Clinical efficacy of chloroquine derivatives in COVID-19 infection: comparative meta-analysis between the big data and the real world.
Identifieur interne : 000972 ( Main/Corpus ); précédent : 000971; suivant : 000973Clinical efficacy of chloroquine derivatives in COVID-19 infection: comparative meta-analysis between the big data and the real world.
Auteurs : M. Million ; P. Gautret ; P. Colson ; Y. Roussel ; G. Dubourg ; E. Chabriere ; S. Honore ; J-M Rolain ; F. Fenollar ; P-E Fournier ; J-C Lagier ; P. Parola ; P. Brouqui ; D. RaoultSource :
- New microbes and new infections [ 2052-2975 ] ; 2020.
Abstract
In the context of the current coronavirus disease 2019 (COVID-19) pandemic, we conducted a meta-analysis on the effects of chloroquine derivatives in patients, based on unpublished and published reports available publicly on the internet as of 27 May 2020. The keywords 'hydroxychloroquine', 'chloroquine', 'coronavirus', 'COVID-19' and 'SARS-Cov-2' were used in the PubMed, Google Scholar and Google search engines without any restrictions as to date or language. Twenty studies were identified involving 105 040 patients (19 270 treated patients) from nine countries (Brazil, China, France, Iran, Saudi Arabia, South Korea, Spain and the USA). Big data observational studies were associated with conflict of interest, lack of treatment dosage and duration, and absence of favourable outcome. Clinical studies were associated with favourable outcomes and details on therapy. Among clinical studies, three of four randomized controlled trials reported a significant favourable effect. Among clinical studies, a significant favourable summary effect was observed for duration of cough (OR 0.19, p 0.00003), duration of fever (OR 0.11, p 0.039), clinical cure (OR 0.21, p 0.0495), death (OR 0.32, p 4.1 × 10-6) and viral shedding (OR 0.43, p 0.031). A trend for a favourable effect was noted for the outcome 'death and/or intensive care unit transfer' (OR 0.29, p 0.069) with a point estimate remarkably similar to that observed for death (∼0.3). In conclusion, a meta-analysis of publicly available clinical reports demonstrates that chloroquine derivatives are effective to improve clinical and virological outcomes, but, more importantly, they reduce mortality by a factor of 3 in patients with COVID-19. Big data are lacking basic treatment definitions and are linked to conflict of interest. The retraction of the only big data study associated with a significantly deleterious effect the day after (June 5, 2020) the acceptance of the present work (June 4, 2020) confirms the relevance of this work.
DOI: 10.1016/j.nmni.2020.100709
PubMed: 33088574
PubMed Central: PMC7558783
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Clinical efficacy of chloroquine derivatives in COVID-19 infection: comparative meta-analysis between the big data and the real world.</title><author><name sortKey="Million, M" sort="Million, M" uniqKey="Million M" first="M" last="Million">M. Million</name><affiliation><nlm:affiliation>IHU-Méditerranée Infection, Marseille, France.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Aix Marseille Université, IRD, AP-HM, MEPHI, Marseille, France.</nlm:affiliation></affiliation></author><author><name sortKey="Gautret, P" sort="Gautret, P" uniqKey="Gautret P" first="P" last="Gautret">P. Gautret</name><affiliation><nlm:affiliation>IHU-Méditerranée Infection, Marseille, France.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Aix Marseille Université, IRD, AP-HM, SSA, VITROME, Marseille, France.</nlm:affiliation></affiliation></author><author><name sortKey="Colson, P" sort="Colson, P" uniqKey="Colson P" first="P" last="Colson">P. Colson</name><affiliation><nlm:affiliation>IHU-Méditerranée Infection, Marseille, France.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Aix Marseille Université, IRD, AP-HM, MEPHI, Marseille, France.</nlm:affiliation></affiliation></author><author><name sortKey="Roussel, Y" sort="Roussel, Y" uniqKey="Roussel Y" first="Y" last="Roussel">Y. Roussel</name><affiliation><nlm:affiliation>IHU-Méditerranée Infection, Marseille, France.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Aix Marseille Université, IRD, AP-HM, MEPHI, Marseille, France.</nlm:affiliation></affiliation></author><author><name sortKey="Dubourg, G" sort="Dubourg, G" uniqKey="Dubourg G" first="G" last="Dubourg">G. Dubourg</name><affiliation><nlm:affiliation>IHU-Méditerranée Infection, Marseille, France.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Aix Marseille Université, IRD, AP-HM, MEPHI, Marseille, France.