The Outcome of Hydroxychloroquine in Patients Treated for COVID-19: Systematic Review and Meta-Analysis.
Identifieur interne : 000B45 ( Main/Exploration ); précédent : 000B44; suivant : 000B46The Outcome of Hydroxychloroquine in Patients Treated for COVID-19: Systematic Review and Meta-Analysis.
Auteurs : Teshale Ayele Mega [Éthiopie] ; Temesgen Mulugeta Feyissa [Éthiopie] ; Dula Dessalegn Bosho [Éthiopie] ; Kabaye Kumela Goro [Éthiopie] ; Getandale Zeleke Negera [Éthiopie]Source :
- Canadian respiratory journal [ 1916-7245 ] ; 2020.
Descripteurs français
- KwdFr :
- Antibactériens (usage thérapeutique), Antienzymes (usage thérapeutique), Antiviraux (usage thérapeutique), Azithromycine (usage thérapeutique), Betacoronavirus (MeSH), Humains (MeSH), Hydroxychloroquine (usage thérapeutique), Infections à coronavirus (traitement médicamenteux), Pandémies (MeSH), Pneumopathie virale (traitement médicamenteux).
- MESH :
- traitement médicamenteux : Infections à coronavirus, Pneumopathie virale.
- usage thérapeutique : Antibactériens, Antienzymes, Antiviraux, Azithromycine, Hydroxychloroquine.
- Betacoronavirus, Humains, Pandémies.
English descriptors
- KwdEn :
- Anti-Bacterial Agents (therapeutic use), Antiviral Agents (therapeutic use), Azithromycin (therapeutic use), Betacoronavirus (MeSH), COVID-19 (MeSH), Coronavirus Infections (drug therapy), Enzyme Inhibitors (therapeutic use), Humans (MeSH), Hydroxychloroquine (therapeutic use), Pandemics (MeSH), Pneumonia, Viral (drug therapy), SARS-CoV-2 (MeSH).
- MESH :
- chemical , therapeutic use : Anti-Bacterial Agents, Antiviral Agents, Azithromycin, Enzyme Inhibitors, Hydroxychloroquine.
- drug therapy : Coronavirus Infections, Pneumonia, Viral.
- Betacoronavirus, COVID-19, Humans, Pandemics, SARS-CoV-2.
Abstract
Background
The pandemic of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) resulted in an unprecedented public health challenge worldwide. Despite urgent and extensive global efforts, the existing evidence is inconclusive regarding the medications used for the treatment of COVID-19.
Purpose
To generate an up-to-date evidence for the clinical safety and efficacy of hydroxychloroquine (HCQ) with or without azithromycin (AZ) among patients treated for COVID-19.
Conclusion
This meta-analysis and systematic review, which included a limited number of poorly designed studies of patients with COVID-19, revealed HCQ is intolerable, unsafe, and not efficacious. Similarly, HCQ + AZ combination was not different from HCQ alone in curbing mortality and ICU admission.
DOI: 10.1155/2020/4312519
PubMed: 33082891
PubMed Central: PMC7556078
Affiliations:
Links toward previous steps (curation, corpus...)
