Global HCQ/CQ studies
June 6, 2023
@CovidAnalysis
June 6, 2023
@CovidAnalysis
481 HCQ COVID-19 studies,
389 peer reviewed, 393 comparing
treatment and control groups.
Late treatment and high dosages may be harmful, while early treatment
consistently shows positive results.
Negative evaluations typically ignore treatment delay.
Some In Vitro evidence suggested
therapeutic levels would not be reached, however that was incorrect
[Ruiz].
Recent:Galgate Souza Neves Said Yilgwan AlQadheeb Loo Bassets-Bosch.
HCQ/CQ was adopted
in all or part of 42 countries (57 including non-government medical organizations).
Submit updates/corrections .
May 23 |
(Preprint) (meta analysis) | HCQ for COVID-19: real-time meta analysis of 393 studies |
Early treatment shows 62% [52‑70%] improvement with pooled effects in the 36 early treatment studies. Results are similar after exclusion based sensitivity analysis and after restriction to peer-reviewed studies. The 15 morta.. | ||
May 22 |
, F., Infectious Disorders - Drug Targets, doi:10.2174/1871526523666230522114836 | Does Widespread Use of Hydroxychloroquine Reduce the Transmissibility of SARS-CoV-2 / COVID-19? An Ecological Correlational Study |
Analysis of 7 states in Brazil showing that consumption of HCQ was a significant negative predictor of the COVID-19 effective reproduction number (Rt), and that higher HCQ consumption was associated with faster decline of Rt, suggesting a.. | ||
May 11 |
et al., Nigerian Medical Journal, 64:2 | Clinical profile and Predictors of Outcomes of Hospitalized Patients with Laboratory-Confirmed Severe Acute Respiratory Syndrome Coronavirus 2 in Nigeria: A Retrospective Analysis of 13 High Burden States in Nigeria |
93% lower mortality [p<0.0001]. Retrospective 3,462 hospitalized COVID-19 patients across 13 states in Nigiera, showing lower mortality with HCQ. Authors note that the improved results compared with many other late stage studies may be related to the dose and experience.. | ||
May 10 |
et al., Clinical Infection in Practice, doi:10.1016/j.clinpr.2023.100229 | Impact of common comorbidities on antimicrobial consumption and mortality amongst critically ill COVID-19 patients: A retrospective two center study in Saudi Arabia |
35% lower mortality [p=0.0001]. Retrospective 848 ICU patients in Saudi Arabia, showing lower mortality with HCQ in unadjusted results. | ||
May 1 |
et al., Journal of Coastal Life Medicine, 11:2 (Dosing) | Formulation and Evaluation of Hydroxychloroquine Sulfate Nasal Spray for SARS Covid 19 Virus |
Formulation and testing of a HCQ nasal spray for improved bioavailability and prolonged release. | ||
May 1 |
et al., Journal of Multidisciplinary Healthcare, doi:10.2147/JMDH.S403700 | Profiles of Independent-Comorbidity Groups in Senior COVID-19 Patients Reveal Low Fatality Associated with Standard Care and Low-Dose Hydroxychloroquine over Antivirals |
78% lower mortality [p<0.0001]. Retrospective 750 COVID-19 patients in Saudi Arabia, showing lower mortality with HCQ treatment in unadjusted results. Authors note that the poor results in some other trials may be related to increased dosages and later treatment. | ||
Apr 25 |
et al., Pharmaceutical Research, doi:10.1007/s11095-023-03520-1 (Review) | Recent Advances in Inhaled Nanoformulations of Vaccines and Therapeutics Targeting Respiratory Viral Infections |
Review of nanoformulations for inhaled therapeutics for respiratory viral infections including COVID-19. Inhaled formulations can deliver treatment directly to the respiratory tract, enabling higher concentrations while minimising systemi.. | ||
Apr 24 |
et al., The Lancet Rheumatology, doi:10.1016/S2665-9913(23)00066-8 | Post-COVID-19 condition in patients with autoimmune rheumatic diseases: the COVID-19 Vaccination in Autoimmune Diseases (COVAD) study |
40% lower PASC [p=0.08]. Retrospective 755 autoimmune rheumatic disease patients, showing lower risk of PASC (long COVID) with HCQ use, without statistical significance. | ||
Apr 4 |
et al., medRxiv, doi:10.1101/2023.04.03.23287649 (Preprint) | Early Treatment with Hydroxychloroquine and Azithromycin: A Real-Life Monocentric Retrospective Cohort Study of 30,423 COVID-19 Patients |
59% lower mortality [p=0.008]. Retrospective 30,423 patients in France, showing very low mortality overall for outpatients treated with HCQ+AZ and for patients <50, and significantly lower mortality with HCQ and HCQ+AZ versus other treatments. Efficacy was greater for .. | ||
Mar 31 |
et al., Malaysian Journal of Medicine and Health Sciences, doi:10.47836/mjmhs19.2.3 | Hydroxychloroquine for COVID-19: A Single Center, Retrospective Cohort Study |
890% higher progression [p=0.03]. Retrospective 325 hospitalized COVID-19 patients in Malaysia, showing higher progression with HCQ, however the groups are not comparable. 17 HCQ vs. 3 control patients had severity category ≥3 at baseline (7 vs. 0 for severity ≥4). | ||
Mar 29 |
et al., Scientific Reports, doi:10.1038/s41598-023-31944-7 | Mortality rates of severe COVID-19-related respiratory failure with and without extracorporeal membrane oxygenation in the Middle Ruhr Region of Germany |
40% lower mortality [p=0.12]. Retrospective 149 patients under invasive mechanical ventilation in Germany showing no significant difference in mortality with HCQ in unadjusted results. | ||
Mar 22 |
et al., Frontiers in Medicine, doi:10.3389/fmed.2023.1152587 | CovAID: Identification of factors associated with severe COVID-19 in patients with inflammatory rheumatism or autoimmune diseases |
35% lower mortality [p=0.19] and 19% lower hospitalization [p=0.36]. Retrospective 1,213 rheumatic disease patients in France, showing lower risk of mortality and severe cases with HCQ use in univariate analysis, without statistical significance. | ||
Mar 22 |
et al., Authorea, Inc., doi:10.22541/au.167948825.59270994/v1 (Preprint) | Viral clearance in patients with COVID-19: associated factors and the role of antiviral treatment |
15% improved viral clearance [p=0.04]. Retrospective 1,276 patients in France, showing faster viral clearance with HCQ treatment. | ||
Mar 17 |
et al., MDPI AG, doi:10.20944/preprints202303.0325.v1 (Preprint) | Cardiovascular Safety of Hydroxychloroquine-Azithromycin in 424 COVID-19 Patients |
Retrospective 424 consecutive patients in France showing that HCQ+AZ treatment was safe for early stage COVID-19 treatment with the protocol used, which excluded 11 patients for contraindications. Treatment contraindications were the pres.. | ||
Mar 2 |
et al., Microbiology Spectrum, doi:10.1128/spectrum.04674-22 | A Randomized Clinical Trial Testing Hydroxychloroquine for Reduction of SARS-CoV-2 Viral Shedding and Hospitalization in Early Outpatient COVID-19 Infection |
73% higher hospitalization [p=0.54], 20% improved recovery [p=0.19], and 17% improved viral clearance [p=0.19]. Delayed publication of an early terminated late treatment RCT with low-risk (no mortality) outpatients in the USA, showing no significant differences with HCQ. Authors do not provide symptom onset data, but the subgroup analysis suggests .. | ||
Feb 28 |
et al., Rheumatology Advances in Practice, doi:10.1093/rap/rkad025 | Predictors of COVID-19 severity and outcomes in Indian patients with rheumatic diseases: a prospective cohort study |
20% lower mortality [p=0.8], no change in hospitalization [p=0.94], and 40% lower severe cases [p=0.37]. Prospective study of 64 rheumatic disease patients with COVID-19, showing no significant difference in outcomes with HCQ use. | ||
Feb 28 |
et al., BMC Research Notes, doi:10.1186/s13104-023-06281-7 | Hydroxychloroquine to prevent SARS-CoV-2 infection among healthcare workers: early termination of a phase 3, randomised, open-label, controlled clinical trial |
69% more cases [p=0.46]. Early terminated healthcare worker PrEP RCT with only 68 patients and 8 cases, showing no significant difference with HCQ. No information on symptoms per group, case severity, or the timing of cases is provided. | ||
Feb 20 |
et al., Research Square, doi:10.21203/rs.3.rs-2596201/v1 (Preprint) | Investigational medications in 9,638 hospitalized patients with severe COVID-19: lessons from the “fail-and-learn” strategy during the first two waves of the pandemic in 2020 |
26% lower mortality [p=0.002]. PSM retrospective 9,638 patients in the USA, showing significantly lower mortality with HCQ in early 2020 (1,157 HCQ patients), and no significant difference in late 2020 (82 HCQ patients). The few patients treated in the later period may.. | ||
Feb 15 |
et al., Saudi Pharmaceutical Journal, doi:10.1016/j.jsps.2023.02.004 | Comprehensive evaluation of six interventions for hospitalized patients with COVID-19: A propensity score matching study |
50% lower mortality [p=0.18], 37% lower progression [p=0.21], 9% shorter ICU admission [p=0.66], and 3% longer hospitalization [p=0.7]. PSM retrospective 29 hospitals in Saudi Arabia, finding lower mortality with HCQ, without reaching statistical significance (described by authors as "no impact"). | ||
Jan 27 |
et al., Advanced Biomedical Research, doi:10.4103/abr.abr_104_21 | Efficacy of hydroxychloroquine in pre-exposure severe acute respiratory syndrome coronavirus 2 prophylaxis among high-risk healthcare workers: A multicenter study |
92% fewer symptomatic cases [p=0.03]. RCT 143 healthcare workers in Iran, showing lower cases with HCQ prophylaxis, statistically significant only for moderate/severe cases. Baseline details are not provided. | ||
Jan 19 |
et al., MDPI AG, doi:10.20944/preprints202301.0341.v1 (Preprint) | Towards Predicting Length of Stay and Identification of Cohort Risk Factors Using Self-Attention Based Transformers and Association Mining: Covid-19 as Phenotype |
Deep learning model for the prediction of hospitalization time for COVID-19 based on 311 patients in Saudi Arabia. Authors report shorter hospitalization time for HCQ and favipiravir, but do not provide details. | ||
Jan 16 |
et al., The Gazette of Medical Sciences, doi:10.46766/thegms.pubheal.22120905 | Intravenous high dose vitamin C and ozonated saline effective treatment for Covid -19: The Evolution of Local Standard of Care |
Retrospective 479 high risk outpatients in the USA treated with a protocol including intravenous vitamin C, vitamin D, zinc, quercetin, bromelain, lactoferrin, HCQ, ivermectin, ozonated saline, azithromycin, ceftriaxone, methylprednisolon.. | ||
Jan 16 |
et al., Journal of Pharmaceutical Policy and Practice, doi:10.1186/s40545-023-00511-w | Effectiveness of different treatment regimens on patients with COVID-19, hospitalized in Sanandaj hospitals: a retrospective cohort study |
Retrospective 660 hospitalized patients in Iran comparing 6 different drug regimens: 1. HCQ or CQ+AZ, 2. interferons (ReciGen/Ziphron) or interferon + Kaletra (lopinavir/ritonavir), 3. atazanavir, 4. remdesivir, 5. favipiravir, and 6. cor.. | ||
Jan 13 |
et al., Journal of Aerosol Medicine and Pulmonary Drug Delivery, doi:10.1089/jamp.2022.0062 | Safety, Tolerability, and Pharmacokinetics of Nebulized Hydroxychloroquine: A Pilot Study in Healthy Volunteers |
Analysis of a nebulized HCQ formulation with 12 healthy patients, showing low systemic concentrations and supporting efficacy, safety, and tolerability. | ||
Jan 7 |
et al., Scientific Reports, doi:10.1038/s41598-022-26053-w | The ‘myth of Hydroxychloroquine (HCQ) as post-exposure prophylaxis (PEP) for the prevention of COVID-19’ is far from reality |
27% fewer symptomatic cases [p=0.32] and 21% fewer cases [p=0.21]. Low dose low-risk patient HCQ PEP RCT, showing lower symptomatic cases with treatment, without statistical significance. There were no moderate or severe cases. HCQ 800mg on day one followed by 400mg once weekly for 3 weeks. | ||
Jan 4 |
et al., Clinical and Translational Science, doi:10.1111/cts.13468 | Hydroxychloroquine for treatment of non-hospitalized adults with COVID-19: A meta-analysis of individual participant data of randomized trials |
33% improved viral clearance [p=0.02]. Extremely high COI (includes authors of trials playing a key role in the suppression of treatment, and funded by the Gates Foundation) IPD meta analysis of 11 HCQ outpatient treatment and prophylaxis trials, showing significantly improved.. | ||
Dec 16 |
et al., JAMA, doi:10.1001/jama.2022.23257 | Long-term (180-Day) Outcomes in Critically Ill Patients With COVID-19 in the REMAP-CAP Randomized Clinical Trial |
51% higher mortality [p=0.06]. Long-term followup for the REMAP-CAP very late stage ICU trial, showing higher risk with HCQ, not quite reaching statistical significance. | ||
Dec 13 |
et al., The Lancet Regional Health - Southeast Asia, doi:10.1016/j.lansea.2022.100129 | An observational multi-centric COVID-19 sequelae study among health care workers |
5% lower PASC [p=0.78]. Retrospective 679 healthcare workers post COVID-19 discharge, 76 using HCQ prophylaxis, showing no significant difference in PASC. | ||
Dec 7 |
et al., Life, doi:10.3390/life12122047 | Hospital-Based Quasi-Experimental Study on Hydroxychloroquine Pre-Exposure Prophylaxis for COVID-19 in Healthcare Providers with Its Potential Side-Effects |
88% more cases [p=0.09]. Retrospective 230 low risk healthcare workers taking HCQ prophylaxis, and 106 that declined, showing higher cases without statistical significance. No case severity information is provided. The point estimate favored HCQ when excluding th.. | ||
Nov 24 |
et al., Pharmaceuticals, doi:10.3390/ph15121456 | Analyzing the Difference in the Length of Stay (LOS) in Moderate to Severe COVID-19 Patients Receiving Hydroxychloroquine or Favipiravir |
400% higher mortality [p=0.49], 43% shorter hospitalization [p=0.63], and 29% higher hospital discharge [p=0.74]. Retrospective 200 hospitalized COVID-19 patients in Saudi Arabia, showing no significant difference in outcomes between HCQ and favipiravir. | ||
Nov 21 |
et al., Journal of Clinical Medicine, doi:10.3390/jcm11226865 (meta analysis) | COVID-19 Infection in Rheumatic Patients on Chronic Antimalarial Drugs: A Systematic Review and Meta-Analysis |
24% lower mortality [p=0.01] and 20% lower hospitalization [p=0.04]. Systematic review and meta analysis of 20 studies on HCQ use in rheumatic disease patients, showing significantly lower mortality and hospitalization with HCQ prophylaxis. | ||
Nov 17 |
et al., European Journal of Anaesthesiology, doi:10.1097/EJA.0000000000001776 | Clinical characteristics and factors associated with ICU mortality during the first year of the SARS-Cov-2 pandemic in Romania |
22% lower mortality [p=0.01]. Prospective study of 9,058 COVID-19 ICU patients in Romania, showing lower mortality with HCQ treatment. | ||
Nov 14 |
et al., F1000Research, doi:10.12688/f1000research.109023.1 | The Frontline War: A Case-control study of risk factors for COVID-19 among health care workers |
38% fewer cases [p=0.3]. Case control study of healthcare workers in India, showing lower risk of cases with HCQ prophylaxis, without statistical significance. While authors comment negatively, as may be required for publication, and this study alone is not stati.. | ||
Oct 26 |
et al., Seminars in Arthritis and Rheumatism, doi:10.1016/j.semarthrit.2022.152108 | Factors Associated with COVID-19 Breakthrough Infection Among Vaccinated Patients with Rheumatic Diseases: A Cohort Study |
