An umbrella review of systematic reviews with meta-analyses evaluating positive and negative outcomes of Hydroxychloroquine and chloroquine therapy.
Identifieur interne : 000739 ( Main/Exploration ); précédent : 000738; suivant : 000740An umbrella review of systematic reviews with meta-analyses evaluating positive and negative outcomes of Hydroxychloroquine and chloroquine therapy.
Auteurs : Stefano Celotto [Italie] ; Nicola Veronese [Italie] ; Mario Barbagallo [Italie] ; Francesca Ometto [Italie] ; Lee Smith [Royaume-Uni] ; Shahina Pardhan [Royaume-Uni] ; Yvonne Barnett [Royaume-Uni] ; Petre Cristian Ilie [Royaume-Uni] ; P Nar Soysal [Turquie] ; Erik Lagolio [Italie] ; Peter Konstantin Kurotschka [Italie] ; Roberto Tonelli [Italie] ; Jacopo Demurtas [Italie]Source :
- International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases [ 1878-3511 ] ; 2021.
Descripteurs français
- KwdFr :
- MESH :
- effets indésirables : Chloroquine, Hydroxychloroquine.
- usage thérapeutique : Chloroquine, Hydroxychloroquine.
- Humains.
English descriptors
- KwdEn :
- MESH :
- chemical , adverse effects : Chloroquine, Hydroxychloroquine.
- drug therapy : COVID-19.
- chemical , therapeutic use : Chloroquine, Hydroxychloroquine.
- Humans, SARS-CoV-2.
Abstract
BACKGROUND & AIMS
Hydroxychloroquine (HCQ) and chloroquine (CQ) are anti-malarial drugs frequently used in the rheumatologic field. They were recently identified as potential therapeutic options for Coronavirus Disease (COVID-19). The present study aims to map and grade the diverse health outcomes associated with HCQ/CQ using an umbrella review approach.
METHODS
Umbrella review of systematic reviews of observational and intervention studies. For observational studies, random-effects summary effect size, 95% confidence interval, and 95% prediction interval were estimated. We also assessed heterogeneity, evidence for small-study effect, and evidence for excess significance bias. The quality of evidence was then graded using validated criteria from highly convincing to weak. The evidence from randomized controlled trials (RCTs) was graded using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) tool.
RESULTS
From 313 articles returned in the literature search, six meta-analyses were included (n = 25 outcomes). Among meta-analyses (MAs) of observational studies, HCQ/CQ are weakly associated with a reduced risk for cardiovascular events and diabetes when used for autoimmune diseases and with spontaneous abortion; they are also associated with a higher risk of death in COVID-19 patients. Among MAs of RCTs, HCQ/CQ are associated with an improvement of articular manifestations of rheumatic diseases.
CONCLUSIONS
There is high evidence of the efficacy of HCQ/CQ in the rheumatologic field. The lack of evidence for efficacy and the risk of death associated with the use of HCQ/CQ for COVID-19 indicate the inappropriateness of their inclusion in recent COVID-19 therapy guidelines and the urgent need for RCTs to determine eventual appropriateness as a COVID-19 therapy.
DOI: 10.1016/j.ijid.2020.12.018
PubMed: 33316389
PubMed Central: PMC7833426
Affiliations:
Links toward previous steps (curation, corpus...)
