Hydroxychloroquine and Coronavirus Disease 2019: A Systematic Review of a Scientific Failure.
Identifieur interne : 000E94 ( Main/Corpus ); précédent : 000E93; suivant : 000E95Hydroxychloroquine and Coronavirus Disease 2019: A Systematic Review of a Scientific Failure.
Auteurs : Stav Rakedzon ; Yara Khoury ; Gilad Rozenberg ; Ami NeubergerSource :
- Rambam Maimonides medical journal [ 2076-9172 ] ; 2020.
Abstract
INTRODUCTION
Hydroxychloroquine (HCQ) emerged early in the course of the coronavirus disease 2019 (COVID-19) pandemic as a possible drug with potential therapeutic and prophylactic benefits. It was quickly adopted in China, Europe, and the USA. We systematically reviewed the existing clinical evidence of HCQ use for the prevention and treatment of COVID-19.
METHODS
We screened for clinical studies describing HCQ administration to treat or prevent COVID-19 in PubMed. We included randomized controlled trials (RCTs), non-randomized comparative cohorts, and case series studies that had all undergone peer review.
RESULTS
A total of 623 studies were screened; 17 studies evaluating HCQ treatment were included. A total of 13 were observational studies, and 4 were RCTs. In terms of effect on mortality rates, observational studies provided conflicting results. As a whole, RCTs, including one large British RCT that has not yet been published, showed no significant effect of HCQ on mortality rates, clinical cure, and virologic response. The use of HCQ as a post-exposure prophylactic agent was found to be ineffective in one RCT.
CONCLUSION
There is no evidence supporting HCQ for prophylaxis or treatment of COVID-19. Many observational trials were methodologically flawed. Scientific efforts have been disappointingly fragmented, and well-conducted trials have only recently been completed, more than 7 months and 600,000 deaths into the pandemic.
DOI: 10.5041/RMMJ.10416
PubMed: 32792041
PubMed Central: PMC7426548
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<author><name sortKey="Khoury, Yara" sort="Khoury, Yara" uniqKey="Khoury Y" first="Yara" last="Khoury">Yara Khoury</name>
<affiliation><nlm:affiliation>Department of Internal Medicine, Rambam Health Care Campus, Haifa, Israel.</nlm:affiliation>
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<author><name sortKey="Rozenberg, Gilad" sort="Rozenberg, Gilad" uniqKey="Rozenberg G" first="Gilad" last="Rozenberg">Gilad Rozenberg</name>
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<author><name sortKey="Neuberger, Ami" sort="Neuberger, Ami" uniqKey="Neuberger A" first="Ami" last="Neuberger">Ami Neuberger</name>
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<affiliation><nlm:affiliation>Division of Infectious Diseases, Rambam Health Care Campus, Haifa, Israel.</nlm:affiliation>
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<front><div type="abstract" xml:lang="en"><p><b>INTRODUCTION</b>
</p>
<p>Hydroxychloroquine (HCQ) emerged early in the course of the coronavirus disease 2019 (COVID-19) pandemic as a possible drug with potential therapeutic and prophylactic benefits. It was quickly adopted in China, Europe, and the USA. We systematically reviewed the existing clinical evidence of HCQ use for the prevention and treatment of COVID-19.</p>
</div>
<div type="abstract" xml:lang="en"><p><b>METHODS</b>
</p>
<p>We screened for clinical studies describing HCQ administration to treat or prevent COVID-19 in PubMed. We included randomized controlled trials (RCTs), non-randomized comparative cohorts, and case series studies that had all undergone peer review.</p>
</div>
<div type="abstract" xml:lang="en"><p><b>RESULTS</b>
</p>
<p>A total of 623 studies were screened; 17 studies evaluating HCQ treatment were included. A total of 13 were observational studies, and 4 were RCTs. In terms of effect on mortality rates, observational studies provided conflicting results. As a whole, RCTs, including one large British RCT that has not yet been published, showed no significant effect of HCQ on mortality rates, clinical cure, and virologic response. The use of HCQ as a post-exposure prophylactic agent was found to be ineffective in one RCT.</p>
</div>
<div type="abstract" xml:lang="en"><p><b>CONCLUSION</b>
</p>
<p>There is no evidence supporting HCQ for prophylaxis or treatment of COVID-19. Many observational trials were methodologically flawed. Scientific efforts have been disappointingly fragmented, and well-conducted trials have only recently been completed, more than 7 months and 600,000 deaths into the pandemic.</p>
</div>
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