</nlm:affiliation></affiliation></author><author><name sortKey="Chabriere, E" sort="Chabriere, E" uniqKey="Chabriere E" first="E" last="Chabriere">E. 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Fenollar</name><affiliation><nlm:affiliation>IHU-Méditerranée Infection, Marseille, France.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Aix Marseille Université, IRD, AP-HM, SSA, VITROME, Marseille, France.</nlm:affiliation></affiliation></author><author><name sortKey="Fournier, P E" sort="Fournier, P E" uniqKey="Fournier P" first="P-E" last="Fournier">P-E Fournier</name><affiliation><nlm:affiliation>IHU-Méditerranée Infection, Marseille, France.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Aix Marseille Université, IRD, AP-HM, SSA, VITROME, Marseille, France.</nlm:affiliation></affiliation></author><author><name sortKey="Lagier, J C" sort="Lagier, J C" uniqKey="Lagier J" first="J-C" last="Lagier">J-C Lagier</name><affiliation><nlm:affiliation>IHU-Méditerranée Infection, Marseille, France.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Aix Marseille Université, IRD, AP-HM, MEPHI, Marseille, France.</nlm:affiliation></affiliation></author><author><name sortKey="Parola, P" sort="Parola, P" uniqKey="Parola P" first="P" last="Parola">P. Parola</name><affiliation><nlm:affiliation>IHU-Méditerranée Infection, Marseille, France.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Aix Marseille Université, IRD, AP-HM, SSA, VITROME, Marseille, France.</nlm:affiliation></affiliation></author><author><name sortKey="Brouqui, P" sort="Brouqui, P" uniqKey="Brouqui P" first="P" last="Brouqui">P. Brouqui</name><affiliation><nlm:affiliation>IHU-Méditerranée Infection, Marseille, France.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Aix Marseille Université, IRD, AP-HM, MEPHI, Marseille, France.</nlm:affiliation></affiliation></author><author><name sortKey="Raoult, D" sort="Raoult, D" uniqKey="Raoult D" first="D" last="Raoult">D. Raoult</name><affiliation><nlm:affiliation>IHU-Méditerranée Infection, Marseille, France.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Aix Marseille Université, IRD, AP-HM, MEPHI, Marseille, France.</nlm:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2020">2020</date><idno type="RBID">pubmed:33088574</idno><idno type="pmid">33088574</idno><idno type="doi">10.1016/j.nmni.2020.100709</idno><idno type="pmc">PMC7558783</idno><idno type="wicri:Area/Main/Corpus">000972</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Corpus" wicri:corpus="PubMed">000972</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Clinical efficacy of chloroquine derivatives in COVID-19 infection: comparative meta-analysis between the big data and the real world.</title><author><name sortKey="Million, M" sort="Million, M" uniqKey="Million M" first="M" last="Million">M. Million</name><affiliation><nlm:affiliation>IHU-Méditerranée Infection, Marseille, France.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Aix Marseille Université, IRD, AP-HM, MEPHI, Marseille, France.</nlm:affiliation></affiliation></author><author><name sortKey="Gautret, P" sort="Gautret, P" uniqKey="Gautret P" first="P" last="Gautret">P. Gautret</name><affiliation><nlm:affiliation>IHU-Méditerranée Infection, Marseille, France.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Aix Marseille Université, IRD, AP-HM, SSA, VITROME, Marseille, France.</nlm:affiliation></affiliation></author><author><name sortKey="Colson, P" sort="Colson, P" uniqKey="Colson P" first="P" last="Colson">P. Colson</name><affiliation><nlm:affiliation>IHU-Méditerranée Infection, Marseille, France.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Aix Marseille Université, IRD, AP-HM, MEPHI, Marseille, France.</nlm:affiliation></affiliation></author><author><name sortKey="Roussel, Y" sort="Roussel, Y" uniqKey="Roussel Y" first="Y" last="Roussel">Y. Roussel</name><affiliation><nlm:affiliation>IHU-Méditerranée Infection, Marseille, France.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Aix Marseille Université, IRD, AP-HM, MEPHI, Marseille, France.</nlm:affiliation></affiliation></author><author><name sortKey="Dubourg, G" sort="Dubourg, G" uniqKey="Dubourg G" first="G" last="Dubourg">G. Dubourg</name><affiliation><nlm:affiliation>IHU-Méditerranée Infection, Marseille, France.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Aix Marseille Université, IRD, AP-HM, MEPHI, Marseille, France.</nlm:affiliation></affiliation></author><author><name sortKey="Chabriere, E" sort="Chabriere, E" uniqKey="Chabriere E" first="E" last="Chabriere">E. Chabriere</name><affiliation><nlm:affiliation>IHU-Méditerranée Infection, Marseille, France.