No benefit of hydroxychloroquine in COVID-19: Results of Systematic Review and Meta-Analysis of Randomized Controlled Trials"

Diabetes Metab Syndr. Nov-Dec 2020;14(6):1673-1680. doi: 10.1016/j.dsx.2020.08.033. Epub 2020 Sep 1.

Abstract

Background and aims: Coronavirus pandemic is currently a global public health emergency with no definitive treatment guidelines. We conducted a systematic review and meta-analysis of the literature evaluating the efficacy of hydroxychloroquine and its related formulations in COVID-19 patients.

Methods: A systematic search of PubMed, Scopus, MedRxiv data and Cochrane Central Register of Clinical Trials for published articles that reported the outcomes of COVID-19 patients treated with hydroxychloroquine or its compounds was done. We identified 1071 published studies and 7 studies were included in the analysis.

Results: The study population consisted of a total of 4984 patients, of which 1721 (34.5%) received hydroxychloroquine or its congeners (HCQ group) while 3091 (62.01%) received standard of care or had included antiviral medication (control group). The pooled estimate of successful treatment in the hydroxychloroquine group and the control group was 77.45% and 77.87% respectively, which indicated similar clinical outcomes in patients treated with hydroxychloroquine compared to the control group. The odds ratio of a favourable outcome with hydroxychloroquine was 1.11 (95 CI 0.72 to 1.69) (p = 0.20). The pooled risk difference of favourable outcome with hydroxychloroquine versus control group was 0.00 (95 CI -0.03 to 0.03) which was statistically not significant (p = 0.10).

Conclusions: The present evidence shows no benefit of hydroxychloroquine in patients affected by mild to moderate COVID-19 disease. However, now several trials on HCQ are ongoing and hopefully more data will be available soon. Hence, the management of COVID-19 is set to change for better in the future.

Keywords: COVID-19; Chloroquine; Hydroxychloroquine; Mortality; SARS-CoV-2 infection.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • COVID-19 / drug therapy*
  • Enzyme Inhibitors / therapeutic use*
  • Humans
  • Hydroxychloroquine / therapeutic use*
  • Randomized Controlled Trials as Topic
  • SARS-CoV-2
  • Treatment Outcome

Substances

  • Enzyme Inhibitors
  • Hydroxychloroquine

Supplementary concepts

  • COVID-19 drug treatment