Le document en format XML
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Respiratory Intensive Care Unit, University Hospital of Modena, Modena, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, Modena, Italy; Respiratory Intensive Care Unit, University Hospital of Modena, Modena</wicri:regionArea><wicri:noRegion>Modena</wicri:noRegion></affiliation></author><author><name sortKey="Demurtas, Jacopo" sort="Demurtas, Jacopo" uniqKey="Demurtas J" first="Jacopo" last="Demurtas">Jacopo Demurtas</name><affiliation wicri:level="1"><nlm:affiliation>Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, Modena, Italy; Primary Care Department, USL Toscana Sud Est-Grosseto, Grosseto, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, Modena, Italy; Primary Care Department, USL Toscana Sud Est-Grosseto, Grosseto</wicri:regionArea><wicri:noRegion>Grosseto</wicri:noRegion></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2021">2021</date><idno type="RBID">pubmed:33316389</idno><idno type="pmid">33316389</idno><idno type="doi">10.1016/j.ijid.2020.12.018</idno><idno type="pmc">PMC7833426</idno><idno type="wicri:Area/Main/Corpus">000669</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Corpus" wicri:corpus="PubMed">000669</idno><idno type="wicri:Area/Main/Curation">000669</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Curation">000669</idno><idno type="wicri:Area/Main/Exploration">000669</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">An umbrella review of systematic reviews with meta-analyses evaluating positive and negative outcomes of Hydroxychloroquine and chloroquine therapy.</title><author><name sortKey="Celotto, Stefano" sort="Celotto, Stefano" uniqKey="Celotto S" first="Stefano" last="Celotto">Stefano Celotto</name><affiliation wicri:level="1"><nlm:affiliation>Primary Care Department, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Primary Care Department, Azienda Sanitaria Universitaria Friuli Centrale, Udine</wicri:regionArea><wicri:noRegion>Udine</wicri:noRegion></affiliation></author><author><name sortKey="Veronese, Nicola" sort="Veronese, Nicola" uniqKey="Veronese N" first="Nicola" last="Veronese">Nicola Veronese</name><affiliation wicri:level="1"><nlm:affiliation>Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, Palermo, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, Palermo</wicri:regionArea><wicri:noRegion>Palermo</wicri:noRegion></affiliation></author><author><name sortKey="Barbagallo, Mario" sort="Barbagallo, Mario" uniqKey="Barbagallo M" first="Mario" last="Barbagallo">Mario Barbagallo</name><affiliation wicri:level="1"><nlm:affiliation>Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, Palermo, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, Palermo</wicri:regionArea><wicri:noRegion>Palermo</wicri:noRegion></affiliation></author><author><name sortKey="Ometto, Francesca" sort="Ometto, Francesca" uniqKey="Ometto F" first="Francesca" last="Ometto">Francesca Ometto</name><affiliation wicri:level="1"><nlm:affiliation>Rheumatological Unit, Local Health Unit 1, 6, Veneto Region, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Rheumatological Unit, Local Health Unit 1, 6, Veneto Region</wicri:regionArea><wicri:noRegion>Veneto Region</wicri:noRegion></affiliation></author><author><name sortKey="Smith, Lee" sort="Smith, Lee" uniqKey="Smith L" first="Lee" last="Smith">Lee Smith</name><affiliation wicri:level="1"><nlm:affiliation>The Cambridge Centre for Sport and Exercise Sciences, Anglia Ruskin University, Cambridge, United Kingdom. Electronic address: lee.smith@anglia.ac.uk.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>The Cambridge Centre for Sport and Exercise Sciences, Anglia Ruskin University, Cambridge</wicri:regionArea><wicri:noRegion>Cambridge</wicri:noRegion></affiliation></author><author><name sortKey="Pardhan, Shahina" sort="Pardhan, Shahina" uniqKey="Pardhan S" first="Shahina" last="Pardhan">Shahina Pardhan</name><affiliation wicri:level="1"><nlm:affiliation>Vision and Eye Research Institute, School of Medicine, Anglia Ruskin Univerity, Cambridge, United Kingdom.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Vision and Eye Research Institute, School of Medicine, Anglia Ruskin Univerity, Cambridge</wicri:regionArea><wicri:noRegion>Cambridge</wicri:noRegion></affiliation></author><author><name sortKey="Barnett, Yvonne" sort="Barnett, Yvonne" uniqKey="Barnett Y" first="Yvonne" last="Barnett">Yvonne Barnett</name><affiliation wicri:level="1"><nlm:affiliation>School of Life Scinces, Anglia Ruskin University, Cambridge, United Kingdom.