41% fewer cases [p=0.02]. Retrospective 11,468 vaccinated rheumatic disease patients, showing lower risk of COVID-19 cases with HCQ/CQ (antimalarial) treatment compared with all other treatments, statistically significant for 6 treatments. | ||
Oct 21 |
, H., Current Issues in Pharmacy and Medical Sciences, doi:10.2478/cipms-2022-0020 | Pharmacotherapy prescribing pattern and outcome for hospitalized patients with severe and critical COVID-19 |
60% lower mortality [p=0.002]. Retrospective 346 hospitalized patients in Iraq, showing lower mortality with HCQ in unadjusted results. HCQ results are only provided within the 93% of patients treated with enoxaparin. | ||
Oct 18 |
et al., Journal of Clinical Medicine, doi:10.3390/jcm11206138 | Early Outpatient Treatment of COVID-19: A Retrospective Analysis of 392 Cases in Italy |
Retrospective 392 outpatients in Italy showing 0.2% mortality with early treatment, compared with >3% in Italy at the time. Treatment varied for individual patients and included HCQ, vitamin D, vitamin C, vitamin A, zinc, quercetin, bromh.. | ||
Oct 13 |
et al., Medicina Clínica (English Edition), doi:10.1016/j.medcle.2022.01.020 | Mortality risk factors in patients with SARS-CoV-2 infection and atrial fibrillation: Data from the SEMI-COVID-19 registry |
36% lower mortality [p<0.0001]. Retrospective 1,799 hospitalized COVID-19 patients with atrial fibrillation in Spain, showing lower mortality with HCQ treatment in unadjusted results. | ||
Oct 6 |
et al., Clinical Rheumatology, doi:10.1007/s10067-022-06393-8 | Sociodemographic and clinical factors associated with poor COVID-19 outcomes in patients with rheumatic diseases: data from the SAR-COVID Registry |
34% lower mortality [p=0.23], 48% lower severe cases [p=0.02], and 17% lower hospitalization [p=0.09]. Retrospective 1,915 rheumatic disease patients with COVID-19 in Argentina, showing lower mortality, severe oxygen requirement, and hospitalization with CQ/HCQ (antimalarial) use in unadjusted results, statistically significant only for se.. | ||
Sep 28 |
et al., Biomedicines, doi:10.3390/biomedicines10102423 | Characteristics of SARS-CoV-2 Infection in an Actively Monitored Cohort of Patients with Lupus Nephritis |
87% fewer cases [p=0.01]. Prospective analysis of 95 Lupus Nephritis patients in Romania, showing lower risk of COVID-19 with HCQ use. | ||
Sep 27 |
et al., Frontiers in Pharmacology, doi:10.3389/fphar.2022.935370 | Hydroxychloroquine, azithromycin and methylprednisolone and in hospital survival in severe COVID-19 pneumonia |
55% lower mortality [p=0.03]. Retrospective 759 hospitalized patients in the USA, showing lower mortality with combined HCQ+AZ+methylprednisolone treatment compared to methylprednisolone monotherapy. | ||
Sep 14 |
et al., Communications Biology, doi:10.1038/s42003-022-03841-8 (In Vitro) | Hydroxychloroquine blocks SARS-CoV-2 entry into the endocytic pathway in mammalian cell culture |
In Vitro study showing that HCQ blocks SARS-CoV-2 entry into the endocytic pathway, and that HCQ was more effective with higher cholesterol. Authors also obtained lung samples from adults with chronic obstructive pulmonary disease, findin.. | ||
Sep 11 |
et al., The American Journal of the Medical Sciences, doi:10.1016/j.amjms.2022.08.006 | Development of SARS-CoV-2 infection in patients with rheumatic conditions on hydroxychloroquine monotherapy vs. patients without rheumatic conditions: a retrospective, propensity-matched cohort study |
12% lower mortality [p=0.99], 12% lower hospitalization [p=0.81], and 14% more cases [p=0.57]. Updated version of [Gentry] showing no significant difference in outcomes with HCQ use. The previous version is more informative because authors previously analyzed rheumatic disease patients, while they now compare rheumatic disease pati.. | ||
Sep 9 |
et al., Anti-Infective Agents, doi:10.2174/2211352520666220514112951 | Hydroxychloroquine and Mortality in SARS-Cov-2 Infection; The HOPE- Covid-19 Registry. |
53% lower mortality [p<0.0001]. PSM retrospective 6,217 hospitalized patients in Spain, showing lower mortality with HCQ. The higher efficacy reported with obesity is consistent with the greater efficacy predicted for higher cholesterol [Yuan]. | ||
Sep 7 |
et al., Reumatologia/Rheumatology, doi:10.5114/reum.2022.119039 | Influence of biologic and conventional disease-modifying antirheumatic drugs on COVID-19 incidence among rheumatic patients during the first and second wave of the pandemic in Iran |
56% fewer cases [p=0.02]. Retrospective 512 rheumatic disease patients in Iran, showing lower risk of COVID-19 with HCQ use. | ||
Sep 6 |
et al., Modern Rheumatology, doi:10.1093/mr/roac104 | Risk factors for hospitalization or mortality for COVID-19 in patients with rheumatic diseases: Results of a nation-wide JCR COVID-19 registry in Japan |
92% lower mortality [p=1] and 12% lower hospitalization [p=0.34]. Retrospecttive 220 COVID-19 patients with rheumatic disease in Japan, showing lower mortality and hospitalization with HCQ prophylaxis, without statistical significance. | ||
Sep 1 |
et al., Clinical and Experimental Rheumatology, doi:10.55563/clinexprheumatol/pt3syo | SARS-CoV-2 infection in 898 patients with Sjögren’s syndrome: characteristics associated with poor outcomes |
Retrospective 898 patients with Sjögren’s disease, showing a lower risk of worse outcomes with HCQ compared to corticosteroids, immunosuppressive agents, and B-cell depleting agents. | ||
Aug 31 |
et al., Frontiers in Medicine, doi:10.3389/fmed.2022.894126 | The association of antiviral drugs with COVID-19 morbidity: The retrospective analysis of a nationwide COVID-19 cohort |
112% higher ventilation [p=0.21], 53% higher ICU admission [p=0.33], and 17% longer hospitalization [p=0.05]. Retrospective 1,472 hospitalized patients in Turkey, showing a higher risk of ICU admission and ventilation with HCQ, without statistical significance. | ||
Aug 25 |
et al., Open Forum Infectious Diseases, doi:10.1093/ofid/ofac436 | Reduction in risk of death among patients admitted with COVID-19 between first and second epidemic waves in New York City |
20% lower mortality [p=0.007]. Retrospective 4,631 hospitalized patients in New York, showing higher mortality with remdesivir, and lower mortality with HCQ. Authors suggest that increased mortality during the first epidemic wave was partly due to strain on hospital re.. | ||
Aug 16 |
et al., medRxiv, doi:10.1101/2022.08.14.22278751 (Preprint) | Real-world evidence with a retrospective cohort of 15,968 Andalusian COVID-19 hospitalized patients suggests 21 new effective treatments and one drug that increases death risk |
69% lower mortality [p=0.0002]. Retrospective 15,968 COVID-19 hospitalized patients in Spain, showing lower mortality with existing use of several medications including metformin, HCQ, aspirin, vitamin D, vitamin C, and budesonide. | ||
Aug 12 |
et al., British Journal of Clinical Pharmacology, doi:10.1111/bcp.15489 | Systemic Exposure to Hydroxychloroquine and its relationship with outcome in severely ill COVID-19 patients in New York City |
48% higher mortality [p<0.0001]. Retrospective very late stage hospitalized patients in New York during the first wave, showing no significant relationship between HCQ levels and outcomes. Authors note that the patients with data were the sickest patients. | ||
Aug 9 |
et al., European Journal of Epidemiology, doi:10.1007/s10654-022-00891-4 (date from earlier preprint) (meta analysis) | Systematic review and meta-analysis of randomized trials of hydroxychloroquine for the prevention of COVID-19 |
28% fewer cases [p=0.003]. Systematic review and meta-analysis of HCQ prophylaxis RCTs showing a statistically significant reduction in cases for pre-exposure prophylaxis. For PEP trials there were very long treatment delays - in one trial about a third of particip.. | ||
Aug 5 |
et al., Qatar Medical Journal, doi:10.5339/qmj.2022.37 | Prevalence of coronavirus disease 2019 in a multiethnic cohort of patients with autoimmune rheumatic diseases in Qatar |
37% fewer cases [p=0.17]. Retrospective 700 patients with autoimmune rheumatic disease in Qatar, showing lower risk of COVID-19 with HCQ use, without statistical significance. For patients having close contact with COVID-19 cases, there was a statistically signifi.. | ||
Aug 5 |
et al., Clinical Microbiology and Infection, doi:10.1016/j.cmi.2022.07.006 | Daily tenofovir disoproxil fumarate/emtricitabine and hydroxychloroquine for pre-exposure prophylaxis of COVID-19: a double-blind placebo controlled randomized trial in healthcare workers |
51% fewer symptomatic cases [p=0.79] and 27% fewer cases [p=0.31]. Early terminated healthcare worker prophylaxis RCT in Spain, showing lower risk of symptomatic cases with HCQ prophylaxis, without statistical significance due to the small number of events. | ||
Jul 26 |
et al., Rapid Communications in Mass Spectrometry, doi:10.1002/rcm.9358 (Dosing) | A study of impurities in the repurposed COVID-19 drug hydroxychloroquine sulfate by UHPLC-Q/TOF-MS and LC-SPE-NMR |
Analysis of HCQ from two manufacturers showing 9 different impurities, with significantly different concentrations for each manufacturer. | ||
Jul 15 |
et al., medRxiv, doi:10.1101/2022.07.13.22277606 (Preprint) | Factors Associated with COVID-19 Breakthrough Infection in the Pre-Omicron Era Among Vaccinated Patients with Rheumatic Diseases: A Cohort Study |
46% fewer cases [p=0.001]. Retrospective 11,468 vaccinated rheumatic disease patients in the USA, showing lower risk of COVID-19 with HCQ/CQ use compared with all other treatments. Adjusted results are only provided with respect to specific other treatments. | ||
Jul 14 |
et al., IJID Regions, doi:10.1016/j.ijregi.2022.07.009 | Predictors of Mortality among inpatients with COVID-19 Infection in a Tertiary Referral Center in the Philippines |
24% higher mortality [p=0.32]. Retrospective 1,215 hospitalized patients in the Phillipines, showing no significant difference in outcomes with remdesivir or HCQ use in unadjusted results subject to confounding by indication. | ||
Jul 11 |
et al., Indian Journal of Community Medicine, doi:10.4103/ijcm.ijcm_684_21 | Hydroxychloroquine/chloroquine prophylaxis among health-care workers: Was it really preventive? – Evidence from a multicentric cross-sectional study |
20% lower seropositivity [p=0.1]. Retrospective 2,224 healthcare workers in India, showing lower risk of seropositivity with HCQ prophylaxis, without statistical significance. | ||
Jul 3 |
et al., medRxiv, doi:10.1101/2022.07.01.22277058 (Preprint) | Hydroxychloroquine pre-exposure prophylaxis to prevent SARS-CoV-2 among health care workers at risk for SARS-CoV-2 exposure: A nonrandomized controlled trial |
82% fewer symptomatic cases [p=0.17]. Small prophylaxis study with 130 healthcare workers in the USA, showing lower symptomatic cases with HCQ prophylaxis, without statistical significance. HCQ participants were significantly older. The only symptomatic HCQ patient reported h.. | ||
Jul 1 |
et al., The Journal of Critical Care Medicine, doi:10.2478/jccm-2022-0015 | Characteristics and risk factors for mortality in critically ill patients with COVID-19 receiving invasive mechanical ventilation: the experience of a private network in Sao Paulo, Brazil |
29% lower mortality [p=0.07]. Retrospective 215 mechanically ventilated COVID-19 patients in Brazil, 71 treated with HCQ, showing lower mortality with treatment in unadjusted results, without statistical significance. Authors note HCQ was used more toward the start of.. | ||
Jun 29 |
et al., Journal of Global Infectious Diseases, doi:10.4103/jgid.jgid_281_21 | A randomized controlled trial of combined ivermectin and zinc sulfate versus combined hydroxychloroquine, darunavir/ritonavir, and zinc sulfate among adult patients with asymptomatic or mild coronavirus-19 infection |
50% worse viral clearance [p=0.12]. RCT low-risk patients in Thailand comparing HCQ, darunavir/ritonavir, and zinc, with ivermectin and zinc, showing no significant differences. All patients recovered. 65% of patients were asymptomatic at baseline, 26% were PCR- at baseline.. | ||
Jun 1 |
et al., BMJ Open, doi:10.1136/bmjopen-2021-059540 | Hydroxychloroquine plus personal protective equipment versus personal protective equipment alone for the prevention of laboratory-confirmed COVID-19 infections among healthcare workers: a multicentre, parallel-group randomised controlled trial from India |
196% higher progression [p=1], 52% lower hospitalization [p=0.62], and 14% fewer cases [p=0.73]. Low-dose prophylaxis RCT with low-risk healthcare workers in India, showing no significant differences. Symptomatic case results are not provided. Followup was over 6 months, however treatment ended after 3 months. 21% of patients discont.. | ||
May 20 |
et al., Frontiers in Cellular and Infection Microbiology, doi:10.3389/fcimb.2022.899702 | Clinical-Epidemiology Aspect of Inpatients With Moderate or Severe COVID-19 in a Brazilian Macroregion: Disease and Countermeasures |
46% higher mortality [p=0.22]. Retrospective 395 hospitalized patients in Brazil, showing higher mortality with HCQ treatment, without statistical significance. | ||
May 16 |
et al., Authorea, Inc., doi:10.22541/au.164745391.17821933/v2 (Preprint) | Frequentist and Bayesian analysis methods for case series data and application to early outpatient COVID-19 treatment case series of high risk patients |
Hybrid statistical framework for evaluating treatment protocols. COVID-19 treatment protocols often use risk stratification, multiple treatments, and customization based on the disease stage and the patient. Authors find strong evidence f.. | ||
May 4 |
et al., PLOS ONE, doi:10.1371/journal.pone.0267645 | Use of combined treatment of 3rd-generation cephalosporin, azithromycin and antiviral agents on moderate SARs-CoV-2 patients in South Korea: A retrospective cohort study |
25% faster recovery [p=0.45], 13% longer hospitalization [p=0.75], and no change in viral clearance [p=0.99]. Retrospective 25 hospitalized patients treated with cephalosporin, azithromycin, and HCQ, and 217 SOC patients in South Korea, reporting no significant differences. 5 patients receiving lopinavir/ritonavir and HCQ >5 days were excluded fo.. | ||
Apr 30 |
et al., Anales de Pediatría, doi:10.1016/j.anpedi.2021.01.006 | Negativización de PCR a SARS-CoV-2 en muestra respiratoria en pacientes con necesidad de asistencia recurrente |
29% faster viral clearance [p=0.45]. Retrospective 15 pediatric patients in Spain, showing faster viral clearance with HCQ+AZ, without statistical significance. Treatment time and details are not provided. | ||
Apr 22 |
et al., Cureus, doi:10.7759/cureus.24382 | Characteristics and Obstetric Outcomes in Women With Autoimmune Rheumatic Disease During the COVID-19 Pandemic in Qatar |
61% fewer cases [p=0.04]. Retrospective 80 consecutive pregnant patients with autoimmune rheumatic diseases in Qatar, showing lower risk of COVID-19 cases with HCQ prophylaxis. | ||
Apr 17 |
et al., Pharmaceutics, doi:10.3390/pharmaceutics14040877 (In Vitro) | Enhanced In Vitro Antiviral Activity of Hydroxychloroquine Ionic Liquids against SARS-CoV-2 |
In Vitro study showing improved antiviral activity with ionic formulations of HCQ. | ||
Apr 16 |