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Aix Marseille Université, IRD, AP-HM, MEPHI, Marseille, France.</nlm:affiliation></affiliation></author><author><name sortKey="Honore, S" sort="Honore, S" uniqKey="Honore S" first="S" last="Honore">S. Honore</name><affiliation><nlm:affiliation>Service de Pharmacie, Hôpital Timone, AP-HM, Marseille, France.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Laboratoire de Pharmacie Clinique, Aix Marseille Université, Marseille, France.</nlm:affiliation></affiliation></author><author><name sortKey="Rolain, J M" sort="Rolain, J M" uniqKey="Rolain J" first="J-M" last="Rolain">J-M Rolain</name><affiliation><nlm:affiliation>IHU-Méditerranée Infection, Marseille, France.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Aix Marseille Université, IRD, AP-HM, MEPHI, Marseille, France.</nlm:affiliation></affiliation></author><author><name sortKey="Fenollar, F" sort="Fenollar, F" uniqKey="Fenollar F" first="F" last="Fenollar">F. Fenollar</name><affiliation><nlm:affiliation>IHU-Méditerranée Infection, Marseille, France.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Aix Marseille Université, IRD, AP-HM, SSA, VITROME, Marseille, France.</nlm:affiliation></affiliation></author><author><name sortKey="Fournier, P E" sort="Fournier, P E" uniqKey="Fournier P" first="P-E" last="Fournier">P-E Fournier</name><affiliation><nlm:affiliation>IHU-Méditerranée Infection, Marseille, France.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Aix Marseille Université, IRD, AP-HM, SSA, VITROME, Marseille, France.</nlm:affiliation></affiliation></author><author><name sortKey="Lagier, J C" sort="Lagier, J C" uniqKey="Lagier J" first="J-C" last="Lagier">J-C Lagier</name><affiliation><nlm:affiliation>IHU-Méditerranée Infection, Marseille, France.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Aix Marseille Université, IRD, AP-HM, MEPHI, Marseille, France.</nlm:affiliation></affiliation></author><author><name sortKey="Parola, P" sort="Parola, P" uniqKey="Parola P" first="P" last="Parola">P. Parola</name><affiliation><nlm:affiliation>IHU-Méditerranée Infection, Marseille, France.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Aix Marseille Université, IRD, AP-HM, SSA, VITROME, Marseille, France.</nlm:affiliation></affiliation></author><author><name sortKey="Brouqui, P" sort="Brouqui, P" uniqKey="Brouqui P" first="P" last="Brouqui">P. Brouqui</name><affiliation><nlm:affiliation>IHU-Méditerranée Infection, Marseille, France.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Aix Marseille Université, IRD, AP-HM, MEPHI, Marseille, France.</nlm:affiliation></affiliation></author><author><name sortKey="Raoult, D" sort="Raoult, D" uniqKey="Raoult D" first="D" last="Raoult">D. Raoult</name><affiliation><nlm:affiliation>IHU-Méditerranée Infection, Marseille, France.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Aix Marseille Université, IRD, AP-HM, MEPHI, Marseille, France.</nlm:affiliation></affiliation></author></analytic><series><title level="j">New microbes and new infections</title><idno type="ISSN">2052-2975</idno><imprint><date when="2020" type="published">2020</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">In the context of the current coronavirus disease 2019 (COVID-19) pandemic, we conducted a meta-analysis on the effects of chloroquine derivatives in patients, based on unpublished and published reports available publicly on the internet as of 27 May 2020. The keywords 'hydroxychloroquine', 'chloroquine', 'coronavirus', 'COVID-19' and 'SARS-Cov-2' were used in the PubMed, Google Scholar and Google search engines without any restrictions as to date or language. Twenty studies were identified involving 105 040 patients (19 270 treated patients) from nine countries (Brazil, China, France, Iran, Saudi Arabia, South Korea, Spain and the USA). Big data observational studies were associated with conflict of interest, lack of treatment dosage and duration, and absence of favourable outcome. Clinical studies were associated with favourable outcomes and details on therapy. Among clinical studies, three of four randomized controlled trials reported a significant favourable effect. Among clinical studies, a significant favourable summary effect was observed for duration of cough (OR 0.19, p 0.00003), duration of fever (OR 0.11, p 0.039), clinical cure (OR 0.21, p 0.0495), death (OR 0.32, p 4.1 × 10<sup>-6</sup>) and viral shedding (OR 0.43, p 0.031). A trend for a favourable effect was noted for the outcome 'death and/or intensive care unit transfer' (OR 0.29, p 0.069) with a point estimate remarkably similar to that observed for death (∼0.3). In conclusion, a meta-analysis of publicly available clinical reports demonstrates that chloroquine derivatives are effective to improve clinical and virological outcomes, but, more importantly, they reduce mortality by a factor of 3 in patients with COVID-19. Big data are lacking basic treatment definitions and are linked to conflict of interest. The retraction of the only big data study associated with a significantly deleterious effect the day after (June 5, 2020) the acceptance of the present work (June 4, 2020) confirms the relevance of this work.