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>School of Life Scinces, Anglia Ruskin University, Cambridge</wicri:regionArea><wicri:noRegion>Cambridge</wicri:noRegion></affiliation></author><author><name sortKey="Ilie, Petre Cristian" sort="Ilie, Petre Cristian" uniqKey="Ilie P" first="Petre Cristian" last="Ilie">Petre Cristian Ilie</name><affiliation wicri:level="1"><nlm:affiliation>Research and Innovation Department, The Queen Elizabeth Hospital Foundation Trust, King's Lynn, United Kingdom.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Research and Innovation Department, The Queen Elizabeth Hospital Foundation Trust, King's Lynn</wicri:regionArea><wicri:noRegion>King's Lynn</wicri:noRegion></affiliation></author><author><name sortKey="Soysal, P Nar" sort="Soysal, P Nar" uniqKey="Soysal P" first="P Nar" last="Soysal">P Nar Soysal</name><affiliation wicri:level="1"><nlm:affiliation>Department of Geriatric Medicine, Bezmialem Vakif University, Faculty of Medicine, Istanbul, Turkey.</nlm:affiliation><country xml:lang="fr">Turquie</country><wicri:regionArea>Department of Geriatric Medicine, Bezmialem Vakif University, Faculty of Medicine, Istanbul</wicri:regionArea><wicri:noRegion>Istanbul</wicri:noRegion></affiliation></author><author><name sortKey="Lagolio, Erik" sort="Lagolio, Erik" uniqKey="Lagolio E" first="Erik" last="Lagolio">Erik Lagolio</name><affiliation wicri:level="1"><nlm:affiliation>Emergency Medicine (A&E) - Asl2 - H Santa Corona, Pietra Ligure and First Aid, H Santa Maria Misericordia, Albenga, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Emergency Medicine (A&E) - Asl2 - H Santa Corona, Pietra Ligure and First Aid, H Santa Maria Misericordia, Albenga</wicri:regionArea><wicri:noRegion>Albenga</wicri:noRegion></affiliation></author><author><name sortKey="Kurotschka, Peter Konstantin" sort="Kurotschka, Peter Konstantin" uniqKey="Kurotschka P" first="Peter Konstantin" last="Kurotschka">Peter Konstantin Kurotschka</name><affiliation wicri:level="1"><nlm:affiliation>Department of Medical Sciences and Public Health, University of Cagliari, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Department of Medical Sciences and Public Health, University of Cagliari</wicri:regionArea><wicri:noRegion>University of Cagliari</wicri:noRegion></affiliation></author><author><name sortKey="Tonelli, Roberto" sort="Tonelli, Roberto" uniqKey="Tonelli R" first="Roberto" last="Tonelli">Roberto Tonelli</name><affiliation wicri:level="1"><nlm:affiliation>Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, Modena, Italy; Respiratory Intensive Care Unit, University Hospital of Modena, Modena, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, Modena, Italy; Respiratory Intensive Care Unit, University Hospital of Modena, Modena</wicri:regionArea><wicri:noRegion>Modena</wicri:noRegion></affiliation></author><author><name sortKey="Demurtas, Jacopo" sort="Demurtas, Jacopo" uniqKey="Demurtas J" first="Jacopo" last="Demurtas">Jacopo Demurtas</name><affiliation wicri:level="1"><nlm:affiliation>Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, Modena, Italy; Primary Care Department, USL Toscana Sud Est-Grosseto, Grosseto, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, Modena, Italy; Primary Care Department, USL Toscana Sud Est-Grosseto, Grosseto</wicri:regionArea><wicri:noRegion>Grosseto</wicri:noRegion></affiliation></author></analytic><series><title level="j">International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases</title><idno type="eISSN">1878-3511</idno><imprint><date when="2021" type="published">2021</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>COVID-19 (drug therapy)</term><term>Chloroquine (adverse effects)</term><term>Chloroquine (therapeutic use)</term><term>Humans (MeSH)</term><term>Hydroxychloroquine (adverse effects)</term><term>Hydroxychloroquine (therapeutic use)</term><term>SARS-CoV-2 (MeSH)</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Chloroquine (effets indésirables)</term><term>Chloroquine (usage thérapeutique)</term><term>Humains (MeSH)</term><term>Hydroxychloroquine (effets indésirables)</term><term>Hydroxychloroquine (usage thérapeutique)</term></keywords><keywords scheme="MESH" type="chemical" qualifier="adverse effects" xml:lang="en"><term>Chloroquine</term><term>Hydroxychloroquine</term></keywords><keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>COVID-19</term></keywords><keywords scheme="MESH" qualifier="effets