et al., medRxiv, doi:10.1101/2022.04.06.22273531 (Preprint) | Efficacy and Safety of Fixed Combination of Hydroxychloroquine with Azithromycin Versus Hydroxychloroquine and Placebo in Patients with Mild COVID-19: Randomized, double blind, Placebo controlled trial |
Small early terminated RCT in Mexico with 31 HCQ and 31 control patients, showing higher progression with treatment. There were no hospitalizations in the HCQ and control groups. HCQ patients were older, 38 vs. 32. There were no differenc.. | ||
Apr 8 |
et al., Antibiotics, doi:10.3390/antibiotics11040498 | Antiviral Used among Non-Severe COVID-19 Cases in Relation to Time till Viral Clearance: A Retrospective Cohort Study |
12% faster viral clearance [p=0.59]. Retrospective hospitalized patients in the United Arab Emirates, showing no significant difference in viral clearance with different combinations of HCQ, AZ, favipiravir, and lopinavir/ritonavir. | ||
Apr 6 |
et al., Journal of International Medical Research, doi:10.1177/03000605221090363 | Effect of chronic hydroxychloroquine use on COVID-19 risk in patients with rheumatoid arthritis and systemic lupus erythematosus: a multicenter retrospective cohort |
Retrospective RA/SLE patients in Saudi Arabia. Numbers in this paper are contradictory. Figure 1 and the introduction to the results indicate 304 HCQ users, while Table 1 and later in the results shows 207 (arms switched). The subsequent .. | ||
Apr 2 |
et al., Pharmaceuticals, doi:10.3390/ph15040445 (In Vitro) | Antiviral Activity of Repurposing Ivermectin against a Panel of 30 Clinical SARS-CoV-2 Strains Belonging to 14 Variants |
In Vitro study with 30 COVID-19 strains from 14 variants, showing stronger efficacy with ivermectin compared to CQ and remdesivir, and relatively homogeneous efficacy with ivermectin regardless of strain/variant, in contrast to results fo.. | ||
Mar 31 |
et al., The Lancet Regional Health - Americas, doi:10.1016/j.lana.2022.100243 | Hydroxychloroquine versus placebo in the treatment of non-hospitalised patients with COVID-19 (COPE – Coalition V): A double-blind, multicentre, randomised, controlled trial |
1% lower mortality [p=1], 32% higher ventilation [p=0.79], 16% lower ICU admission [p=0.61], and 23% lower hospitalization [p=0.18]. Authors have not responded to a request for the data. Outpatient RCT with 687 HCQ and 682 control patients in Brazil, showing lower hospitalization with treatment, not reaching statistical significance. Higher efficacy was seen with treat.. | ||
Mar 29 |
et al., Open Forum Infectious Diseases, doi:10.1093/ofid/ofac156 | Screening Large Population Health Databases for Potential COVID-19 Therapeutics: A Pharmacopeia-Wide Association Study (PWAS) of Commonly Prescribed Medications |
12% fewer cases [p=0.01]. Retrospective 26,121 cases and 2,369,020 controls ≥65yo in Canada, showing lower cases with chronic use of HCQ. | ||
Mar 23 |
et al., Scientific Reports, doi:10.1038/s41598-022-08794-w | Randomized controlled trial of favipiravir, hydroxychloroquine, and standard care in patients with mild/moderate COVID-19 disease |
4% improved recovery [p=0.94] and 47% improved viral clearance [p=0.13]. RCT with 54 favipiravir, 51 HCQ, and 52 SOC hospitalized patients in Bahrain, showing no significant differences. Viral clearance improved with both treatments, but did not reach statistical significance with the small sample size. | ||
Mar 21 |
et al., Journal of Medical Virology, doi:10.1002/jmv.27731 | Frequency and Severity of COVID-19 in Patients with Various Rheumatic Diseases Treated Regularly with Colchicine or Hydroxychloroquine |
215% higher hospitalization [p=0.36], 40% more symptomatic cases [p=0.44], and 5% more cases [p=0.88]. Retrospective 317 HCQ users and 333 household contacts, showing higher risk with HCQ. | ||
Mar 19 |
et al., Future Pharmacology, doi:10.3390/futurepharmacol2010007 (Dosing) | Drug Repositioning in Intensive Care Patients and Pharmacokinetic Variability: The Illustration of Hydroxychloroquine |
Comparison of two HCQ dosing regimens, showing high inter-individual variability of HCQ concentrations (as in [Ruiz]), and significantly better plasma concentrations for the dosing regimen including a loading dose. | ||
Mar 18 |
et al., Travel Medicine and Infectious Disease, doi:10.1016/j.tmaid.2022.102292 | Factors predicting in-hospital all-cause mortality in COVID 19 patients at the Laquintinie Hospital Douala, Cameroon |
43% lower mortality [p=0.04]. Retrospective 580 hospitalized COVID+ patients in Cameroon, showing lower mortality with HCQ+AZ treatment. | ||
Mar 17 |
et al., Acta Medica, doi:10.32552/2022.ActaMedica.719 | Comparison of Favipiravir to Hydroxychloroquine Plus Azithromycin in the Treatment of Patients with Non-critical COVID-19: A Single-center, Retrospective, Propensity Score-matched Study |
200% higher mortality [p=1], 67% lower ICU admission [p=1], and 10% shorter hospitalization [p=0.9]. PSM retrospective 260 late stage hospitalized COVID-19 pneumonia patients in Turkey, showing no significant difference between favipiravir and HCQ. | ||
Mar 11 |
et al., Research Square, doi:10.21203/rs.3.rs-1362678/v1 (Preprint) | Risk factors of death in mechanically ventilated COVID-19 patients: a retrospective multi-center study |
14% higher mortality [p=0.44]. Retrospective 125 mechanically ventilated ICU patients in Iran, showing no significant difference with HCQ treatment in unadjusted results. | ||
Mar 10 |
et al., Medicina Clínica, doi:10.1016/j.medcli.2022.01.008 | Mortality risk factors in patients with SARS-CoV-2 infection and atrial fibrillation: Data from the SEMI-COVID-19 registry |
36% lower mortality [p<0.0001]. Retrospective 1,816 COVID-19 patients with atrial fibrillation in Spain, showing lower mortality with HCQ treatment. | ||
Mar 3 |
et al., Infectious Disorders - Drug Targets, doi:10.2174/1871526522666220303121209 | Hydroxychloroquine (HCQ) treatment for hospitalized patients with COVID-19 |
58% lower mortality [p=0.03], 74% lower ventilation [p=0.0007], and 70% lower ICU admission [p=0.0004]. PSM prospective study of 260 COVID-19 patients in Bulgaria, showing lower mortality, ventilation, and ICU admission with HCQ treatment. | ||
Mar 2 |
et al., PLOS ONE, doi:10.1371/journal.pone.0264789 | Mortality and associated risk factors in patients hospitalized due to COVID-19 in a Peruvian reference hospital |
6% higher mortality [p=0.46]. Retrospective 1,418 very late stage (46% mortality) patients in Peru, showing no significant difference with HCQ. There is strong confounding by indication, for example 48% of patients with baseline SpO2 <70% were treated compared with 22.. | ||
Feb 26 |
et al., International Journal of Infectious Diseases, doi:10.1016/j.ijid.2022.02.034 | Assessment of Recovery Time, Worsening and Death, among COVID-19 inpatients and outpatients, under treatment with Hydroxychloroquine or Chloroquine plus Azithromycin Combination in Burkina Faso |
80% lower mortality [p<0.0001], 20% lower progression [p=0.43], and 31% faster viral clearance [p=0.26]. Retrospective 863 COVID-19 patients in Burkina Faso, showing lower mortality, lower progression for outpatients, and faster viral clearance with HCQ/CQ treatment. Only the lower mortality was statistically significant. NCT04445441. | ||
Feb 23 |
et al., Clinical Pharmacology & Therapeutics, doi:10.1002/cpt.2551 | Identification of Risk Factors for COVID-19 Hospitalization in Patients with Anti-Rheumatic Drugs: Results from a Multicenter Nested Case Control Study |
45% lower hospitalization [p=0.18]. Retrospective 81 cases and 396 controls among rheumatic disease patients in the Netherlands, showing lower risk of hospitalization with HCQ prophylaxis, without statistical significance. | ||
Feb 18 |
et al., The Annals of Thoracic Surgery, doi:10.1016/j.athoracsur.2022.01.043 | Multi-institutional Analysis of 505 COVID-19 Patients Supported with ECMO: Predictors of Survival |
11% lower mortality [p=0.31]. Retrospective 505 ECMO patients showing no significant difference in mortality in unadjusted results. | ||
Feb 16 |
et al., Annals of the Rheumatic Diseases, doi:10.1136/annrheumdis-2021-221636 | Characteristics associated with poor COVID-19 outcomes in individuals with systemic lupus erythematosus: data from the COVID-19 Global Rheumatology Alliance |
44% lower severe cases [p=0.007]. Retrospective 1,606 SLE patients showing lower risk of severe COVID-19 outcomes with HCQ/CQ use. | ||
Feb 13 |
et al., Infectious Diseases Now, doi:10.1016/j.idnow.2022.02.001 | Factors associated with hospital admission and adverse outcome for COVID-19: role of social factors and medical care |
14% lower combined mortality/intubation [p=0.55]. Retrospective 296 hospitalized patients in France, showing no significant difference with HCQ treatment. | ||
Feb 3 |
et al., Journal of Infection and Public Health, doi:10.1016/j.jiph.2022.02.001 | Clinical Characteristics and Treatment Outcomes of Mild to Moderate Covid-19 Patients in Saudi Arabia: A Single Centre Study |
35% higher mortality [p=0.46]. Retrospective 811 hospitalized COVID+ patients in Saudi Arabia, showing higher mortality with HCQ treatment in unadjusted results subject to confounding by indication. | ||
Jan 31 |
et al., Clinical Infection in Practice, doi:10.1016/j.clinpr.2022.100137 | Higher mortality of hospitalized haematologic patients with COVID-19 compared to non-haematologic is driven by thrombotic complications and development of ARDS: An age-matched cohorts study |
27% lower mortality [p=0.47]. Retrospective 71 hospitalized haematologic patients in Spain, showing lower mortality with HCQ treatment in unadjusted results and without statistical significance. | ||
Jan 31 |
et al., The Journal of Infection in Developing Countries, doi:10.3855/jidc.14933 | Hydroxychloroquine shortened hospital stay and reduced intensive care unit admissions in hospitalized COVID-19 patients |
28% lower mortality [p=0.3], 50% lower ICU admission [p=0.004], and 17% shorter hospitalization [p=0.007]. Retrospective 393 hospitalized COVID-19 patients in Turkey, showing lower ICU admission and shorter hospitalization time with HCQ. There was no significant difference for mortality. Severity was higher in the HCQ group with greater baseli.. | ||
Jan 23 |
et al., Bratislava Medical Journal, doi:10.4149/BLL_2022_018 | COVID-19 outcomes in patients with antiphospholipid syndrome: a retrospective cohort study |
75% lower hospitalization [p=0.23]. Retrospective 9 COVID-19 patients with antiphospholipid syndrome in Turkey, showing no significant differences based on existing HCQ treatment. | ||
Jan 21 |
et al., PLOS ONE, doi:10.1371/journal.pone.0261711 | Use of glucocorticoids megadoses in SARS-CoV-2 infection in a spanish registry: SEMI-COVID-19 |
36% lower mortality [p<0.0001]. Retrospective 14,921 hospitalized patients in Spain, showing lower mortality with HCQ treatment. | ||
Jan 20 |
et al., Cureus, doi:10.7759/cureus.21442 | Negative Nasopharyngeal SARS-CoV-2 PCR Conversion in Response to Different Therapeutic Interventions |
15% improved viral clearance [p=0.65]. Retrospective 93 hospitalized patients in Saudi Arabia, 45 treated with CQ/HCQ, showing no significant difference in viral clearance. More patients treated with CQ/HCQ had severe cases at baseline (20% vs. 2%). | ||
Jan 13 |
et al., Infectious Diseases & Immunity, doi:10.1097/ID9.0000000000000037 | Risk Factors for Severity and Mortality in Adult Patients Confirmed with COVID-19 in Sierra Leone: A Retrospective Study |
17% lower mortality [p=0.81]. Retrospective 180 hospitalized COVID-19 patients in Sierra Leone, showing no significant difference with HCQ treatment in unadjusted results, however HCQ was significantly more likely to be used for severe patients (33% vs. 12%). | ||
Jan 13 |
et al., Preprint (Preprint) | Low Rates of Hospitalization and Death in 4,376 COVID-19 Patients Given Early Ambulatory Medical and Supportive Care. A Case Series and Observational Study. |
100% lower mortality [p<0.0001] and 100% lower hospitalization [p<0.0001]. Retrospective 4,376 patients with mild/moderate COVID-19 in the USA treated with multiple medications including HCQ/ivermectin, favipiravir, vitamin C, D, quercetin, zinc, mAbs, budesonide, dexamethasone, prednisone, and colchicine (exact.. | ||
Jan 11 |
et al., PLOS ONE, doi:10.1371/journal.pone.0262348 | Prediction of mortality in hospitalized Egyptian patients with Coronavirus disease-2019: A multicenter retrospective study |
100% lower mortality [p<0.0001]. Retrospective 3,712 hospitalized patients in Egypt, showing lower mortality with HCQ treatment in unadjusted results. According to the official treatment protocol, HCQ was recommended with higher risk and/or more serious cases. | ||
Jan 7 |
et al., Journal of Basic and Clinical Physiology and Pharmacology, doi:10.1515/jbcpp-2021-0221 | Hydroxychloroquine pre-exposure prophylaxis provides no protection against COVID-19 among health care workers: a cross-sectional study in a tertiary care hospital in North India |
142% higher severe cases [p=0.59] and 6% more cases [p=0.67]. Retrospective 2,200 healthcare workers in India, 996 taking HCQ prophylaxis, showing no significant differences. There were large differences in the occupation of participants and therefore exposure, and the authors make no adjustments. | ||
Dec 23 2021 |
et al., International Journal of Infectious Diseases, doi:10.1016/j.ijid.2021.12.343 | Safety and Tolerability of Hydroxychloroquine in healthcare workers and first responders for the prevention of COVID-19: WHIP COVID-19 Study |
2% fewer symptomatic cases [p=1] and 51% fewer cases [p=0.6]. HCQ prophylaxis RCT with 201 weekly HCQ patients, 197 daily HCQ patients, and 200 control patients, concluding the prophylaxis is safe. There were no grade 3 or 4 AEs, SAEs, ER visits, or hospitalizations. There was only 4 confirmed cases.. | ||
Dec 4 2021 |
et al., Expert Review of Anti-infective Therapy, doi:10.1080/14787210.2022.2015326 | Hydroxychloroquine as pre-exposure prophylaxis against COVID-19 infection among healthcare workers: a prospective cohort study |
11% fewer cases [p=0.68]. Prospective PrEP study with low risk healthcare workers in India showing RR=0.89 [0.53-1.52]. There were no significant adverse effects. Only mean age and gender distribution are provided for baseline characteristics, no severity informat.. | ||
Nov 26 2021 |
et al., Revista da Associação Médica Brasileira, doi:10.1590/1806-9282.20210661 | Outcomes associated with Hydroxychloroquine and Ivermectin in hospitalized patients with COVID-19: a single-center experience |
151% higher mortality [p=0.03] and 46% higher combined mortality/intubation [p=0.23]. Retrospective 230 hospitalized patients in Brazil showing higher mortality with HCQ treatment. Authors note that the treatments were more likely to be offered to sicker patients. Authors indicate that they do not know when medication was .. | ||
Nov 23 2021 |
et al., PAMJ - Clinical Medicine, doi:10.11604/pamj-cm.2021.7.15.30981 | Treatment with hydroxychloroquine vs nitazoxanide in patients with COVID-19: brief report |
215% higher mortality [p=0.38], 652% higher ventilation [p=0.15], 145% higher ICU admission [p<0.0001], and 107% longer hospitalization [p=0.007]. Planned RCT of HCQ vs. HCQ+nitazoxanide which was aborted due to the retracted Surgisphere paper. Authors retrospectively analyze a small set of HCQ vs. nitazoxanide patients (which were protocol deviations in the planned RCT), showing re.. | ||
