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RESEARCH PRODUCT
Update I. A systematic review on the efficacy and safety of chloroquine/hydroxychloroquine for COVID-19
Antonino GiarratanoPasquale IozzoAndrea CortegianiSharon EinavMariachiara IppolitoGiulia Ingogliasubject
ICU Intensive care unit;medicine.medical_treatmentCritical Care and Intensive Care MedicineRR Risk Ratio0302 clinical medicineChloroquineRCT Randomized clinical trialMedicineHCQ Hydroxychloroquine;Prospective StudiesProspective cohort studyChloroquine COVID-19 Hydroxychloroquine Mortality SARS-CoV-2ChloroquineECG Electrocardiogram;Rob2 Revised tool for Risk of Bias in randomized trials;CI Confidence interval;Coronavirus InfectionsPost-Exposure ProphylaxisHydroxychloroquinemedicine.drugmedicine.medical_specialtyCoronavirus disease 2019 (COVID-19)Pneumonia ViralMEDLINEContext (language use)Antiviral AgentsArticleWHO World Health OrganizationBetacoronavirus03 medical and health sciencesInternal medicineHumansMortalityCOVID-19 Coronavirus disease 2019;Post-exposure prophylaxisPandemicsRetrospective StudiesCQ Chloroquine;SARS-CoV-2ROBINS-I Risk of Bias in Non-randomized Studies of Interventions;business.industryCOVID-19030208 emergency & critical care medicineHydroxychloroquineRetrospective cohort studyHCWs Healthcare workers;NOS Newcastle Ottawa Scale;COVID-19 Drug Treatment030228 respiratory systembusinessHR Hazard Ratio;description
Purpose To assess efficacy and safety of chloroquine (CQ)/hydroxychloroquine (HCQ) for treatment or prophylaxis of COVID-19 in adult humans. Materials and methods MEDLINE, PubMed, EMBASE and two pre-print repositories (bioRxiv, medRxiv) were searched from inception to 8th June 2020 for RCTs and nonrandomized studies (retrospective and prospective, including single-arm, studies) addressing the use of CQ/HCQ in any dose or combination for COVID-19. Results Thirty-two studies were included (6 RCTs, 26 nonrandomized, 29,192 participants). Two RCTs had high risk, two ‘some concerns’ and two low risk of bias (Rob2). Among nonrandomized studies with comparators, nine had high risk and five moderate risk of bias (ROBINS-I). Data synthesis was not possible. Low and moderate risk of bias studies suggest that treatment of hospitalized COVID-19 with CQ/HCQ may not reduce risk of death, compared to standard care. High dose regimens or combination with macrolides may be associated with harm. Postexposure prophylaxis may not reduce the rate of infection but the quality of the evidence is low. Conclusions Patients with COVID-19 should be treated with CQ/HCQ only if monitored and within the context of high quality RCTs. High quality data about efficacy/safety are urgently needed.
| year | journal | country | edition | language |
|---|---|---|---|---|
| 2020-10-01 | Journal of Critical Care |