Le document en format XML
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Systematic Review and Meta-Analysis.</title><author><name sortKey="Ayele Mega, Teshale" sort="Ayele Mega, Teshale" uniqKey="Ayele Mega T" first="Teshale" last="Ayele Mega">Teshale Ayele Mega</name><affiliation wicri:level="1"><nlm:affiliation>Deaprtment of Pharmacology and Clinical Pharmacy, School of Pharmacy, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.</nlm:affiliation><country xml:lang="fr">Éthiopie</country><wicri:regionArea>Deaprtment of Pharmacology and Clinical Pharmacy, School of Pharmacy, College of Health Sciences, Addis Ababa University, Addis Ababa</wicri:regionArea><wicri:noRegion>Addis Ababa</wicri:noRegion></affiliation></author><author><name sortKey="Feyissa, Temesgen Mulugeta" sort="Feyissa, Temesgen Mulugeta" uniqKey="Feyissa T" first="Temesgen Mulugeta" last="Feyissa">Temesgen Mulugeta Feyissa</name><affiliation wicri:level="1"><nlm:affiliation>Department of Clinical Pharmacy, School of Pharmacy, Institute of Health, Jimma University, Jimma, Ethiopia.</nlm:affiliation><country xml:lang="fr">Éthiopie</country><wicri:regionArea>Department of Clinical Pharmacy, School of Pharmacy, Institute of Health, Jimma University, Jimma</wicri:regionArea><wicri:noRegion>Jimma</wicri:noRegion></affiliation></author><author><name sortKey="Dessalegn Bosho, Dula" sort="Dessalegn Bosho, Dula" uniqKey="Dessalegn Bosho D" first="Dula" last="Dessalegn Bosho">Dula Dessalegn Bosho</name><affiliation wicri:level="1"><nlm:affiliation>Department of Clinical Pharmacy, School of Pharmacy, Institute of Health, Jimma University, Jimma, Ethiopia.</nlm:affiliation><country xml:lang="fr">Éthiopie</country><wicri:regionArea>Department of Clinical Pharmacy, School of Pharmacy, Institute of Health, Jimma University, Jimma</wicri:regionArea><wicri:noRegion>Jimma</wicri:noRegion></affiliation></author><author><name sortKey="Kumela Goro, Kabaye" sort="Kumela Goro, Kabaye" uniqKey="Kumela Goro K" first="Kabaye" last="Kumela Goro">Kabaye Kumela 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Jimma</wicri:regionArea><wicri:noRegion>Jimma</wicri:noRegion></affiliation></author></analytic><series><title level="j">Canadian respiratory journal</title><idno type="eISSN">1916-7245</idno><imprint><date when="2020" type="published">2020</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Anti-Bacterial Agents (therapeutic use)</term><term>Antiviral Agents (therapeutic use)</term><term>Azithromycin (therapeutic use)</term><term>Betacoronavirus (MeSH)</term><term>COVID-19 (MeSH)</term><term>Coronavirus Infections (drug therapy)</term><term>Enzyme Inhibitors (therapeutic use)</term><term>Humans (MeSH)</term><term>Hydroxychloroquine (therapeutic use)</term><term>Pandemics (MeSH)</term><term>Pneumonia, Viral (drug therapy)</term><term>SARS-CoV-2 (MeSH)</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Antibactériens (usage thérapeutique)</term><term>Antienzymes (usage thérapeutique)</term><term>Antiviraux (usage thérapeutique)</term><term>Azithromycine (usage thérapeutique)</term><term>Betacoronavirus (MeSH)</term><term>Humains (MeSH)</term><term>Hydroxychloroquine (usage thérapeutique)</term><term>Infections à coronavirus (traitement médicamenteux)</term><term>Pandémies (MeSH)</term><term>Pneumopathie virale (traitement médicamenteux)</term></keywords><keywords scheme="MESH" type="chemical" qualifier="therapeutic use" xml:lang="en"><term>Anti-Bacterial Agents</term><term>Antiviral Agents</term><term>Azithromycin</term><term>Enzyme Inhibitors</term><term>Hydroxychloroquine</term></keywords><keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>Coronavirus Infections</term><term>Pneumonia, Viral</term></keywords><keywords scheme="MESH" qualifier="traitement médicamenteux" xml:lang="fr"><term>Infections à coronavirus</term><term>Pneumopathie virale</term></keywords><keywords scheme="MESH" qualifier="usage thérapeutique" xml:lang="fr"><term>Antibactériens</term><term>Antienzymes</term><term>Antiviraux</term><term>Azithromycine</term><term>Hydroxychloroquine</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Betacoronavirus</term><term>COVID-19</term><term>Humans</term><term>Pandemics</term><term>SARS-CoV-2</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Betacoronavirus</term><term>Humains</term><term>Pandémies</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>Background</b></p><p>The pandemic of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) resulted in an unprecedented public health challenge worldwide. Despite urgent and extensive global efforts, the existing evidence is inconclusive regarding the medications used for the treatment of COVID-19.