Nov 23 2021 |
et al., BioMed Research International, doi:10.1155/2021/1676914 | Factors Affecting the Incidence, Progression, and Severity of COVID-19 in Type 1 Diabetes Mellitus |
99% fewer cases [p=0.08]. Retrospective type 1 diabetes patients in Saudi Arabia showing reduced risk of cases with HCQ prophylaxis. | ||
Nov 17 2021 |
et al., Journal of the Association of Physicians India, 69:11 | Ivermectin and Hydroxychloroquine for Chemo-Prophylaxis of COVID-19: A Questionnaire Survey of Perception and Prescribing Practice of Physicians vis-a-vis Outcomes |
75% fewer cases [p<0.0001]. Physician survey in India with 164 ivermectin prophylaxis, 129 HCQ prophylaxis, and 81 control patients, showing significantly lower COVID-19 cases with treatment. Details of the treatment and control groups and the definition of cases ar.. | ||
Nov 12 2021 |
et al., JAMA Network Open, doi:10.1001/jamanetworkopen.2021.34330 | Association Between Androgen Deprivation Therapy and Mortality Among Patients With Prostate Cancer and COVID-19 |
333% higher mortality [p=0.0001] and 613% higher severe cases [p<0.0001]. Retrospective 1,106 prostate cancer patients, showing higher mortality with HCQ treatment. | ||
Nov 11 2021 |
et al., Western Pacific Surveillance and Response Journal, doi:10.5365/wpsar.2021.12.4.852 | Clinical characteristics and outcomes of COVID-19 patients in a tertiary hospital in Baguio City, Philippines |
15% lower mortality [p=1]. Retrospective 280 hospitalized patients in the Philippines, 25 treated with HCQ, not showing any significant differences in unadjusted results. | ||
Nov 5 2021 |
et al., Heliyon, doi:10.1016/j.heliyon.2023.e15337 (date from earlier preprint) | Evaluation of patients treated by telemedicine in the beginning of the COVID-19 pandemic in São Paulo, Brazil: A non-randomized clinical trial preliminary study |
95% lower hospitalization [p=0.004]. Prospective study of 187 telemedicine patients in Brazil. 74 presenting with moderate symptoms were offered treatment with HCQ+AZ, 12 did not accept HCQ (taking AZ only), forming a control group. There was lower hospitalization and improv.. | ||
Nov 2 2021 |
et al., Journal of Infection and Public Health, doi:10.1016/j.jiph.2021.10.024 | Efficacy of the early treatment with tocilizumab-hydroxychloroquine and tocilizumab-remdesivir in severe COVID-19 Patients |
26% lower mortality [p=0.39], 26% higher hospital discharge [p=0.39], and 25% longer hospitalization [p=0.06]. Small 108 patient RCT comparing HCQ vs. remdesivir in very late stage treatment. All patients received tocilizumab. There were significant unadjusted baseline differences in ventilation and ICU admission. NCT04779047. REC-H-PhBSU-21011. | ||
Oct 28 2021 |
et al., World Journal of Gastroenterology, doi:10.3748/wjg.v27.i40.6951 | Hepatic and gastrointestinal disturbances in Egyptian patients infected with coronavirus disease 2019: A multicentre cohort study |
12% lower mortality [p=0.87]. Retrospective 547 hospitalized COVID+ patients in Egypt, showing no significant differences with CQ/HCQ treatment in unadjusted analysis. Treatments were applied according to patient conditions, demographics, and comorbidities as per the .. | ||
Oct 25 2021 |
et al., Scientific Reports, doi:10.1038/s41598-021-00243-4 | Treatment for COVID-19—a cohort study from Northern Italy |
28% lower mortality [p=0.1]. Retrospective 600 hospitalized patients in Italy, showing lower mortality with HCQ treatment, without reaching statistical significance (p = 0.1). | ||
Oct 6 2021 |
et al., ClinicalTrials.gov, NCT04354870 (Preprint) | COVID-19 PrEP HCW HCQ Study |
79% fewer symptomatic cases [p=0.21]. Prospective study of HCQ prophylaxis in the USA, with 56 HCQ patients and 24 control patients, showing no significant differences. NCT04354870 | ||
Oct 5 2021 |
et al., SSRN Electronic Journal, doi:10.2139/ssrn.3936499 | Various Combinations of Favipiravir, Lopinavir-Ritonavir, Darunavir-Ritonavir, High-Dose Oseltamivir, and Hydroxychloroquine for the Treatment of COVID-19: A Randomized Controlled Trial (FIGHT-COVID-19 Study) |
56% lower mortality [p=0.07], 54% lower progression [p=0.02], and 7% faster viral clearance [p=0.51]. RCT 320 patients in Thailand, showing significantly lower progression with HCQ for moderate/severe patients, and faster viral clearance with mild patients (statistically significant for 800mg). There are two sets of results - for moderate.. | ||
Oct 1 2021 |
et al., PLoS ONE, doi:10.1371/journal.pone.0266922 (date from earlier preprint) | Effect of common maintenance drugs on the risk and severity of COVID-19 in elderly patients |
13% lower mortality [p=0.15], 3% lower hospitalization [p=0.63], and 9% fewer cases [p=0.02]. Retrospective database analysis of 374,229 patients in the USA, showing no significant difference with HCQ use, however authors do not adjust for the very different baseline risk for systemic autoimmune disease patients. Other research sh.. | ||
Oct 1 2021 |
et al., Journal of Infectious Diseases and Epidemiology, doi:10.23937/2474-3658/1510233 (date from earlier preprint) | A Randomized Controlled Trial of Ivermectin Monotherapy Versus Hydroxychloroquine, Ivermectin, and Azithromycin Combination Therapy in Covid-19 Patients in Nigeria |
55% lower hospital discharge [p=0.2] and 10% improved viral clearance [p=0.78]. Small RCT with 61 patients in Nigeria, all patients treated with ivermectin, zinc, and vitamin C, showing no significant improvements in recovery with the addition of HCQ+AZ. | ||
Sep 30 2021 |
et al., Clinical Pharmacology: Advances and Applications, doi:10.2147/CPAA.S325083 | Antiviral Combination Clinically Better Than Standard Therapy in Severe but Not in Non-Severe COVID-19 |
48% lower mortality [p=0.45]. RCT 111 patients in India in 5 groups: severe patients: A) standard treatment, B) hydroxychloroquine+ribavirin+standard treatment, or C) lopinavir+ritonavir+ribavirin+standard treatment, and non-severe: A) standard treatment or B).. | ||
Sep 30 2021 |
et al., PharmAdvances, doi:10.36118/pharmadvances.2021.15 | A retrospective analysis on pharmacological approaches to COVID-19 patients in an Italian hub hospital during the early phase of the pandemic |
35% lower mortality [p=0.12]. Retrospective 277 hospitalized patients in Italy, showing lower mortality with HCQ treatment, not reaching statistical significance, and subject to confounding by indication. | ||
Sep 15 2021 |
et al., Northern Clinics of Istanbul, doi:10.14744/nci.2021.65471 | Effect of Hydroxychloroquine Use on the Length Of Hospital Stay in Children Diagnosed With Covid 19 |
12% faster viral clearance [p=0.05]. Retrospective 40 pediatric hospitalized patients, 15 treated with HCQ, showing 7.2 vs. 8.2 days until PCR-, not quite reaching statistical significance. | ||
Sep 15 2021 |
et al., Turk. J. Haematol., doi:10.4274/tjh.galenos.2021.2021.0287 | Clinical Characteristics and Outcome of COVID-19 in Turkish Hematological Malignancy Patients |
399% higher mortality [p=0.003]. Retrospective 340 patients with hematological malignancy in Turkey, showing higher mortality with HCQ treatment. Confounding by time is likely because more HCQ patients were earlier in time when overall treatment protocols were significan.. | ||
Sep 14 2021 |
et al., International Journal of General Medicine, 2021:14 | Effectiveness and Safety of Favipiravir Compared to Hydroxychloroquine for Management of Covid-19: A Retrospective Study |
134% higher mortality [p=0.05]. Retrospective hospitalized patients in Saudi Arabia, showing lower mortality with favipiravir compared to HCQ, not quite reaching statistical significance. Authors do not indicate the factors behind which therapy was chosen. May be subjec.. | ||
Sep 14 2021 |
et al., medRxiv, doi:10.1101/2021.09.13.21262971 (Preprint) | Low dose hydroxychloroquine prophylaxis for COVID-19 - a prospective study |
27% lower progression [p=0.21] and 5% more cases [p=0.81]. Small prophylaxis trial with 29 low dose HCQ and 455 control healthcare workers in India, showing no statistically significant differences. | ||
Sep 14 2021 |
et al., Travel Medicine and Infectious Disease, doi:10.1016/j.tmaid.2021.102163 | Hydroxychloroquine / azithromycin in COVID-19: The association between time to treatment and case fatality rate |
Retrospective 1,265 outpatients in Peru treated with HCQ+AZ showing mortality associated with treatment delay. Mortality was six times lower than the national average. | ||
Sep 9 2021 |
et al., Southeast Asian Journal of Tropical Medicine and Public Health, 52:4 | Assessment of outcomes following implementation of antiviral treatment guidelines for COVID-19 during the first wave in Thailand |
42% lower progression [p=0.37]. Retrospective 744 hospitalized patients in Thailand, showing lower risk of a poor outcome for favipiravir treatment within 4 days of symptom onset. Early treatment with CQ/HCQ and lopinavir/ritonavir or darunavir/ritonavir also showed low.. | ||
Sep 1 2021 |
et al., Microbial Drug Resistance, doi:10.1089/mdr.2020.0489 | Multidrug-Resistant Infections and Outcome of Critically Ill Patients with Coronavirus Disease 2019: A Single Center Experience |
5% lower mortality [p=1]. Retrospective 32 ICU patients, showing no significant difference with HCQ treatment in unadjusted results. | ||
Aug 27 2021 |
et al., Journal of Clinical Medicine, doi:10.3390/jcm10173842 | Incidence of COVID-19 Hospitalisation in Patients with Systemic Lupus Erythematosus: A Nationwide Cohort Study from Denmark |
40% lower hospitalization [p=0.39]. Retrospective 2,533 SLE patients in Denmark showing no significant difference in hospitalization risk for COVID-19 cases with HCQ treatment. | ||
Aug 25 2021 |
et al., International Journal of Antimicrobial Agents, doi:10.1016/j.ijantimicag.2021.106428 | Hydroxychloroquine plus azithromycin early treatment of mild COVID-19 in outpatient setting: a randomized, double-blinded, placebo-controlled clinical trial evaluating viral clearance |
14% improved viral clearance [p=0.15]. RCT 84 low risk patients, 42 treated with HCQ/AZ, showing no significant differences. There was only one hospitalization which was in the treatment arm. | ||
Aug 25 2021 |
et al., International Journal of Infectious Diseases, doi:10.1016/j.ijid.2023.01.019 (date from earlier preprint) | Hydroxychloroquine for pre-exposure prophylaxis of COVID-19 in health care workers: A randomized, multicenter, placebo-controlled trial (HERO-HCQ) |
24% fewer symptomatic cases [p=0.18]. HCQ prophylaxis RCT reporting statistically significant lower cases when pooling results with the COVID PREP RCT, OR 0.74 [0.55-1.0] p = 0.046. There were no significant safety issues. The trials were both terminated early resulting in a .. | ||
Aug 24 2021 |
et al., Research Square, doi:10.21203/rs.3.rs-805748/v1 (Preprint) | A Prospective Longitudinal Study Evaluating The Influence of Immunosuppressives and Other Factors On COVID-19 in Autoimmune Rheumatic Diseases |
66% lower mortality [p=0.1] and 9% fewer cases [p=0.43]. Prospective study of 9,212 autoimmune rheumatic disease patients showing lower mortality with HCQ, without reaching statistical significance. Authors incorrectly state "HCQ use did not influence occurrence of COVID-19 (RR = 0.909, CI.. | ||
Aug 16 2021 |
et al., Microbes and Infectious Diseases, doi:10.21608/mid.2021.85877.1177 | Comparative study between the therapeutic effect of remdesivir versus hydroxychloroquine in COVID-19 hospitalized patients |
Small study comparing 25 HCQ and 25 remdesivir hospitalized patients, reporting faster viral clearance with remdesivir. The article proof is missing the results for the HCQ group. Confounding by time is likely - remdesivir patients were a.. | ||
Aug 14 2021 |
et al., Pharmaceutics, doi:10.3390/pharmaceutics13081260 | Nebulised Isotonic Hydroxychloroquine Aerosols for Potential Treatment of COVID-19 |
Analysis of HCQ solutions suitable for nebulization for COVID-19. | ||
Aug 10 2021 |
et al., Pulmonary Pharmacology & Therapeutics, doi:10.1016/j.pupt.2021.102069 | Evaluation of the Prophylactic Effect of Hydroxychloroquine on People in Close-Contact with Patients with Covid-19 |
19% fewer symptomatic cases [p=1] and 6% more cases [p=1]. Small PEP trial with 51 HCQ patients, not showing a significant difference in cases. IRCT20130917014693N10. | ||
Aug 5 2021 |
et al., Journal of Infection and Public Health, doi:10.1016/j.jiph.2021.08.001 (meta analysis) | Hydroxychloroquine Pre-Exposure Prophylaxis for COVID-19 in Healthcare Workers from India: A Meta-Analysis |
75% lower mortality [p<0.0001]. Meta analysis of 11 HCQ PrEP studies in India covering 7,616 healthcare workers, showing significantly lower cases with treatment. | ||
Aug 4 2021 |
et al., Turkish Journal of Medical Sciences, doi:10.3906/sag-2009-64 | The Efficacy of Hydroxychloroquine and Azithromycin Combination Therapy on Hospital Mortality in COVID 19 Pneumonia Patients |
Retrospective 370 hospitalized patients, 222 receiving HCQ+AZ and 148 receiving HCQ, showing mortality OR 0.61 [0.23-1.59], p = 0.31 for the addition of AZ. | ||
Aug 4 2021 |
et al., medRxiv, doi:10.1101/2021.08.02.21260750 (Preprint) | Hydroxychloroquine Prophylaxis against Coronavirus Disease-19: Practice Outcomes among Health-Care Workers |
49% more cases [p=0.02]. Observational study of 927 low-risk healthcare workers in India, 731 volunteering for weekly HCQ prophylaxis, showing higher cases with treatment in unadjusted results. Clinical outcome was in the protocol, however no information on which.. | ||
Aug 4 2021 |
et al., Saudi Pharmaceutical Journal, doi:10.1016/j.jsps.2021.08.008 | Clinical characteristics and treatment outcomes of severe (ICU) COVID-19 patients in Saudi Arabia: A single centre study |
39% higher mortality [p=0.52]. Retrospective 171 ICU patients in Saudi Arabia showing no significant difference for HCQ treatment in unadjusted results. | ||
Jul 31 2021 |
et al., medRxiv, doi:10.1101/2021.07.30.21261220 (Preprint) | COVID-19 in hospitalized patients in 4 hospitals in San Isidro, Buenos Aires, Argentina |
11% lower mortality [p=1]. Retrospective 668 hospitalized patients in Argentina, 18 treated with HCQ, not showing a significant difference in unadjusted results. | ||
Jul 29 2021 |
et al., medRxiv, doi:10.1101/2021.07.25.21260838 (Preprint) | Doxycycline is a safe alternative to Hydroxychloroquine + Azithromycin to prevent clinical worsening and hospitalization in mild COVID-19 patients: An open label randomized clinical trial (DOXYCOV) |
52% improved recovery [p=0.44] and 3% improved viral clearance [p=0.88]. RCT 194 mild/asymptomatic low-risk patients in Cameroon, 97 treated with HCQ+AZ and 97 treated with doxycycline, showing 2.1% symptomatic patients at day 10 with HCQ+AZ, versus 4.3% with doxycycline, but without statistical significance. .. | ||
Jul 20 2021 |
et al., Research Square, doi:10.21203/rs.3.rs-43812/v1 (Preprint) | The effect of hydroxychloroquine against SARS-CoV-2 infection in rheumatoid arthritis patients |
43% higher ICU admission [p=1]. Retrospective 17 rheumatoid arthritis COVID-19+ patients, 7 on HCQ treatment, showing no significant differences. They study reports only including hospitalized patients, but the results include non-hospitalized patients. Results do not r.. | ||