indésirables" xml:lang="fr"><term>Chloroquine</term><term>Hydroxychloroquine</term></keywords><keywords scheme="MESH" type="chemical" qualifier="therapeutic use" xml:lang="en"><term>Chloroquine</term><term>Hydroxychloroquine</term></keywords><keywords scheme="MESH" qualifier="usage thérapeutique" xml:lang="fr"><term>Chloroquine</term><term>Hydroxychloroquine</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Humans</term><term>SARS-CoV-2</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Humains</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>BACKGROUND & AIMS</b></p><p>Hydroxychloroquine (HCQ) and chloroquine (CQ) are anti-malarial drugs frequently used in the rheumatologic field. They were recently identified as potential therapeutic options for Coronavirus Disease (COVID-19). The present study aims to map and grade the diverse health outcomes associated with HCQ/CQ using an umbrella review approach.</p></div><div type="abstract" xml:lang="en"><p><b>METHODS</b></p><p>Umbrella review of systematic reviews of observational and intervention studies. For observational studies, random-effects summary effect size, 95% confidence interval, and 95% prediction interval were estimated. We also assessed heterogeneity, evidence for small-study effect, and evidence for excess significance bias. The quality of evidence was then graded using validated criteria from highly convincing to weak. The evidence from randomized controlled trials (RCTs) was graded using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) tool.</p></div><div type="abstract" xml:lang="en"><p><b>RESULTS</b></p><p>From 313 articles returned in the literature search, six meta-analyses were included (n = 25 outcomes). Among meta-analyses (MAs) of observational studies, HCQ/CQ are weakly associated with a reduced risk for cardiovascular events and diabetes when used for autoimmune diseases and with spontaneous abortion; they are also associated with a higher risk of death in COVID-19 patients. Among MAs of RCTs, HCQ/CQ are associated with an improvement of articular manifestations of rheumatic diseases.</p></div><div type="abstract" xml:lang="en"><p><b>CONCLUSIONS</b></p><p>There is high evidence of the efficacy of HCQ/CQ in the rheumatologic field. The lack of evidence for efficacy and the risk of death associated with the use of HCQ/CQ for COVID-19 indicate the inappropriateness of their inclusion in recent COVID-19 therapy guidelines and the urgent need for RCTs to determine eventual appropriateness as a COVID-19 therapy.</p></div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" IndexingMethod="Curated" Owner="NLM"><PMID Version="1">33316389</PMID><DateCompleted><Year>2021</Year><Month>02</Month><Day>16</Day></DateCompleted><DateRevised><Year>2021</Year><Month>02</Month><Day>16</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1878-3511</ISSN><JournalIssue CitedMedium="Internet"><Volume>103</Volume><PubDate><Year>2021</Year><Month>Feb</Month></PubDate></JournalIssue><Title>International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases</Title><ISOAbbreviation>Int J Infect Dis</ISOAbbreviation></Journal><ArticleTitle>An umbrella review of systematic reviews with meta-analyses evaluating positive and negative outcomes of Hydroxychloroquine and chloroquine therapy.</ArticleTitle><Pagination><MedlinePgn>599-606</MedlinePgn></Pagination><ELocationID EIdType="pii" ValidYN="Y">S1201-9712(20)32541-8</ELocationID><ELocationID EIdType="doi" ValidYN="Y">10.1016/j.ijid.2020.12.018</ELocationID><Abstract><AbstractText Label="BACKGROUND & AIMS" NlmCategory="OBJECTIVE">Hydroxychloroquine (HCQ) and chloroquine (CQ) are anti-malarial drugs frequently used in the rheumatologic field. They were recently identified as potential therapeutic options for Coronavirus Disease (COVID-19). The present study aims to map and grade the diverse health outcomes associated with HCQ/CQ using an umbrella review approach.</AbstractText><AbstractText Label="METHODS" NlmCategory="METHODS">Umbrella review of systematic reviews of observational and intervention studies. For observational studies, random-effects summary effect size, 95% confidence interval, and 95% prediction interval were estimated. We also assessed heterogeneity, evidence for small-study effect, and evidence for excess significance bias. The quality of evidence was then graded using validated criteria from highly convincing to weak. The evidence from randomized controlled trials (RCTs) was graded using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) tool.