</p></div><div type="abstract" xml:lang="en"><p><b>Purpose</b></p><p>To generate an up-to-date evidence for the clinical safety and efficacy of hydroxychloroquine (HCQ) with or without azithromycin (AZ) among patients treated for COVID-19. </p></div><div type="abstract" xml:lang="en"><p><b>Conclusion</b></p><p>This meta-analysis and systematic review, which included a limited number of poorly designed studies of patients with COVID-19, revealed HCQ is intolerable, unsafe, and not efficacious. Similarly, HCQ + AZ combination was not different from HCQ alone in curbing mortality and ICU admission.</p></div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">33082891</PMID><DateCompleted><Year>2020</Year><Month>10</Month><Day>30</Day></DateCompleted><DateRevised><Year>2020</Year><Month>12</Month><Day>10</Day></DateRevised><Article PubModel="Electronic-eCollection"><Journal><ISSN IssnType="Electronic">1916-7245</ISSN><JournalIssue CitedMedium="Internet"><Volume>2020</Volume><PubDate><Year>2020</Year></PubDate></JournalIssue><Title>Canadian respiratory journal</Title><ISOAbbreviation>Can Respir J</ISOAbbreviation></Journal><ArticleTitle>The Outcome of Hydroxychloroquine in Patients Treated for COVID-19: Systematic Review and Meta-Analysis.</ArticleTitle><Pagination><MedlinePgn>4312519</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1155/2020/4312519</ELocationID><Abstract><AbstractText Label="Background">The pandemic of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) resulted in an unprecedented public health challenge worldwide. Despite urgent and extensive global efforts, the existing evidence is inconclusive regarding the medications used for the treatment of COVID-19.</AbstractText><AbstractText Label="Purpose">To generate an up-to-date evidence for the clinical safety and efficacy of hydroxychloroquine (HCQ) with or without azithromycin (AZ) among patients treated for COVID-19. <i>Data Source</i>. PubMed, Cochrane CENTRAL, LITCOVID, Web of Science, SCOPUS, BioRxiv, Embase, MedRxiv, and Wiley online library were searched from 2019/12/30 to 2020/05/23. <i>Study Selection</i>. Three investigators assessed the quality of the studies. <i>Data Extraction</i>. Data about study characteristics, effect estimates, and the quality of the studies were extracted by two independent reviewers and cross-checked by the third reviewer. <i>Data Synthesis</i>. The data of 6,782 (HCQ group, 3623; HCQ + AZ group, 1,020; control group, 2139) participants were included. HCQ was compared with standard care for virologic efficacy, disease progression, mortality, and adverse effects. HCQ was also compared with HCQ + AZ for QTc prolongation, admission to the intensive care unit, and mortality. The study found HCQ did not alter the rate of virologic cure (OR = 0.78; 95% CI: 0.39-1.56) and the risk of mortality (OR = 1.26; 95% CI: 0.66-2.39). The pooled prevalence for mortality was 5.8% (95% CI: 0.9%-10.8%). Moreover, HCQ did not impact disease progression (OR = 0.9; 95% CI: 0.36-2.29) but resulted in a higher risk of adverse effects (OR = 2.35; 95% CI: 1.15-4.8). HCQ was also compared against HCQ + AZ, and no difference was observed in QTc prolongation above 500 ms (OR = 1.11; 95% CI: 0.54-2.28), admission to the intensive care unit (OR = 0.92; 95% CI: 0.52-1.63), and mortality (OR = 0.88; 95% CI: 0.55-1.43). However, in the analysis of single-arm studies, about 11.2% (95% CI: 7.0%-15.5%) of patients have developed an absolute increase of QTc greater than 500 ms, and 4.1% (95% CI: 1.1%-7.1%) of patients discontinued their medication.