Jul 16 2021 |
et al., medRxiv, doi:10.1101/2021.07.13.21260428 (Preprint) | Epidemiology and Clinical Characteristics in Individuals with Confirmed SARS-CoV-2 Infection During the Early COVID-19 Pandemic in Saudi Arabia |
52% higher mortality [p=0.58]. Retrospective hospitalized patients in Saudi Arabia showing higher mortality with most treatments although not reaching statistical significance. Confounding by indication, time, or other factors is likely (a 19x higher risk with lopinavi.. | ||
Jul 13 2021 |
et al., Annals of Internal Medicine, doi:10.7326/M21-0653 | Evaluation of the Effects of Remdesivir and Hydroxychloroquine on Viral Clearance in COVID-19 |
120% higher mortality [p=0.35]. Small RCT in Norway with 52 HCQ and 42 remdesivir patients, showing no significant differences with treatment. Add-on trial to WHO Solidarity. NCT04321616. | ||
Jul 13 2021 |
et al., Diabetology & Metabolic Syndrome, doi:10.1186/s13098-021-00695-8 | Outcome and death risk of diabetes patients with Covid-19 receiving pre-hospital and in-hospital metformin therapies |
299% higher mortality [p=0.04]. Retrospective 188 hospitalized patients in Brazil, showing higher risk of mortality with HCQ. Relatively few patients received HCQ. The results are likely subject to confounding by indication with treatment more likely for severe cases, a.. | ||
Jul 12 2021 |
et al., Intensive Care Medicine | Lopinavir-ritonavir and hydroxychloroquine for critically ill patients with COVID-19: REMAP-CAP randomized controlled trial |
44% higher mortality [p=0.01]. Very late stage RCT with 50 ICU patients treated with HCQ, 255 lopinavir-ritonavir patients, and 27 combined therapy patients, showing higher mortality with all treatments. | ||
Jul 10 2021 |
et al., Anaesthesia Critical Care & Pain Medicine, doi:10.1016/j.accpm.2021.100931 | French Multicentre Observational Study on SARS-CoV-2 infections Intensive care initial management: the FRENCH CORONA Study |
no change in mortality [p=0.94]. Prospective study of 966 ICU patients in France, 289 treated with HCQ, showing no significant difference with treatment. Time based confounding is likely because HCQ became increasingly controversial and less used over the time covered, w.. | ||
Jul 6 2021 |
et al., The Annals of Thoracic Surgery, doi:10.1016/j.athoracsur.2021.06.026 | Multi-institutional Analysis of 200 COVID-19 Patients treated with ECMO:Outcomes and Trends |
7% lower mortality [p=0.74]. Prospective study of 200 ECMO patients showing no significant difference in unadjusted results for HCQ treatment. Time based confounding is likely because HCQ became increasingly controversial and less used over the time covered (as shown.. | ||
Jul 1 2021 |
et al., Journal of Drugs in Dermatology, doi:10.36849/JDD.5843 | COVID-19 in Individuals Treated With Long-Term Hydroxychloroquine: A Propensity Score-Matched Analysis of Cicatricial Alopecia Patients |
13% fewer cases [p=0.006]. PSM retrospective 144 alopecia patients in the USA, showing lower risk of COVID-19 with HCQ prophylaxis. The supplemental appendix is not available. | ||
Jun 30 2021 |
et al., J. Clin. Med. 2021, doi:10.3390/jcm10132954 | Hydroxychloroquine and Azithromycin Treatment of Hospitalized Patients Infected with SARS-CoV-2 in Senegal from March to October 2020 |
39% higher hospital discharge [p=0.02]. Retrospective 926 patients in Senegal, 674 treated with HCQ+AZ, showing significantly higher hospital discharge at day 15 with treatment. | ||
Jun 24 2021 |
et al., American Journal of Epidemiology, doi:10.1093/aje/kwab183 | Pharmacoepidemiology, Machine Learning and COVID-19: An intent-to-treat analysis of hydroxychloroquine, with or without azithromycin, and COVID-19 outcomes amongst hospitalized US Veterans |
22% higher mortality [p=0.18] and 55% higher ventilation [p=0.02]. Retrospective 1,769 hospitalized patients in the USA showing no significant differences for HCQ, and higher intubation for HCQ+AZ. | ||
Jun 21 2021 |
et al., Research Square, doi:10.21203/rs.3.rs-628277/v1 (Preprint) | Repurposing the Combination Drug of Favipiravir, Hydroxychloroquine and Oseltamivir as a Potential Inhibitor Against SARS-CoV-2: A Computational Study |
In Silico study showing stronger inhibition of SAR-CoV-2 for HCQ+favipiravir+oseltamivir compared to any of these alone or combinations of two of these drugs. | ||
Jun 18 2021 |
et al., CMAJ Open, doi:10.9778/cmajo.20210069 | Assessing the efficacy and safety of hydroxychloroquine as outpatient treatment of COVID-19: a randomized controlled trial |
133% higher ICU admission [p=1] and 533% higher hospitalization [p=0.57]. Small early terminated late treatment RCT not showing significant differences. The HCQ group was a median of 7 days from symptom onset at baseline, which may not include the delay delivering the medication. From the 4 HCQ hospitalizations.. | ||
Jun 18 2021 |
et al., PLOS One, doi:10.1371/journal.pone.0252302 (In Vitro) | An in vitro study of dual drug combinations of anti-viral agents, antibiotics, and/or hydroxychloroquine against the SARS-CoV-2 virus isolated from hospitalized patients in Surabaya, Indonesia |
In Vitro study of combinations of drugs showing antiviral efficacy of HCQ alone and in combination with AZ, favipiravir, and doxycycline. No high levels of cytotoxicity were observed, and authors conclude that using a combination of drugs.. | ||
Jun 11 2021 |
et al., Vaccines, 10.3390/vaccines9060640 | Clinical Course and Risk Factors for In-Hospital Mortality of 205 Patients with SARS-CoV-2 Pneumonia in Como, Lombardy Region, Italy |
10% lower mortality [p=0.15]. Retrospective 205 patients in Italy, 160 treated with HCQ, showing lower mortality with treatment in multivariate analysis, but not reaching statistical significance. | ||
Jun 9 2021 |
et al., PLOS ONE, doi:10.1371/journal.pone.0252388 | Lack of efficacy of hydroxychloroquine and azithromycin in patients hospitalized for COVID-19 pneumonia: A retrospective study |
125% higher combined mortality/intubation [p=0.23]. 203 hospitalized patients in France, not showing significant differences with treatment. Confounding by indication is likely. Authors do not discuss confounding. | ||
Jun 8 2021 |
et al., medRxiv, doi:0.1101/2021.06.06.21258091 (Preprint) | Safety and efficacy of antiviral therapy alone or in combination in COVID-19 - a randomized controlled trial (SEV COVID Trial) |
48% lower mortality [p=0.45] and 14% improved recovery [p=0.76]. Very small early terminated RCT in India, showing lower mortality but without statistical significance with the very small sample size. Time since symptom onset is not provided. The recovery percentage for non-severe group B (86.7%) does .. | ||
Jun 7 2021 |
et al., Journal of the Association of Physicians of India, Volume 69, June 2021 | Hydroxychloroquine for SARS CoV2 Prophylaxis in Healthcare Workers – A Multicentric Cohort Study Assessing Effectiveness and Safety |
60% fewer cases [p<0.0001]. Prophylaxis study with 12,089 Indian healthcare workers, showing lower risk of COVID-19 cases with treatment, and increasingly lower risk for longer durations of HCQ prophylaxis. The appendices are not currently available. | ||
Jun 4 2021 |
et al., Therapeutics and Clinical Risk Management, doi:10.2147/TCRM.S364022 | Outcomes of 2,111 COVID-19 hospitalised patients treated with 2 hydroxychloroquine/azithromycin and other regimens in Marseille, France: a 3 monocentric retrospective analysis |
32% lower mortality [p=0.004]. Retrospective 2,011 hospitalized patients in France, median age 67, showing lower mortality with HCQ+AZ, and further benefit with the addition of zinc. | ||
Jun 4 2021 |
et al., Research Square, doi:10.21203/rs.3.rs-506195/v1 (Preprint) | Safety and Efficacy of Hydroxychloroquine for Treatment of Non-Severe COVID-19 in Adults in Uganda: A Randomized Open Label Phase II Clinical Trial |
no change in recovery [p=0.91] and 29% improved viral clearance [p=0.47]. Small 105 patient RCT in Uganda showing no significant differences. No mortality was reported. The patients were very young (median age 32), recovering in a median time of 3 days with standard of care, so there is little room for a treatm.. | ||
Jun 3 2021 |
et al., European Respiratory Journal, doi:10.1183/13993003.00752-2021 | Azithromycin and hydroxychloroquine in hospitalised patients with confirmed COVID-19–a randomised double-blinded placebo-controlled trial |
92% lower mortality [p=0.32], 22% higher ICU admission [p=1], and 8% lower hospital discharge [p=0.36]. Early terminated late stage (8 days from onset, 59% on oxygen) RCT not showing statistically significant differences. NCT04322396 ProPAC-COVID. NNF20SA0062834. | ||
Jun 1 2021 |
et al., Authorea, doi:10.22541/au.162257516.68665404/v1 (Preprint) | The effect of Hydroxychloroquine use due to rheumatic disease on the risk of Covid-19 infection and its course |
82% lower mortality [p=0.19] and 94% fewer cases [p<0.0001]. Retrospective 683 patients in a rheumatology department, 384 chronic HCQ users and 299 control patients, showing no mortality for HCQ users vs. 2 deaths in the control group, and significantly fewer cases for HCQ users. | ||
Jun 1 2021 |
et al., International Journal of Infectious Diseases, doi:10.1016/j.ijid.2021.05.076 | Hydroxychloroquine as a primary prophylactic agent against sars-cov-2 infection: a cohort study |
44% higher hospitalization [p=0.25] and 10% fewer cases [p=0.23]. Retrospective HCQ users in Denmark, not showing a significant difference, however authors do not adjust for the very different baseline risk for systemic autoimmune disease patients. Authors appear unaware of research in the area, for exa.. | ||
May 31 2021 |
et al., Archivos de Medicina Universitaria | Hydroxychloroquine and Tocilizumab in the Treatment of COVID-19: A Longitudinal Observational Study |
67% lower mortality [p<0.0001] and 6% higher ICU admission [p=1]. Retrospective 403 hospitalized patients in Spain, showing lower mortality with treatment, however authors do not adjust for the differences between the groups. Confounding by indication is likely. | ||
May 31 2021 |
et al., medRxiv, doi:10.1101/2021.05.28.21258012 (Preprint) | Observational Study on 255 Mechanically Ventilated Covid Patients at the Beginning of the USA Pandemic |
27% lower mortality [p=0.002]. Retrospective 255 mechanical ventilation patients in USA, showing that weight-adjusted HCQ+AZ improved survival by over 100%. QTc prolongation did not correlate with cumulative HCQ dose or HCQ serum level. Although authors mention immorta.. | ||
May 29 2021 |
et al., Journal of Pharmaceutical Research International, doi:10.9734/jpri/2020/v32i830468 (Dosing) | Optimizing the Use of Hydroxychloroquine in the Management of COVID-19 Given Its Pharmacological Profile |
Review of the mechanisms of action, pharmacokinetics and toxicity of HCQ, recommending use as early as possible with a loading dose in 3-4 divided doses to minimize toxicity, and daily maintenance divided into two doses, continued until r.. | ||
May 27 2021 |
et al., Reviews in Cardiovascular Medicine, doi:10.31083/j.rcm2203116 (date from earlier preprint) | Early Treatment with Hydroxychloroquine and Azithromycin in 10,429 COVID-19 Outpatients: A Monocentric Retrospective Cohort Study |
83% lower mortality [p=0.0007], 44% lower ICU admission [p=0.18], and 4% lower hospitalization [p=0.77]. Retrospective 10,429 outpatients in France, 8,315 treated with HCQ+AZ a median of 4 days from symptom onset, showing significantly lower mortality with treatment. | ||
May 17 2021 |
et al., Cureus, doi:10.7759/cureus.20572 (date from earlier preprint) | Pre-exposure Prophylaxis With Various Doses of Hydroxychloroquine Among Healthcare Personnel With High-Risk Exposure to COVID-19: A Randomized Controlled Trial |
60% more symptomatic cases [p=0.41] and 92% more cases [p=0.12]. Small PrEP RCT of low risk healthcare workers, showing no significant differences. Authors report that there was no hospitalization, ICU care, or death from COVID-19, however table 3 of the preprint shows severe events labeled as "re.. | ||
May 16 2021 |
et al., medRxiv, doi:10.1101/2021.05.14.21257059 (Preprint) | Hydroxychloroquine For Prophylaxis Of COVID-19 In Health Workers: A Randomized Clinical Trial |
82% fewer symptomatic cases [p=0.12]. Early terminated HCQ PrEP RCT with 62 HCQ and 65 placebo patients, showing 82% lower cases with treatment, p = 0.12. NCT04318015. If the trial is continued and the same event rate is observed, statistical significance will be reached afte.. | ||
May 12 2021 |
et al., Viruses, doi:10.3390/v13050890 | SARS-CoV-2 Persistent Viral Shedding in the Context of Hydroxychloroquine-Azithromycin Treatment |
Retrospective 3,737 patients in France, showing lower risk of persistent viral shedding with HCQ+AZ treatment. | ||
May 10 2021 |
et al., PLOS One, doi:10.1371/journal.pone.0251262 | Predictors for inpatient mortality during the first wave of the SARS-CoV-2 pandemic: A retrospective analysis |
240% higher mortality [p=0.002]. Retrospective 1,108 hospitalized patients in New York showing significantly higher mortality with HCQ treatment. Time based confounding is very likely because HCQ became increasingly controversial and less used over the time covered (Mar .. | ||
May 8 2021 |
et al., Journal of Applied Pharmaceutical Science, doi:10.7324/JAPS.2021.110825 (Review) | Review of four major biomolecular target sites for COVID-19 and possible inhibitors as treatment interventions |
Review of major target sites in SARS-CoV-2 and the host organism along with potential inhibitors. | ||
May 1 2021 |
et al., J. Clin. Med., doi:10.3390/jcm10091951 | Risk Factors for Mortality in COVID-19 Hospitalized Patients in Piedmont, Italy: Results from the Multicenter, Regional, CORACLE Registry |
35% lower mortality [p=0.02]. Retrospective 1,538 hospitalized patients in Italy, showing only HCQ associated with reduced mortality. Authors analyze mortality amongst those that were alive at day 7 to avoid survival time bias due to drug recording requiring a minimum.. | ||
Apr 30 2021 |
et al., South. Clin. Ist. Euras., doi:10.14744/scie.2021.89847 | The Effect of Pre-admission Hydroxychloroquine Treatment on COVID-19-Related Intensive Care Follow-up in Geriatric Patients |
3% lower mortality [p=0.85]. Retrospective 147 ICU patients in Turkey, showing no significant difference in outcomes based on HCQ treatment before ICU admission. This is not very informative, for example we do not know if HCQ treated patients were much less likely to.. | ||
Apr 30 2021 |
et al., Infect. Dis. Ther., doi:10.1007/s40121-021-00496-6 | Favipiravir and Hydroxychloroquine Combination Therapy in Patients with Moderate to Severe COVID19 (FACCT Trial): An Open-Label, Multicenter, Randomized, Controlled Trial |
4% lower mortality [p=0.91], 8% higher ventilation [p=0.78], 31% higher ICU admission [p=0.24], and 29% slower recovery [p=0.29]. RCT 254 very late stage (93% on oxygen, 17% in ICU at baseline) hospitalized patients in Saudi Arabia not showing significant differences with HCQ+favipiravir treatment. Only SaO2 < 94% patients were eligible, however the actual SaO2 of e.. | ||
Apr 29 2021 |
et al., Journal of Medical Virology, doi:10.1002/jmv.27053 | Decreased in-hospital mortality associated with aspirin administration in hospitalized patients due to severe COVID-19 |
