ongoing and hopefully more data will be available soon. Hence, the management of COVID-19 is set to change for better in the future.

Hydroxychloroquine with azithromycin in patients hospitalized for mild and moderate COVID-19

“…Our findings are also consistent with recent published meta-analyses assessing the outcomes of COVID-19 patients treated with hydroxychloroquine as monotherapy or combined with azithromycin that showed no benefit in mild to moderate disease. 27 , 28 , 29…”

The Role of Methemoglobin and Carboxyhemoglobin in COVID-19: A Review

“…Chloroquine is such a drug for which reports were published regarding induced methemoglobinemia due to its intake [ 29 , 30 , 31 ]. Both chloroquine and hydroxychloroquine (a derivative of chloroquine) are currently used to treat COVID-19, while debate is ongoing about their effectiveness and safety [ 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 ]. Moderately certain evidence suggests that hydroxychloroquine lacks efficacy in reducing short-term mortality in patients hospitalized with COVID-19 or at risk of hospitalization in outpatients with COVID-19.…”

Molecular mechanism, diagnosis, and potential treatment for novel coronavirus (COVID-19): a current literature review and perspective

“… Therapeutic drug Common name Target Comments/significance References 1 Chloroquine derives hydroxy-chloroquine Aralen/plaquenil SARS-CoV 2 More useful to improve clinical and virological outcomes. But reduce mortality Million et al ( 2020 ), Pathak et al ( 2020 ), Siemieniuk et al ( 2020 ) 2 Dexamethasone Decadron SARS-CoV 2 Risk of mortality and benefits for severing clinical condition patients Abeldano Zuniga et al ( 2020 ), Siemieniuk et al ( 2020 ) 3 Lopinavir-Ritonavir Kaletra HIV, SARS-CoV 2 Risk of mortality, adverse events Abeldano Zuniga et al ( 2020 ), Siemieniuk et al ( 2020 ) 4 Remdesivir with placebo Veklury Ebola, COVID-19 Risk of mortality Abeldano Zuniga et al ( 2020 ), Siemieniuk et al ( 2020 ) 5 Hydroxy-chloroquine with azithromycin Aralen/plaquenil and zitromax SARS-CoV 2 Not alter the rate of risk of virologic cure and risk of mortality, Not different from hydroxy-chloroquine alone Ayele Mega et al ( 2020 ), Chen et al ( 2020c ), (Tang et al ( 2020 ), Fiolet et al ( 2020 ), Abeldano Zuniga et al ( 2020 ), Siemieniuk et al ( 2020 ) 6 Tolicizumab Actemra …”