</AbstractText><AbstractText Label="RESULTS" NlmCategory="RESULTS">From 313 articles returned in the literature search, six meta-analyses were included (n = 25 outcomes). Among meta-analyses (MAs) of observational studies, HCQ/CQ are weakly associated with a reduced risk for cardiovascular events and diabetes when used for autoimmune diseases and with spontaneous abortion; they are also associated with a higher risk of death in COVID-19 patients. Among MAs of RCTs, HCQ/CQ are associated with an improvement of articular manifestations of rheumatic diseases.</AbstractText><AbstractText Label="CONCLUSIONS" NlmCategory="CONCLUSIONS">There is high evidence of the efficacy of HCQ/CQ in the rheumatologic field. The lack of evidence for efficacy and the risk of death associated with the use of HCQ/CQ for COVID-19 indicate the inappropriateness of their inclusion in recent COVID-19 therapy guidelines and the urgent need for RCTs to determine eventual appropriateness as a COVID-19 therapy.</AbstractText><CopyrightInformation>Copyright © 2020. Published by Elsevier Ltd.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Celotto</LastName><ForeName>Stefano</ForeName><Initials>S</Initials><AffiliationInfo><Affiliation>Primary Care Department, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Veronese</LastName><ForeName>Nicola</ForeName><Initials>N</Initials><AffiliationInfo><Affiliation>Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, Palermo, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Barbagallo</LastName><ForeName>Mario</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, Palermo, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Ometto</LastName><ForeName>Francesca</ForeName><Initials>F</Initials><AffiliationInfo><Affiliation>Rheumatological Unit, Local Health Unit 1, 6, Veneto Region, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Smith</LastName><ForeName>Lee</ForeName><Initials>L</Initials><AffiliationInfo><Affiliation>The Cambridge Centre for Sport and Exercise Sciences, Anglia Ruskin University, Cambridge, United Kingdom. Electronic address: lee.smith@anglia.ac.uk.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Pardhan</LastName><ForeName>Shahina</ForeName><Initials>S</Initials><AffiliationInfo><Affiliation>Vision and Eye Research Institute, School of Medicine, Anglia Ruskin Univerity, Cambridge, United Kingdom.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Barnett</LastName><ForeName>Yvonne</ForeName><Initials>Y</Initials><AffiliationInfo><Affiliation>School of Life Scinces, Anglia Ruskin University, Cambridge, United Kingdom.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Ilie</LastName><ForeName>Petre Cristian</ForeName><Initials>PC</Initials><AffiliationInfo><Affiliation>Research and Innovation Department, The Queen Elizabeth Hospital Foundation Trust, King's Lynn, United Kingdom.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Soysal</LastName><ForeName>Pınar</ForeName><Initials>P</Initials><AffiliationInfo><Affiliation>Department of Geriatric Medicine, Bezmialem Vakif University, Faculty of Medicine, Istanbul, Turkey.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Lagolio</LastName><ForeName>Erik</ForeName><Initials>E</Initials><AffiliationInfo><Affiliation>Emergency Medicine (A&E) - Asl2 - H Santa Corona, Pietra Ligure and First Aid, H Santa Maria Misericordia, Albenga, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Kurotschka</LastName><ForeName>Peter Konstantin</ForeName><Initials>PK</Initials><AffiliationInfo><Affiliation>Department of Medical Sciences and Public Health, University of Cagliari, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Tonelli</LastName><ForeName>Roberto</ForeName><Initials>R</Initials><AffiliationInfo><Affiliation>Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, Modena, Italy; Respiratory Intensive Care Unit, University Hospital of Modena, Modena, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Demurtas</LastName><ForeName>Jacopo</ForeName><Initials>J</Initials><AffiliationInfo><Affiliation>Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, Modena, Italy; Primary Care Department, USL Toscana Sud Est-Grosseto, Grosseto, Italy.