19% lower mortality [p=0.09]. Retrospective 991 hospitalized patients in Iran, showing lower mortality with HCQ, not reaching statistical significance. | ||
Apr 29 2021 |
et al., Journal of Medical Virology, doi:10.1002/jmv.27053 | Decreased In-Hospital Mortality Associated with Aspirin Administration in Hospitalized Patients Due to Severe COVID-19 |
19% lower mortality [p=0.09]. Retrospective 991 hospitalized patients in Iran focusing on aspirin use but also showing results for HCQ, remdesivir, and favipiravir. | ||
Apr 28 2021 |
et al., Respiratory Medicine, doi:10.1016/j.rmed.2021.106433 | The predictors of COVID-19 mortality in a nationwide cohort of Turkish patients |
4% higher mortality [p=0.97]. Retrospective 1,500 hospitalized late stage (median SaO2 87.7) patients in Turkey, showing no significant difference with HCQ treatment. | ||
Apr 27 2021 |
et al., Scientific Reports, doi:10.1038/s41598-021-88509-9 | An open-label randomized controlled trial evaluating the efficacy of chloroquine/hydroxychloroquine in severe COVID-19 patients |
57% higher mortality [p=0.2], 115% higher ventilation [p=0.03], and 147% worse recovery [p=0.02]. Early terminated very late stage (99% on oxygen, 81% in ICU, 18% on mechanical ventilation at baseline) RCT with 24 CQ patients, 29 HCQ, and 52 control patients, showing worse clinical outcomes with treatment. NCT04420247. | ||
Apr 26 2021 |
et al., | Clinical review of COVID-19 patients presenting to a quaternary care private hospital in South India: A retrospective study |
81% higher mortality [p=0.007]. Retrospective 3,345 hospitalized patients in India, 11.5% treated with HCQ, showing unadjusted higher mortality with treatment. Confounding by indication and time based confounding (due to declining use over the period when overall treatm.. | ||
Apr 24 2021 |
et al., Internal and Emergency Medicine, doi:10.1007/s11739-021-02742-8 | Clinical factors associated with death in 3044 COVID-19 patients managed in internal medicine wards in Italy: results from the SIMI-COVID-19 study of the Italian Society of Internal Medicine (SIMI) |
70% lower mortality [p<0.0001]. Retrospective 3,044 hospitalized COVID-19 patients in Italy, showing HCQ significantly associated with survival in light, mild, and moderate cases in multivariable analysis, but not in severe cases. | ||
Apr 23 2021 |
et al., SSRN (Preprint) | A Cross-Country Analysis of the Determinants of COVID-19 Fatalities |
Country based analysis finding lower mortality with the use of HCQ. | ||
Apr 22 2021 |
et al., JAMA Network Open, doi:10.1001/jamanetworkopen.2021.6468 | Effect of Early Treatment With Hydroxychloroquine or Lopinavir and Ritonavir on Risk of Hospitalization Among Patients With COVID-19 The TOGETHER Randomized Clinical Trial |
24% lower hospitalization [p=0.57] and 4% improved viral clearance [p=0.1]. Early terminated RCT in Brazil showing lower mortality and hospitalization with HCQ, but not reaching statistical significance. Although the title includes "early treatment", treatment was relatively late, with most patients bei.. | ||
Apr 15 2021 |
et al., Rheumatology International , doi:10.1007/s00296-021-04857-9 | Clinical characteristics and outcome of COVID-19 in patients with rheumatic diseases |
59% lower mortality [p=1], 81% lower ventilation [p=0.54], and 33% lower severe cases [p=0.7]. Retrospective 47 rheumatic disease patients not finding significant differences with HCQ. | ||
Apr 15 2021 |
et al., Rheumatology, doi:10.1093/rheumatology/keab348 | Risk of COVID-19 hospitalization and mortality in rheumatic patients treated with hydroxychloroquine or other conventional DMARDs in Italy |
8% higher mortality [p=0.64] and 18% lower hospitalization [p=0.03]. Retrospective database analysis case control study of rheumatic patients. When compared with other cDMARDs, HCQ users had significantly lower hospitalization, however there was no significant difference in mortality. Results differ signif.. | ||
Apr 14 2021 |
et al., International Journal of Infectious Diseases, doi:10.1016/j.ijid.2021.04.035 | Positive impact of oral hydroxychloroquine and povidone-iodine throat spray for COVID-19 prophylaxis: an open-label randomized trial |
35% fewer symptomatic cases [p=0.05] and 32% fewer cases [p=0.009]. Prophylaxis RCT in Singapore with 3,037 low risk patients, showing lower serious cases, lower symptomatic cases, and lower confirmed cases of COVID-19 with all treatments (ivermectin, HCQ, PVP-I, and Zinc + vitamin C) compared to vitamin .. | ||
Apr 8 2021 |
et al., BMJ Open, doi:10.1136/bmjopen-2020-042549 | Clinical characteristics of hospitalised patients with COVID-19 and the impact on mortality: a single-network, retrospective cohort study from Pennsylvania state |
5% higher mortality [p=0.89]. Retrospective 283 patients in the USA showing higher mortality with all treatments (not statistically significant). Confounding by indication is likely. In the supplementary appendix, authors note that the treatments were usually given fo.. | ||
Apr 7 2021 |
et al., BMJ Open, doi:10.1136/bmjopen-2020-042042 | 3219 hospitalised patients with COVID-19 in Southeast Michigan: a retrospective case cohort study |
28% higher mortality [p=0.1]. Retrospective database analysis of 3,219 hospitalized patients in the USA. Very different results in the time period analysis (Table S2), and results significantly different to other studies for the same medications (e.g., heparin OR 3.06.. | ||
Apr 6 2021 |
et al., International Immunopharmacology, doi:10.1016/j.intimp.2021.107636 | Clinical outcomes of patients with mild COVID-19 following treatment with hydroxychloroquine in an outpatient setting |
70% lower mortality [p<0.0001] and 35% lower hospitalization [p<0.0001]. Retrospective 28,759 adult outpatients with mild COVID-19 in Iran, 7,295 treated with HCQ, showing significantly lower hospitalization and mortality with treatment. | ||
Apr 5 2021 |
et al., European Journal of Internal Medicine, doi:10.1016/j.ejim.2021.03.028 | Safety of treatment with chloroquine and hydroxychloroquine: A ten-year systematic review and meta-analysis |
Safety analysis of CQ and HCQ covering 46 RCTs with 23,132 patients, showing no mortality attributed to CQ/HCQ. Authors conclude that the data reinforces that CQ and HCQ have a good safety profile though caution is advised when using high.. | ||
Mar 31 2021 |
et al., Antibiotics, doi:10.3390/antibiotics10040365 | Clinical Efficacy of Hydroxychloroquine in Patients with COVID-19: Findings from an Observational Comparative Study in Saudi Arabia |
7% higher mortality [p=0.88]. Retrospective 775 hospitalized patients in Saudi Arabia showing no significant difference. There was no adjustment for severity or comorbidities. Confounding by indication is likely. | ||
Mar 26 2021 |
et al., Indian J. Med. Res., doi:10.4103/ijmr.IJMR_2294_20 | Safety of hydroxychloroquine in healthcare workers for COVID-19 prophylaxis |
Retrospective 1303 health care workers finding that HCQ prophylaxis was well tolerated. 20% reported an adverse event, mostly gastrointestinal. 1.5% received treatment for adverse effects, with none requiring hospitalization. | ||
Mar 24 2021 |
et al., Transactions of The Royal Society of Tropical Medicine and Hygiene, doi:10.1093/trstmh/trab047 | Risk factors and frequency of COVID-19 among healthcare workers at a tertiary care centre in India: a case–control study |
26% fewer cases [p=0.003]. Retrospective case control study of 3,100 healthcare workers in India showing lower cases with HCQ prophylaxis, and an inverse association between the number of HCQ doses taken and the risk of COVID-19 cases. Low risk population with no m.. | ||
Mar 23 2021 |
et al., International Journal of Infectious Diseases, doi:10.1016/j.ijid.2021.03.058 | Clinical Characteristics and Outcomes of Hospitalized COVID-19 Patients in a MERS-CoV Referral Hospital during the Peak of the Pandemic |
99% lower mortality [p=0.6]. 605 hospitalized patients in Saudi Arabia showing no mortality with HCQ (only 6 patients received HCQ). | ||
Mar 17 2021 |
et al., PLoS ONE, doi:10.1371/journal.pone.0248128 | COVID-19 Evidence Accelerator: A parallel analysis to describe the use of Hydroxychloroquine with or without Azithromycin among hospitalized COVID-19 patients |
18% higher mortality [p=0.27] and 29% higher ventilation [p=0.09]. Collection of seven retrospective database analyses in the USA, showing higher mortality with treatment (not statistically significant). Results contradict strong evidence from the RECOVERY/SOLIDARITY trials, suggesting substantial confou.. | ||
Mar 17 2021 |
et al., bioRxiv, doi:10.1101/2021.03.16.435741 (Preprint) (In Vitro) | Structural basis of anti-SARS-CoV-2 activity of hydroxychloroquine: specific binding to NTD/CTD and disruption of LLPS of N protein |
Microscopy/spectroscopy study showing that HCQ binds to both N-terminal domain and C-terminal domain of SARS-CoV-2 nucleocapsid protein to inhibit their interactions with nucleic acids and disrupt NA-induced liquid-liquid phase separation.. | ||
Mar 12 2021 |
et al., medRxiv, doi:10.1101/2021.03.08.21252883 (Preprint) | Outcome of Different Therapeutic Interventions in Mild COVID-19 Patients in a Single OPD Clinic of West Bengal: A Retrospective study |
2% faster recovery [p=0.96]. Retrospective database analysis of 56 mild COVID-19 patients, all treated with vitamin C, vitamin D, and zinc, comparing ivermectin + doxycycline (n=14), AZ (n=13), HCQ (n=14), and SOC (n=15), finding that all groups recover quickly, and .. | ||
Mar 9 2021 |
et al., Eurosurveillance, doi:/10.2807/1560-7917.ES.2021.26.9.2001202 | Incidence of COVID-19 in patients exposed to chloroquine and hydroxychloroquine: results from a population-based prospective cohort in Catalonia, Spain, 2020 |
46% higher hospitalization [p=0.1] and 8% more cases [p=0.5]. Retrospective database analysis of chronic HCQ users and matched control patients, failing to match or adjust for the very different baseline risk for systemic autoimmune disease patients. Other research shows that the risk of COVID-19 fo.. | ||
Mar 8 2021 |
et al., medRxiv, doi:10.1101/2021.03.08.21253121 (Preprint) | Absent or insufficient anti-SARS-CoV-2 S antibodies at ICU admission are associated to higher viral loads in plasma, antigenemia and mortality in COVID-19 patients |
59% lower mortality [p=0.41]. Retrospective 92 ICU patients with almost all treated with HCQ and only one non-HCQ treated patient that died, showing unadjusted non-statistically significant lower mortality with treatment. | ||
Mar 4 2021 |
et al., Cureus, doi:10.7759/cureus.13687 | Clinical Features and Prognostic Factors of 245 Portuguese Patients Hospitalized With COVID-19 |
33% lower mortality [p=0.1], 448% higher ventilation [p=0.003], and 17% lower combined mortality/intubation [p=0.21]. Prospective study of 245 hospitalized patients, 121 treated with HCQ, showing lower (non-statistically significant) mortality and higher ventilation at 30 days. Confounding by indication is likely. | ||
Mar 2 2021 |
et al., Rheumatology Advances in Practice, 10.1093/rap/rkab014 | Failure of chronic hydroxychloroquine in preventing severe complications of COVID-19 in patients with rheumatic diseases |
20% lower mortality [p=0.77] and 35% higher ICU admission [p=0.61]. Tiny retrospective database analysis of hospitalized COVID-19 patients with rheumatologic disease containing 14 chronic HCQ and 28 control patients. Patients are very poorly matched. Bias against HCQ is clear in the abstract which mention.. | ||
Feb 28 2021 |
et al., Indian J. Med. Res., doi:10.4103/ijmr.IJMR_3665_20 | Chloroquine nasal drops in asymptomatic & mild COVID-19: An exploratory randomized clinical trial |
Small RCT for CQ nasal drops suggesting efficacy in preventing infection, while no significant difference was seen for patients that already had mild COVID-19. | ||
Feb 28 2021 |
et al., International Journal of Medicine and Public Health, doi:10.5530/ijmedph.2021.1.4 | A Preventive Study on Hydroxychloroquine Prophylaxis against COVID-19 in Health Care Workers at a Tertiary Care Center in North India |
Retrospective 4,239 healthcare workers using HCQ prophylaxis showing no mortality, 8 mild symptomatic cases, and 85 asymptomatic cases, with the cases occuring mostly in the first week. | ||
Feb 26 2021 |
et al., medRxiv, doi:10.1101/2021.02.22.21252228 (Preprint) | Hydroxychloroquine for SARS-CoV-2 positive patients quarantined at home: The first interim analysis of a remotely conducted randomized clinical trial |
60% improved recovery [p=0.13]. Tiny early-terminated 34 patient RCT for outpatient treatment showing faster recovery with treatment (not statistically significant). All patients recovered (3 control patients recovered after crossover to the treatment arm) - as per prot.. | ||
Feb 26 2021 |
et al., Turkish Journal of Medical Sciences, doi:doi:10.3906/sag-2005-82 | Hydroxychloroquine plus azithromycin and early hospital admission are beneficial in COVID-19 patients: Turkish experience with real-life data |
Retrospective 83 hospitalized patients in Turkey confirming that earlier treatment is better, and showing that the addition of AZ to HCQ reduced hospitalization time. | ||
Feb 26 2021 |
et al., Research Square, doi:rs.3.rs-251817/v1 (Preprint) | The Need for Early Management in Patients With COVID-19 |
Review of early treatment of COVID-19 at IHU Méditerranée Infection in France, including HCQ+AZ treatment, comparing outcomes to those for all of France. Age-standardized mortality was lower with early treatment for all periods of the epi.. | ||
Feb 23 2021 |
et al., Infectious Disease Reports, doi:10.3390/idr14020020 (date from earlier preprint) | Efficacy and Safety of Ivermectin and Hydroxychloroquine in Patients with Severe COVID-19: A Randomized Controlled Trial |
63% lower mortality [p=0.27] and 25% lower progression [p=0.57]. RCT late stage severe condition (93% SOFA ≥ 2, 96% APACHE ≥ 8) high comorbidity hospitalized patients in Mexico with 33 HCQ and 37 control patients not finding significant differences. NCT04391127. | ||
Feb 20 2021 |
et al., Viruses 2021, doi:10.3390/v13020329 | Recent Hydroxychloroquine Use Is Not Significantly Associated with Positive PCR Results for SARS-CoV-2: A Nationwide Observational Study in South Korea |
30% fewer cases [p=0.18]. Retrospective database analysis of prior HCQ usage in South Korea, showing non-statistically significantly lower mortality and cases with treatment. | ||
Feb 19 2021 |
et al., The Brazilian Journal of Infectious Diseases, doi:10.1016/j.bjid.2021.101549 | Hydroxychloroquine with azithromycin in patients hospitalized for mild and moderate COVID-19 |
9% lower mortality [p=0.83], 20% higher ICU admission [p=0.61], and 12% shorter hospitalization. Retrospective 193 hospitalized patients in Brazil not finding a significant difference with HCQ. The control group was composed of patients refusing HCQ or with contraindications. Time based confounding is very likely because HCQ became m.. | ||
Feb 18 2021 |
et al., American Journal of Health-System Pharmacy, doi:10.1093/ajhp/zxab056 | Impact of hydroxychloroquine on disease progression and ICU admissions in patients with SARS-CoV-2 infection |
