Article1 min read·Published Dec 2020Older

A systematic review and meta-analysis on chloroquine and hydroxychloroquine as monotherapy or combined with azithromycin in COVID-19 treatment

Part of COVID-19 Pandemic Response and Vaccine Research 5 items

pubmed.ncbi.nlm.nih.gov

Ramy Shaaban

Many recent studies have investigated the role of either Chloroquine (CQ) or Hydroxychloroquine (HCQ) alone or in combination with azithromycin (AZM) in the management of the emerging coronavirus. This systematic review and meta-analysis of either published or preprint observational studies or randomized control trials (RCT) aimed to assess mortality rate, duration of hospital stay, need for mechanical ventilation (MV), virologic cure rate (VQR), time to a negative viral polymerase chain reaction (PCR), radiological progression, experiencing drug side effects, and clinical worsening. A search of the online database through June 2020 was performed and examined the reference lists of pertinent articles for in-vivo studies only. Pooled relative risks (RRs), standard mean differences of 95% confidence intervals (CIs) were calculated with the random-effects model. Mortality was not different between the standard care (SC) and HCQ groups (RR = 0.99, 95% CI 0.61-1.59, I2 = 82%), meta-regression analysis proved that mortality was significantly different across the studies from different countries. However, mortality among the HCQ + AZM was significantly higher than among the SC (RR = 1.8, 95% CI 1.19-2.27, I2 = 70%). The duration of hospital stay in days was shorter in the SC in comparison with the HCQ group (standard mean difference = 0.57, 95% CI 0.20-0.94, I2 = 92%), or the HCQ + AZM (standard mean difference = 0.77, 95% CI 0.46-1.08, I2 = 81). Overall VQR, and that at days 4, 10,

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Article · Dec 2020 · 1 min read

In brief

Meta-analysis of COVID-19 studies found hydroxychloroquine monotherapy showed no mortality benefit versus standard care, while hydroxychloroquine plus azithromycin significantly increased mortality risk. Both treatment regimens were associated with longer hospital stays compared to standard care alone.

Written by the GCMD Library team from the article.

Ramy Shaaban

Statements in this article

Mortality was not different between standard care and hydroxychloroquine groups (RR = 0.99, 95% CI 0.61-1.59, I2 = 82%).
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Meta-regression analysis proved that mortality was significantly different across studies from different countries.
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Mortality among the hydroxychloroquine plus azithromycin group was significantly higher than among standard care (RR = 1.8, 95% CI 1.19-2.27, I2 = 70%).
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Duration of hospital stay in days was shorter in standard care compared with the hydroxychloroquine group (standard mean difference = 0.57, 95% CI 0.20-0.94, I2 = 92%).
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Duration of hospital stay was shorter in standard care compared with hydroxychloroquine plus azithromycin (standard mean difference = 0.77, 95% CI 0.46-1.08, I2 = 81%).
Research