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D017418">Meta-Analysis</PublicationType><PublicationType UI="D000078182">Systematic Review</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2020</Year><Month>12</Month><Day>11</Day></ArticleDate></Article><MedlineJournalInfo><Country>Canada</Country><MedlineTA>Int J Infect Dis</MedlineTA><NlmUniqueID>9610933</NlmUniqueID><ISSNLinking>1201-9712</ISSNLinking></MedlineJournalInfo><ChemicalList><Chemical><RegistryNumber>4QWG6N8QKH</RegistryNumber><NameOfSubstance UI="D006886">Hydroxychloroquine</NameOfSubstance></Chemical><Chemical><RegistryNumber>886U3H6UFF</RegistryNumber><NameOfSubstance UI="D002738">Chloroquine</NameOfSubstance></Chemical></ChemicalList><SupplMeshList><SupplMeshName Type="Protocol" UI="C000705127">COVID-19 drug treatment</SupplMeshName></SupplMeshList><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000086382" MajorTopicYN="N">COVID-19</DescriptorName><QualifierName UI="Q000188" MajorTopicYN="Y">drug therapy</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D002738" MajorTopicYN="N">Chloroquine</DescriptorName><QualifierName UI="Q000009" MajorTopicYN="N">adverse effects</QualifierName><QualifierName UI="Q000627" MajorTopicYN="Y">therapeutic use</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006886" MajorTopicYN="N">Hydroxychloroquine</DescriptorName><QualifierName UI="Q000009" MajorTopicYN="N">adverse effects</QualifierName><QualifierName UI="Q000627" MajorTopicYN="Y">therapeutic use</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D000086402" MajorTopicYN="Y">SARS-CoV-2</DescriptorName></MeshHeading></MeshHeadingList><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">COVID-19</Keyword><Keyword MajorTopicYN="N">Chloroquine</Keyword><Keyword MajorTopicYN="N">Hydroxychloroquine</Keyword><Keyword MajorTopicYN="N">umbrella review</Keyword></KeywordList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2020</Year><Month>09</Month><Day>07</Day></PubMedPubDate><PubMedPubDate PubStatus="revised"><Year>2020</Year><Month>12</Month><Day>08</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2020</Year><Month>12</Month><Day>08</Day></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2020</Year><Month>12</Month><Day>15</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2021</Year><Month>2</Month><Day>17</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2020</Year><Month>12</Month><Day>14</Day><Hour>20</Hour><Minute>9</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">33316389</ArticleId><ArticleId IdType="pii">S1201-9712(20)32541-8</ArticleId><ArticleId IdType="doi">10.1016/j.ijid.2020.12.018</ArticleId><ArticleId IdType="pmc">PMC7833426</ArticleId></ArticleIdList></PubmedData></pubmed><affiliations><list><country><li>Italie</li><li>Royaume-Uni</li><li>Turquie</li></country></list><tree><country name="Italie"><noRegion><name sortKey="Celotto, Stefano" sort="Celotto, Stefano" uniqKey="Celotto S" first="Stefano" last="Celotto">Stefano Celotto</name></noRegion><name sortKey="Barbagallo, Mario" sort="Barbagallo, Mario" uniqKey="Barbagallo M" first="Mario" last="Barbagallo">Mario Barbagallo</name><name sortKey="Demurtas, Jacopo" sort="Demurtas, Jacopo" uniqKey="Demurtas J" first="Jacopo" last="Demurtas">Jacopo Demurtas</name><name sortKey="Kurotschka, Peter Konstantin" sort="Kurotschka, Peter Konstantin" uniqKey="Kurotschka P" first="Peter Konstantin" last="Kurotschka">Peter Konstantin Kurotschka</name><name sortKey="Lagolio, Erik" sort="Lagolio, Erik" uniqKey="Lagolio E" first="Erik" last="Lagolio">Erik Lagolio</name><name sortKey="Ometto, Francesca" sort="Ometto, Francesca" uniqKey="Ometto F" first="Francesca" last="Ometto">Francesca Ometto</name><name sortKey="Tonelli, Roberto" sort="Tonelli, Roberto" uniqKey="Tonelli R" first="Roberto" last="Tonelli">Roberto Tonelli</name><name sortKey="Veronese, Nicola" sort="Veronese, Nicola" uniqKey="Veronese N" first="Nicola" last="Veronese">Nicola Veronese</name></country><country name="Royaume-Uni"><noRegion><name sortKey="Smith, Lee" sort="Smith, Lee" uniqKey="Smith L" first="Lee" last="Smith">Lee Smith</name></noRegion><name sortKey="Barnett, Yvonne" sort="Barnett, Yvonne" uniqKey="Barnett Y" first="Yvonne" last="Barnett">Yvonne Barnett</name><name sortKey="Ilie, Petre Cristian" sort="Ilie, Petre Cristian" uniqKey="Ilie P" first="Petre Cristian" last="Ilie">Petre Cristian Ilie</name><name sortKey="Pardhan, Shahina" sort="Pardhan, Shahina" uniqKey="Pardhan S" first="Shahina" last="Pardhan">Shahina Pardhan</name></country><country name="Turquie"><noRegion><name sortKey="Soysal, P Nar" sort="Soysal, P Nar" uniqKey="Soysal P" first="P Nar" last="Soysal">P Nar Soysal</name></noRegion></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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