</div></front></TEI><pubmed><MedlineCitation Status="PubMed-not-MEDLINE" Owner="NLM"><PMID Version="1">33088574</PMID><DateRevised><Year>2020</Year><Month>10</Month><Day>23</Day></DateRevised><Article PubModel="Electronic-eCollection"><Journal><ISSN IssnType="Print">2052-2975</ISSN><JournalIssue CitedMedium="Print"><Volume>38</Volume><PubDate><Year>2020</Year><Month>Nov</Month></PubDate></JournalIssue><Title>New microbes and new infections</Title><ISOAbbreviation>New Microbes New Infect</ISOAbbreviation></Journal><ArticleTitle>Clinical efficacy of chloroquine derivatives in COVID-19 infection: comparative meta-analysis between the big data and the real world.</ArticleTitle><Pagination><MedlinePgn>100709</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1016/j.nmni.2020.100709</ELocationID><Abstract><AbstractText>In the context of the current coronavirus disease 2019 (COVID-19) pandemic, we conducted a meta-analysis on the effects of chloroquine derivatives in patients, based on unpublished and published reports available publicly on the internet as of 27 May 2020. The keywords 'hydroxychloroquine', 'chloroquine', 'coronavirus', 'COVID-19' and 'SARS-Cov-2' were used in the PubMed, Google Scholar and Google search engines without any restrictions as to date or language. Twenty studies were identified involving 105 040 patients (19 270 treated patients) from nine countries (Brazil, China, France, Iran, Saudi Arabia, South Korea, Spain and the USA). Big data observational studies were associated with conflict of interest, lack of treatment dosage and duration, and absence of favourable outcome. Clinical studies were associated with favourable outcomes and details on therapy. Among clinical studies, three of four randomized controlled trials reported a significant favourable effect. Among clinical studies, a significant favourable summary effect was observed for duration of cough (OR 0.19, p 0.00003), duration of fever (OR 0.11, p 0.039), clinical cure (OR 0.21, p 0.0495), death (OR 0.32, p 4.1 × 10<sup>-6</sup>) and viral shedding (OR 0.43, p 0.031). A trend for a favourable effect was noted for the outcome 'death and/or intensive care unit transfer' (OR 0.29, p 0.069) with a point estimate remarkably similar to that observed for death (∼0.3). In conclusion, a meta-analysis of publicly available clinical reports demonstrates that chloroquine derivatives are effective to improve clinical and virological outcomes, but, more importantly, they reduce mortality by a factor of 3 in patients with COVID-19. Big data are lacking basic treatment definitions and are linked to conflict of interest. The retraction of the only big data study associated with a significantly deleterious effect the day after (June 5, 2020) the acceptance of the present work (June 4, 2020) confirms the relevance of this work.</AbstractText><CopyrightInformation>© 2020 The Author(s).</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Million</LastName><ForeName>M</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>IHU-Méditerranée Infection, Marseille, France.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Aix Marseille Université, IRD, AP-HM, MEPHI, Marseille, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Gautret</LastName><ForeName>P</ForeName><Initials>P</Initials><AffiliationInfo><Affiliation>IHU-Méditerranée Infection, Marseille, France.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Aix Marseille Université, IRD, AP-HM, SSA, VITROME, Marseille, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Colson</LastName><ForeName>P</ForeName><Initials>P</Initials><AffiliationInfo><Affiliation>IHU-Méditerranée Infection, Marseille, France.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Aix Marseille Université, IRD, AP-HM, MEPHI, Marseille, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Roussel</LastName><ForeName>Y</ForeName><Initials>Y</Initials><AffiliationInfo><Affiliation>IHU-Méditerranée Infection, Marseille, France.