19% higher mortality [p=0.6], 461% higher ventilation [p<0.0001], and 463% higher ICU admission [p<0.0001]. This paper has inconsistent values - the number of treatment and control patients differs in the text and Table 1, we have used treatment 188 and control 148. Retrospective 336 hospitalized patients in the USA showing higher mortality, IC.. | ||
Feb 15 2021 |
et al., American Journal of Blood Research, 11:1 | Seroprevalence of IgG against SARS-CoV-2 and its determinants among healthcare workers of a COVID-19 dedicated hospital of India |
27% lower IgG positivity [p=0.38]. Retrospective 689 healthcare workers in India, showing no significant difference in IgG positivity with HCQ prophylaxis in unadjusted results. | ||
Feb 11 2021 |
et al., J. Infection, doi:10.1016/j.jinf.2021.02.011 | Early Lopinavir/ritonavir does not reduce mortality in COVID-19 patients: results of a large multicenter study |
50% lower mortality [p<0.0001]. Lopinavir/ritonavir retrospective study also showing univariate results for HCQ, with significantly lower mortality. | ||
Feb 10 2021 |
et al., J. Clinical Medicine, doi:10.3390/jcm10040686 | The Use of Antiviral Agents against SARS-CoV-2: Ineffective or Time and Age Dependent Result? A Retrospective, Observational Study among COVID-19 Older Adults |
Retrospective 143 COVID-19 hospitalized patients >65yo, showing adjusted OR for antiviral treatment starting within 6 days of 0.44 [0.2-0.9], p = 0.02, compared to treatment started later. | ||
Feb 9 2021 |
e al., Archives of Microbiology & Immunology, doi: (meta analysis) | Revisiting a Meta-analysis Shows that Hydroxychloroquine with Azithromycin may be Efficient in Covid-19 patients |
Analysis of the Fiolet meta analysis and correction of bias evaluation, showing HCQ RR 0.45 [0.31-0.59], and HCQ+AZ RR 0.34 [0.06-0.61]. | ||
Feb 9 2021 |
et al., Biochemistry Research International, doi:10.1155/2021/6685921 | A Randomized, Double-Blind, Multicenter Clinical Study Comparing the Efficacy and Safety of a Drug Combination of Lopinavir/Ritonavir-Azithromycin, Lopinavir/Ritonavir-Doxycycline, and Azithromycin-Hydroxychloroquine for Patients Diagnosed with Mild to Moderate COVID-19 Infections |
66% improved viral clearance [p<0.0001]. RCT 754 patients comparing HCQ+AZ along with other treatment groups using lopinavir/ritonavir and doxycycline to a control group taking AZ, finding significantly faster viral clearance with all treatment groups. (The labels in Figure 2 ap.. | ||
Feb 5 2021 |
et al., medRxiv, doi:10.1101/2021.02.03.21251069 (Preprint) | Risk Factors for Infection and Health Impacts of the COVID-19 Pandemic in People with Autoimmune Diseases |
9% fewer cases [p=0.54]. Retrospective 4666 people with autoimmune or inflammatory conditions, showing HCQ adjusted risk of COVID-19 OR 0.91 [0.68-1.23]. Results are not adjusted for the significantly different risk of COVID-19 depending on the type and severity .. | ||
Feb 5 2021 |
et al., medRxiv, doi:10.1101/2021.02.01.21250371 (Preprint) | Hydroxychloroquine for the treatment of severe respiratory infection by COVID-19: a randomized controlled trial |
12% lower mortality [p=0.66]. Very late stage RCT with 214 patients, mean SpO2 65%, 162 on mechanical ventilation, showing no significant difference in mortality. Patients not intubated at baseline show greater improvement, HR 0.43 [0.09-2.03]. Table 4 shows different.. | ||
Feb 5 2021 |
et al., Revue des Maladies Respiratoires, doi:10.1016/j.rmr.2021.02.001 | Factors associated with the occurrence of acute respiratory distress and death in patients with COVID-19 in Burkina Faso |
33% lower mortality [p=0.38] and 68% lower severe cases [p=0.001]. Retrospective 456 patients in Burkina Faso showing lower risk of ARDS (p=0.001) and mortality (p=0.38) with HCQ. | ||
Feb 1 2021 |
et al., medRxiv, doi:10.1101/2021.01.28.21250706 (Review) (Preprint) | Early Multidrug Outpatient Treatment of SARS-CoV-2 Infection (COVID-19) and Reduced Mortality Among Nursing Home Residents |
Review of studies on treatment of COVID-19 for nursing home residents, concluding that there is a large >60% mortality risk reduction associated with multidrug treatment using two or more intracellular anti-infectives (HCQ and either AZM .. | ||
Feb 1 2021 |
et al., Critical Care Research and Practice, 10.1155/2021/7510306 | COVID-19: A Single-Center ICU Experience of the First Wave in the Philippines |
18% lower mortality [p=0.64]. Retrospective ICU patients in the Philippines showing unadjusted HCQ RR 0.82, p = 0.64. | ||
Jan 31 2021 |
et al., Immunopathologia Persa, doi:10.34172/ipp.2021.29 (Preprint) | Prophylactic effects of hydroxychloroquine on the incidence of COVID-19 in patients with rheumatic arthritis: an observational cohort study |
Prospective observational study of 215 RA patients treated with HCQ showing 9 cases, 1 hospitalization (without ICU/intubation), and no mortality. | ||
Jan 31 2021 |
et al., Revista Espanola de Quimioterapia, doi:10.37201/req/130.2020 | Clinical and pharmacological data in COVID-19 hospitalized nonagenarian patients |
16% lower mortality [p=0.76]. Retrospective 79 hospitalized nonagenarian patients showing unadjusted HCQ mortality RR 0.84, p = 0.76. | ||
Jan 29 2021 |
et al., Journal of Healthcare Engineering, doi:10.1155/2021/5556207 (date from earlier preprint) | Disentangling the Association of Hydroxychloroquine Treatment with Mortality in Covid-19 Hospitalized Patients through Hierarchical Clustering |
40% lower mortality [p<0.0001]. Retrospective 4,396 hospitalized patients in Italy showing significantly lower mortality with HCQ treatment, and identifying greater efficacy for a subgroup of patients in clustering analysis. | ||
Jan 27 2021 |
et al., Annals of the Rheumatic Diseases, doi:10.1136/annrheumdis-2020-219498 | Factors associated with COVID-19-related death in people with rheumatic diseases: results from the COVID-19 Global Rheumatology Alliance physician-reported registry |
48% lower mortality [p<0.0001]. Retrospective 3,729 rheumatic disease patients showing lower risk of mortality with HCQ/CQ use (HCQ/CQ vs. no DMARD therapy). | ||
Jan 27 2021 |
et al., Revue du Rhumatisme, doi:10.1016/j.rhum.2021.09.004 (date from earlier preprint) | Effet d’un traitement par hydroxychloroquine prescrit comme traitement de fond de rhumatismes inflammatoires chroniques ou maladies auto-immunes systémiques sur les tests diagnostiques et l’évolution de l’infection à SARS CoV-2: étude de 871 patients |
17% higher mortality [p=0.8], 78% higher combined mortality/ICU admission [p=0.21], and 45% higher hospitalization [p=0.12]. Retrospective 71 chronic HCQ patients compared with 191 matched controls, analyzing only those with a highly suspected or confirmed diagnosis of COVID-19. No significant difference was found in outcomes, however matching failed with extre.. | ||
Jan 26 2021 |
et al., medRxiv, doi:10.1101/2021.01.16.21249941 (Preprint) | Hydroxychloroquine and azithromycin: As a double edge sword for COVID-19? |
Retrospective 172 hospitalized patients, 83% treated and HCQ+AZ and 17% with HCQ, not finding a significant difference in QTc prolongation, but recommending careful monitoring for the use of HCQ+AZ; especially in males, patients with high.. | ||
Jan 25 2021 |
et al., Archives of Virology, doi:10.1007/s00705-021-04956-9 | Efficacy of favipiravir in COVID-19 treatment: a multi-center randomized study |
This study was retracted. | ||
Jan 25 2021 |
et al., Journal of Molecular Structure, doi:10.1016/j.molstruc.2021.129979 | Molecular Docking Identification for the efficacy of Some Zinc Complexes with Chloroquine and Hydroxychloroquine against Main Protease of COVID-19 |
Molecular dynamics analysis recommending Zn (CQ) Cl2(H2O) and Zn (HCQ) Cl2(H2O) as potential inhibitors for COVID-19 Mpro. Zn (HCQ) Cl2(H2O) exhibited a strong binding to the main protease receptor, forming eight hydrogen bonds. | ||
Jan 24 2021 |
, Z., Preprint (Preprint) | Nebulized Hydroxychloroquine for COVID-19 Treatment: 80x Improvement in Breathing |
Report on the use of nebulized HCQ showing much more rapid improvement compared to tablets, with 95% of patients experiencing improved breathing within 1 hour. Author notes that the effectiveness of HCQ is time and dose dependent, with a .. | ||
Jan 23 2021 |
et al., Medicina Clínica (English Edition), doi:10.1016/j.medcle.2020.10.012 | Incidence of COVID-19 in patients under chronic treatment with hydroxychloroquine |
Retrospective 3,817 chronic HCQ patients showing 4.4% COVID-19 positive rate, 1.3% severe. There is no comparison with a control group. Authors note that there was a 3.6% incidence among 2,032,863 patients in one of the regions (Castilla .. | ||
Jan 18 2021 |
et al., Science China Life Sciences, doi:10.1007/s11427-020-1871-4 | Evaluation of the efficacy and safety of hydroxychloroquine in comparison with chloroquine in moderate and severe patients with COVID-19 |
50% higher hospital discharge [p=0.09]. Small RCT comparing HCQ and CQ in China with 88 very late stage (17.6 days from onset to hospitalization and ~10 days to randomization) patients. The primary clinical outcomes (TTCR and TTCI) were not significantly different. Authors note.. | ||
Jan 13 2021 |
et al., Postgraduate Medical Journal, doi:10.1136/postgradmedj-2020-139561 | Prevalence of COVID-19 in patients with rheumatoid arthritis (RA) already treated with hydroxychloroquine (HCQ) compared with HCQ-naive patients with RA: a multicentre cross-sectional study |
17% fewer cases [p=0.59]. Survey analysis of 1,858 RA patients in Iran, showing no significant difference in cases with HCQ prophylaxis. | ||
Jan 12 2021 |
et al., Research Square, doi:10.21203/rs.3.rs-119202/v1 (Preprint) | Treatment of COVID-19 patients with hydroxychloroquine or chloroquine: A retrospective analysis |
40% slower viral clearance [p=0.06]. Small retrospective database analysis of 37 late stage patients hospitalized in an intensive care center in China, not finding a significant difference in viral shedding. Pateints were all in serious condition. There was only one death ho.. | ||
Jan 10 2021 |
et al., Journal of the American Academy of Dermatology, doi:10.1016/j.jaad.2020.10.098 | Chronic Hydroxychloroquine Therapy and COVID-19 Outcomes: A Retrospective Case-Control Analysis |
25% lower mortality [p=0.77] and 22% lower hospitalization [p=0.29]. Retrospective 50 COVID-19 patients that take chronic HCQ, compared to a matched sample of patients not taking chronic HCQ, showing lower mortality and ICU admission, and shorter hospitalization for HCQ patients, but not statistically sign.. | ||
Jan 8 2021 |
et al., medRxiv, doi:10.1101/2021.01.06.20249091 (Preprint) | Epidemiological and Clinical Characteristics, and Virologic Features of COVID-19 Patients in Kazakhstan: a Nation-Wide, Retrospective, Cohort Study |
95% lower mortality [p=1]. Retrospective 1,072 hospitalized patients in Kazakhstan showing no mortality for HCQ treated patients, however only 23 patients received treatment - this result is not statistically significant. | ||
Jan 7 2021 |
et al., Journal of Molecular Structure, doi:10.1016/j.molstruc.2021.129891 | Inhibitory capacity of Chloroquine against SARS-COV-2 by effective binding with Angiotensin converting enzyme-2 receptor: An insight from molecular docking and MD-simulation studies |
Molecular docking study of 16 drugs showing CQ had the highest binding affinity with ACE2, and molecular dynamics study of the docked CQ-ACE2 structure. Authors conclude that CQ binds reasonably strongly with ACE2 and the stable ACE2-CQ m.. | ||
Jan 6 2021 |
et al., Journal of King Saud University - Science, doi:10.1016/j.jksus.2020.101334 | Quantum chemical studies on molecular structure, AIM, ELF, RDG and antiviral activities of hybrid hydroxychloroquine in the treatment of COVID-19: molecular docking and DFT calculations |
In silico analysis of hydroxychloroquine and hydroxychloroquine sulfate predicting that hydroxychloroquine sulfate is more stable and effective for COVID-19. | ||
Jan 4 2021 |
et al., International Journal of Antimicrobial Agents, doi:10.1016/j.ijantimicag.2020.106236 | Safety profile of hydroxychloroquine and azithromycin combined treatment in COVID-19 patients |
Report on the safety of HCQ+AZ with 3,737 COVID-19 patients. 138 had contraindications and treatment was discontinued in 12 cases due to QTc prolongation. There were no cases of torsade de pointe or sudden death. | ||
Jan 2 2021 |
et al., medRxiv, doi:10.1101/2020.12.28.20248920 (Preprint) | Determinants of in-hospital mortality in COVID-19; a prospective cohort study from Pakistan |
45% higher mortality [p=0.07]. Retrospective 186 hospitalized patients in Pakistan showing unadjusted HCQ mortality RR 1.45, p = 0.07. Confounding by indication is likely. | ||
Jan 1 2021 |
et al., Turk. Thorac. J., doi:10.5152/TurkThoracJ.2021.20180 | Use of Hydroxychloroquine in Patients with COVID-19: A Retrospective Observational Study |
25% higher mortality [p=0.76], 41% higher ventilation [p=0.34], and 17% higher ICU admission [p=0.53]. Retrospective 202 patients in Saudi Arabia not showing significant differences with treatment. No information is provided on how patients were selected for treatment, there may be significant confounding by indication. Time varying confou.. | ||
Jan 1 2021 |
et al., International Journal of Infectious Diseases, doi:/10.1016/j.ijid.2020.12.060 | No clinical benefit in mortality associated with hydroxychloroquine treatment in patients with COVID-19 |
70% higher mortality [p=0.01]. Retrospective database analysis of 1,669 patients in the US showing OR 1.81, p = 0.01. Confounding by indication is likely. COVID-19 was determined via PCR+ results, therefore authors include patients asymptomatic for COVID-19, but in th.. | ||
Dec 31 2020 |
et al., Indian Journal of Critical Care Medicine, doi:10.5005/jp-journals-10071-23599 | A Retrospective Observational Study of Hypoxic COVID-19 Patients Treated with Immunomodulatory Drugs in a Tertiary Care Hospital |
29% lower mortality [p=0.36]. Retrospective 134 hospitalized COVID-19 patients in India, showing no significant difference with HCQ treatment in unadjusted results. | ||
Dec 31 2020 |
et al., Bioorganic & Medicinal Chemistry, doi:10.1016/j.bmc.2020.115973 (Review) | A comprehensive review on the biological interest of quinoline and its derivatives |
Review of quinolone and derivatives, natural and drug sources, and biological activity. | ||
Dec 31 2020 |
et al., Open Forum Infectious Diseases, doi:10.1093/ofid/ofaa439.721 | Corona Virus Disease-19 (COVID-19) in a Veterans Affairs Hospital at Suffolk County, Long Island, New York |
63% higher mortality [p=0.52]. Retrospective 67 hospitalized patients in the USA showing non-statistically significant unadjusted increased mortality with HCQ. Confounding by indication is likely. Time varying confounding is likely. HCQ became controversial and was sus.. | ||
Dec 31 2020 |
et al., Open Forum Infectious Diseases, doi:10.1093/ofid/ofaa439.560 | Characteristics and outcomes of COVID-19 patients admitted to a regional health system in the southeast |
79% higher mortality [p=0.1]. Retrospective 161 hospitalized patients in the USA showing non-statistically significant unadjusted increased mortality with HCQ. Confounding by indication is likely. Time varying confounding is likely. HCQ became controversial and was su.. | ||
Dec 31 2020 |
