The authors provide an in-depth literature review of 10 studies that assessed the efficacy and safety of HCQ in patients with COVID-19
7 studies initially selected that compared HCQ to a control in COVID-19 patients
3 studies with specific outcomes of interest
HCQ and Viral Clearance
3 studies included | n = 210 | 2 RCTs and a non-randomized trial
HCQ showed no benefit (p=0.74)
RR: 1.05 (95% CI, 0.79 to 1.38)
HCQ and Death
3 studies included | n = 474 | 2 Retrospective and 1 RCT
HCQ was associated with increased risk of death vs controls (p = 0.002)
RR: 2.17 (95% CI, 1.32 to 3.57)
In this study HCQ did not hasten viral clearance and may be associated with a twofold risk of death from all causes in patients with COVID-19
The authors acknowledge study limitations including
Small overall ‘n’ | No individual patient data | Combination of randomized and non-randomized data | Some data pre-print publications | Data could not be sufficiently adjusted for confounders
There are studies that suggest improvement of pneumonia and chest imaging findings
The authors conclude that
Despite several limitations of this meta-analysis, we feel this finding would instill some degree of skepticism and shall help in curbing the exuberant use of over enthusiastically claimed “magical” drug
Hopefully, large randomized controlled trial such as DISCOVERY (EudraCT 2020-000936-23) and RECOVERY (UK), that is currently studying the effect of HCQ in COVID-19 and comparing it with other anti-viral drugs will finally decide its fate
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