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Aix Marseille Université, IRD, AP-HM, MEPHI, Marseille, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Dubourg</LastName><ForeName>G</ForeName><Initials>G</Initials><AffiliationInfo><Affiliation>IHU-Méditerranée Infection, Marseille, France.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Aix Marseille Université, IRD, AP-HM, MEPHI, Marseille, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Chabriere</LastName><ForeName>E</ForeName><Initials>E</Initials><AffiliationInfo><Affiliation>IHU-Méditerranée Infection, Marseille, France.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Aix Marseille Université, IRD, AP-HM, MEPHI, Marseille, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Honore</LastName><ForeName>S</ForeName><Initials>S</Initials><AffiliationInfo><Affiliation>Service de Pharmacie, Hôpital Timone, AP-HM, Marseille, France.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Laboratoire de Pharmacie Clinique, Aix Marseille Université, Marseille, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Rolain</LastName><ForeName>J-M</ForeName><Initials>JM</Initials><AffiliationInfo><Affiliation>IHU-Méditerranée Infection, Marseille, France.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Aix Marseille Université, IRD, AP-HM, MEPHI, Marseille, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Fenollar</LastName><ForeName>F</ForeName><Initials>F</Initials><AffiliationInfo><Affiliation>IHU-Méditerranée Infection, Marseille, France.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Aix Marseille Université, IRD, AP-HM, SSA, VITROME, Marseille, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Fournier</LastName><ForeName>P-E</ForeName><Initials>PE</Initials><AffiliationInfo><Affiliation>IHU-Méditerranée Infection, Marseille, France.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Aix Marseille Université, IRD, AP-HM, SSA, VITROME, Marseille, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Lagier</LastName><ForeName>J-C</ForeName><Initials>JC</Initials><AffiliationInfo><Affiliation>IHU-Méditerranée Infection, Marseille, France.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Aix Marseille Université, IRD, AP-HM, MEPHI, Marseille, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Parola</LastName><ForeName>P</ForeName><Initials>P</Initials><AffiliationInfo><Affiliation>IHU-Méditerranée Infection, Marseille, France.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Aix Marseille Université, IRD, AP-HM, SSA, VITROME, Marseille, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Brouqui</LastName><ForeName>P</ForeName><Initials>P</Initials><AffiliationInfo><Affiliation>IHU-Méditerranée Infection, Marseille, France.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Aix Marseille Université, IRD, AP-HM, MEPHI, Marseille, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Raoult</LastName><ForeName>D</ForeName><Initials>D</Initials><AffiliationInfo><Affiliation>IHU-Méditerranée Infection, Marseille, France.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Aix Marseille Université, IRD, AP-HM, MEPHI, Marseille, France.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2020</Year><Month>06</Month><Day>06</Day></ArticleDate></Article><MedlineJournalInfo><Country>England</Country><MedlineTA>New Microbes New Infect</MedlineTA><NlmUniqueID>101624750</NlmUniqueID><ISSNLinking>2052-2975</ISSNLinking></MedlineJournalInfo><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">Chloroquine</Keyword><Keyword MajorTopicYN="N">coronavirus</Keyword><Keyword MajorTopicYN="N">coronavirus disease 2019</Keyword><Keyword MajorTopicYN="N">hydroxychloroquine</Keyword><Keyword MajorTopicYN="N">meta-analysis</Keyword><Keyword MajorTopicYN="N">severe acute respiratory syndrome coronavirus 2</Keyword></KeywordList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2020</Year><Month>05</Month><Day>08</Day></PubMedPubDate><PubMedPubDate PubStatus="revised"><Year>2020</Year><Month>05</Month><Day>28</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2020</Year><Month>06</Month><Day>04</Day></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2020</Year><Month>10</Month><Day>22</Day><Hour>5</Hour><Minute>37</Minute></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2020</Year><Month>10</Month><Day>23</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2020</Year><Month>10</Month><Day>23</Day><Hour>6</Hour><Minute>1</Minute></PubMedPubDate></History><PublicationStatus>epublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">33088574</ArticleId><ArticleId IdType="doi">10.1016/j.nmni.2020.100709</ArticleId><ArticleId IdType="pii">S2052-2975(20)30061-5</ArticleId><ArticleId 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