</AbstractText><AbstractText Label="Conclusion">This meta-analysis and systematic review, which included a limited number of poorly designed studies of patients with COVID-19, revealed HCQ is intolerable, unsafe, and not efficacious. Similarly, HCQ + AZ combination was not different from HCQ alone in curbing mortality and ICU admission.</AbstractText><CopyrightInformation>Copyright © 2020 Teshale Ayele Mega et al.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Ayele Mega</LastName><ForeName>Teshale</ForeName><Initials>T</Initials><Identifier Source="ORCID">0000-0003-1619-0104</Identifier><AffiliationInfo><Affiliation>Deaprtment of Pharmacology and Clinical Pharmacy, School of Pharmacy, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Feyissa</LastName><ForeName>Temesgen Mulugeta</ForeName><Initials>TM</Initials><AffiliationInfo><Affiliation>Department of Clinical Pharmacy, School of Pharmacy, Institute of Health, Jimma University, Jimma, Ethiopia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Dessalegn Bosho</LastName><ForeName>Dula</ForeName><Initials>D</Initials><AffiliationInfo><Affiliation>Department of Clinical Pharmacy, School of Pharmacy, Institute of Health, Jimma University, Jimma, Ethiopia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Kumela Goro</LastName><ForeName>Kabaye</ForeName><Initials>K</Initials><AffiliationInfo><Affiliation>Department of Clinical Pharmacy, School of Pharmacy, Institute of Health, Jimma University, Jimma, Ethiopia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Zeleke Negera</LastName><ForeName>Getandale</ForeName><Initials>G</Initials><Identifier Source="ORCID">0000-0002-0178-5888</Identifier><AffiliationInfo><Affiliation>Department of Clinical Pharmacy, School of Pharmacy, Institute of Health, Jimma University, Jimma, Ethiopia.</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>10</Month><Day>13</Day></ArticleDate></Article><MedlineJournalInfo><Country>Egypt</Country><MedlineTA>Can Respir J</MedlineTA><NlmUniqueID>9433332</NlmUniqueID><ISSNLinking>1198-2241</ISSNLinking></MedlineJournalInfo><ChemicalList><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D000900">Anti-Bacterial Agents</NameOfSubstance></Chemical><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D000998">Antiviral Agents</NameOfSubstance></Chemical><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D004791">Enzyme Inhibitors</NameOfSubstance></Chemical><Chemical><RegistryNumber>4QWG6N8QKH</RegistryNumber><NameOfSubstance UI="D006886">Hydroxychloroquine</NameOfSubstance></Chemical><Chemical><RegistryNumber>83905-01-5</RegistryNumber><NameOfSubstance UI="D017963">Azithromycin</NameOfSubstance></Chemical></ChemicalList><SupplMeshList><SupplMeshName Type="Protocol" UI="C000705127">COVID-19 drug treatment</SupplMeshName></SupplMeshList><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000900" MajorTopicYN="N">Anti-Bacterial Agents</DescriptorName><QualifierName UI="Q000627" MajorTopicYN="N">therapeutic use</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D000998" MajorTopicYN="N">Antiviral Agents</DescriptorName><QualifierName UI="Q000627" MajorTopicYN="N">therapeutic use</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D017963" MajorTopicYN="N">Azithromycin</DescriptorName><QualifierName UI="Q000627" MajorTopicYN="N">therapeutic use</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D000073640" MajorTopicYN="Y">Betacoronavirus</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000086382" MajorTopicYN="N">COVID-19</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D018352" MajorTopicYN="N">Coronavirus Infections</DescriptorName><QualifierName UI="Q000188" MajorTopicYN="Y">drug therapy</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D004791" MajorTopicYN="N">Enzyme Inhibitors</DescriptorName><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="Q000627" MajorTopicYN="Y">therapeutic use</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D058873" MajorTopicYN="N">Pandemics</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D011024" MajorTopicYN="N">Pneumonia, 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