et al., Swiss Medical Weekly, doi:10.4414/smw.2020.20446 | Early experimental COVID-19 therapies: associations with length of hospital stay, mortality and related costs |
15% lower mortality [p=0.71] and 49% longer hospitalization [p=0.002]. Retrospective 840 hospitalized patients in Switzerland showing non-statistically significant lower mortality with HCQ but significantly longer hospitalization times. Confounding by indication is likely. PSM fails to adjust for severity wi.. | ||
Dec 30 2020 |
et al., Reviews in Cardiovascular Medicine, doi:10.31083/j.rcm.2020.04.264 (Review) | Multifaceted highly targeted sequential multidrug treatment of early ambulatory high-risk SARS-CoV-2 infection (COVID-19) |
Review urging early treatment of COVID-19 with sequential multidrug treatment that has been shown to be safe and effective. Proposed treatment includes zinc, vitamin D & C, quercetin, and depending on age, comorbidities, and symptoms may .. | ||
Dec 30 2020 |
et al., Reviews in Cardiovascular Medicine, doi:10.31083/j.rcm.2020.04.260 | Clinical outcomes after early ambulatory multidrug therapy for high-risk SARS-CoV-2 (COVID-19) infection |
Retrospective 922 outpatients, with 320 treated early due to age>50 or comorbidities, showing 2.2% hospitalization and 0.3% death, which authors note is considerably lower than reported in other studies in their region. At least two of zi.. | ||
Dec 29 2020 |
et al., Journal of Infection and Public Health, doi:10.1016/j.jiph.2020.12.017 | Comparing ICU Admission Rates of Mild/Moderate COVID-19 Patients Treated with Hydroxychloroquine, Favipiravir, and Hydroxychloroquine plus Favipiravir |
77% lower ICU admission [p=0.16]. Retrospective 824 hospitalized patients in Turkey showing lower ICU admission for HCQ vs. favipiravir. | ||
Dec 28 2020 |
et al., Rheumatology, doi:10.1093/rheumatology/keaa897 | Incidence and severeness of COVID-19 hospitalisation in patients with inflammatory rheumatic disease: a nationwide cohort study from Denmark |
Retrospective 58,052 rheumatic disease patients in Denmark showing that RA patients have a higher risk of COVID-19 hospitalization in general. HCQ treated patients show lower risk, although this is not statistically significant with only .. | ||
Dec 24 2020 |
et al., Blood, doi:10.1182/blood.2020008150 | Clinical features associated with COVID-19 outcome in multiple myeloma: first results from the International Myeloma Society data set |
33% lower mortality [p=0.17]. Retrospective multiple myeloma patients showing lower mortality with HCQ treatment, unadjusted RR 0.67, p = 0.17 (data is in the supplementary material). | ||
Dec 23 2020 |
et al., BioScience Trends, doi:10.5582/bst.2020.03340 | Efficacy of early hydroxychloroquine treatment in preventing COVID-19 pneumonia aggravation, the experience from Shanghai, China |
85% lower progression [p=0.006], 24% faster improvement [p=0.02], and 36% improved viral clearance [p=0.001]. 85% lower disease progression with early use of HCQ. Retrospective 616 patients in China showing adjusted progression HR 0.15, p = 0.006. | ||
Dec 23 2020 |
et al., The Lancet Regional Health - Europe, doi:10.1016/j.lanepe.2020.100019 | The role of organizational characteristics on the outcome of COVID-19 patients admitted to the ICU in Belgium |
25% lower mortality [p=0.02]. Retrospective 1,747 ICU patients in Belgium showing lower mortality with HCQ, multivariate mixed effects analysis HCQ aOR 0.64 [0.45-0.92]. | ||
Dec 22 2020 |
et al., Aging, doi:10.18632/aging.202307 | Mortality in an Italian nursing home during COVID-19 pandemic: correlation with gender, age, ADL, vitamin D supplementation, and limitations of the diagnostic tests |
73% lower mortality [p=0.03]. 73% lower mortality with HCQ. Analysis of 98 PCR+ nursing home residents in Italy, mean age 90, showing HCQ mortality RR 0.27, p = 0.03. Subject to confounding by contraindication. The paper provides the p value for regression but not the.. | ||
Dec 19 2020 |
et al., International Journal of Infectious Diseases, doi:10.1016/j.ijid.2020.12.041 | Association of prescribed medications with the risk of COVID-19 infection and severity among adults in South Korea |
251% higher progression [p=0.11] and 6% fewer cases [p=0.82]. Retrospective database analysis with 17 cases for existing HCQ users and 5 severe cases, showing no significant difference for cases and higher risk for severe cases. However, HCQ users are likely systemic autoimmune disease patients and .. | ||
Dec 18 2020 |
et al., PLoS ONE, doi:10.1371/journal.pone.0244272 | Clinical characteristics of COVID-19 patients hospitalized at Clinique Ngaliema, a public hospital in Kinshasa, in the Democratic Republic of Congo: A retrospective cohort study |
55% lower mortality [p=0.21]. 55% lower death with HCQ+AZ. Retrospective 160 hospitalized patients in the Democratic Republic of Congo, 92% receiving HCQ+AZ, showing adjusted OR 0.24 [0.03-2.2]. | ||
Dec 16 2020 |
et al., Archivos de Bronconeumología, doi:10.1016/j.arbres.2020.11.012 | Prevalence and 30-day mortality in hospitalized patients with COVID-19 and prior lung diseases |
47% lower mortality [p=0.0005]. 47% lower mortality with HCQ/CQ. Retrospective 1,271 patients with lung disease in Canada, China, Cuba, Ecuador, Germany, Italy and Spain, 83% treated with HCQ/CQ. Multivariable Cox regression HCQ/CQ mortality hazard ratio HR 0.53, p < 0... | ||
Dec 16 2020 |
et al., Infectious Diseases and Clinical Microbiology, doi:10.36519/idcm.2022.111 (date from earlier preprint) | Analysis of the Prophylactic use of Hydroxychloroquine at the Beginning of the COVID-19 Pandemic Among Physicians |
30% lower progression [p=0.77] and 19% more cases [p=0.58]. Small prophylaxis survey showing lower, but not statistically significant, progression to pneumonia (3 of 148 HCQ, 12 of 416 control), RR 0.70, p = 0.77. There was a higher incidence of cases with HCQ, OR 1.19, p = 0.58, which may be due .. | ||
Dec 14 2020 |
et al., medRxiv, doi:10.1101/2020.12.11.20247437 (Preprint) | Clinical and Demographic Characteristics of COVID-19 Patients Admitted in a Tertiary Care Hospital in the Dominican Republic |
105% higher mortality [p=0.69]. Retrospective 150 patients in the Dominican Republic, 132 treated with HCQ, showing higher mortality with treatment in unadjusted results. Confounding by indication is likely. | ||
Dec 14 2020 |
et al., Wiener Medizinische Wochenschrift, doi:10.1007/s10354-020-00793-8 | SARS-CoV-2, a virus with many faces: a series of cases with prolonged persistence of COVID-19 symptoms |
Report on a series of 10 patients experiencing prolonged COVID-19 symptoms that were given HCQ 250mg bid for 5 days, with resolution of symptoms in all cases, and patients reporting they felt much better 2 days after treatment initiation. | ||
Dec 14 2020 |
et al., Diabetes & Metabolic Syndrome: Clinical Research & Reviews, doi:10.1016/j.dsx.2020.12.020 | Clinical characteristics and short-term prognosis of in-patients with diabetes and COVID-19: A retrospective study from an academic center in Belgium |
13% lower mortality [p=1]. Small retrospective study of 73 diabetic patients in Belgium, 55 HCQ patients, showing HCQ RR 0.87, p = 1.0. | ||
Dec 14 2020 |
et al., medRxiv, doi:10.1101/2020.12.13.20247254 (Preprint) | Predicting mortality in SARS-COV-2 (COVID-19) positive patients in the inpatient setting using a Novel Deep Neural Network |
33% lower mortality [p=0.34]. Retrospective 1,214 hospitalized patients in Pakistan, 77 HCQ patients, showing 33% lower mortality with HCQ, multivariate Cox HR 0.67, p = 0.34. | ||
Dec 14 2020 |
et al., Virus Research, doi:10.1016/j.virusres.2020.198262 | A retrospective comparison of drugs against COVID-19 |
35% shorter hospitalization [p=0.04]. Retrospective 333 patients in China, with only 8 HCQ patients, showing shorter duration of hospitalization with HCQ. | ||
Dec 11 2020 |
et al., Journal of the American Medical Directors Association, doi:10.1016/j.jamda.2020.12.003 | Clinical characteristics, frailty and mortality of residents with COVID-19 in nursing homes of a region of Madrid |
22% lower mortality [p=0.09]. Retrospective 630 elderly patients in Spain showing lower mortality with HCQ treatment, unadjusted relative risk RR 0.78, p = 0.09. HCQ was used more often with patients that were hospitalized (24% versus 3% use in the nursing homes). Med.. | ||
Dec 11 2020 |
et al., The American Journal of Emergency Medicine, doi:10.1016/j.ajem.2020.12.014 | Safety and efficacy of hydroxychloroquine in 152 outpatients with confirmed COVID-19: A pilot observational study |
Safety study of 152 outpatients concluding that HCQ is safe for COVID-19, was well tolerated, and was not associated with a risk of ventricular arrhythmia due to drug-induced QTc interval prolongation. | ||
Dec 11 2020 |
et al., Clinical Microbiology and Infection, doi:10.1016/j.cmi.2020.12.003 | Effect of hydroxychloroquine pre-exposure on infection with SARS-CoV-2 in rheumatic disease patients: A population-based cohort study |
59% lower mortality [p=1] and 13% more cases [p=0.86]. Retrospective cohort study of RA and SLE patients not showing a significant difference in PCR+ cases. PCR+ does not distinguish asymptomatic cases or severity. There was only one death which was in the control group. No other information .. | ||
Dec 10 2020 |
et al., JAMA Network Open, doi:10.1001/jamanetworkopen.2020.29058 | Risk Factors Associated With In-Hospital Mortality in a US National Sample of Patients With COVID-19 |
8% higher mortality [p=0.13]. Retrospective database analysis of 64,781 hospitalized patients in the USA, showing lower mortality with vitamin C or vitamin D (authors do not distinguish between the two), and higher mortality with zinc and HCQ, statistically significan.. | ||
Dec 10 2020 |
et al., F1000Research, Preprint (Preprint) | Clinical characteristics and predictors of the duration of hospital stay in COVID-19 patients in Jordan |
18% shorter hospitalization [p=0.11]. Prospective observational study of 131 COVID-19 patients in Jordan, showing 18% shorter hospital stay with HCQ, p = 0.11. | ||
Dec 10 2020 |
(News) | Consiglio di Stato, sì all'uso dell'idrossiclorachina per la cura del Covid |
Consiglio di Stato ruling in Italy re-establishes the right of Italian MDs to prescribe HCQ, which was suspended after the retracted Lancet study. | ||
Dec 9 2020 |
et al., EClinicalMedicine, doi:10.1016/j.eclinm.2021.100773 (date from earlier preprint) | Hydroxychloroquine with or Without Azithromycin for Treatment of Early SARS-CoV-2 Infection Among High-Risk Outpatient Adults: A Randomized Clinical Trial |
30% lower hospitalization [p=0.73], 2% improved recovery [p=0.95], and 29% faster viral clearance. Small early terminated late treatment RCT comparing vitamin C + folic acid, HCQ + folic acid, and HCQ+AZ, showing non-statistically significantly lower hospitalization with HCQ/HCQ+AZ, and faster viral clearance with HCQ. Enrollment was a.. | ||
Dec 9 2020 |
et al., Enfermedades Infecciosas y Microbiología Clínica, doi:10.1016/j.eimc.2020.10.023 | Efficacy and safety of hydroxychloroquine in healthcare professionals with mild SARS-CoV-2 infection: prospective, non-randomized trial |
68% lower progression [p=0.21] and 32% faster viral clearance. Small trial of low dose HCQ for healthcare workers with mild SARS-CoV-2 showing 68% lower progression to pneumonia, p = 0.21, and faster, but not statistically significant viral clearance. There were no ICU admissions or deaths. Prospecti.. | ||
Dec 9 2020 |
et al., Journal of Infection and Public Health, doi:10.1016/j.jiph.2020.11.012 | Severe COVID-19 pneumonia in Piacenza, Italy – a cohort study of the first pandemic wave |
35% lower mortality [p=0.22]. Retrospective 218 hospitalized patients in Italy showing non-statistically significant 35% lower mortality with HCQ, hazard ratio aHR 0.65 [0.33–1.30]. | ||
Dec 7 2020 |
et al., Annals of Internal Medicine, doi:10.7326/M20-6519 | Hydroxychloroquine for Post-exposure Prophylaxis to Prevent Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Infection: A Randomized Trial |
27% more cases [p=0.33]. Early terminated PEP RCT comparing HCQ and vitamin C with 781 low-risk patients (83% household contacts), reporting no significant differences. Different results were reported at IDWeek from the AIM results. The study enrolled people with.. | ||
Dec 4 2020 |
et al., Nephrology Dialysis Transplantation, doi:10.1093/ndt/gfaa271 | Mortality analysis of COVID-19 infection in chronic kidney disease, haemodialysis and renal transplant patients compared with patients without kidney disease: a nationwide analysis from Turkey |
44% lower mortality [p=0.14]. Retrospective 1210 hospitalized patients in Turkey focused on chronic kidney disease, haemodialysis and renal transplant patients, but also showing lower mortality with HCQ. Subject to confounding by indication. | ||
Dec 4 2020 |
et al., medRxiv, doi:10.1101/2020.12.03.20239863 (Preprint) | Detailed disease progression of 213 patients hospitalized with Covid-19 in the Czech Republic: An exploratory analysis |
59% lower mortality [p=0.04]. Retrospective 213 hospitalized patients in Czech Republic showing lower mortality with HCQ. Subject to confounding by indication. | ||
Dec 4 2020 |
et al., Nephrology Dialysis Transplantation, doi:10.1093/ndt/gfaa288 | Early versus late acute kidney injury among patients with COVID-19—a multicenter study from Wuhan, China |
11% lower progression [p=0.63]. Retrospective 4020 hospitalized patients in China showing non-statistically significant lower risk of acute kidney injury with HCQ. | ||
Dec 2 2020 |
et al., medRxiv, doi:10.1101/2020.11.29.20235218 (Preprint) (meta analysis) | Effective post-exposure prophylaxis of Covid-19 is associated with use of hydroxychloroquine: Prospective re-analysis of a public dataset incorporating novel data |
42% fewer cases [p=0.04]. 6th independent analysis showing efficacy from the Boulware PEP trial. This prospective analysis corrects an error in the NEJM paper where shipping delays are omitted (still not corrected). 42% reduction in COVID-19 (9.6% vs. 16.5%), RR 0.. | ||
Dec 1 2020 |
et al., Research Square, doi:10.21203/rs.3.rs-113418/v1 (Preprint) | CPAP Treatment In COVID-19 Patients: A Retrospective Observational Study In The Emergency Department |
40% lower ventilation [p=0.3]. Small 52 patient retrospective study of patients with acute respiratory failure showing lower rates of intubation with HCQ. | ||
Nov 30 2020 |
et al., medRxiv, doi:10.1101/2020.11.25.20234914 (Preprint) | The efficacy and safety of hydroxychloroquine in COVID19 patients : a multicenter national retrospective cohort |
17% lower mortality [p=1] and 75% higher combined mortality/intubation [p=0.24]. Retrospective analysis of acute care patients in Bahrain not showing a significant effect of HCQ. Confounding by indication is likely. Matching appears not to have matched for baseline severity. 17.5% of HCQ patients required oxygen while.. | ||
Nov 29 2020 |
et al., Biological Trace Element Research, doi:10.1007/s12011-020-02512-1 | Do Zinc Supplements Enhance the Clinical Efficacy of Hydroxychloroquine?: a Randomized, Multicenter Trial |
191 patient RCT in Egypt comparing the addition of zinc to HCQ, not showing a significant difference. No information on baseline zinc values was recorded. Egypt has a low rate of zinc deficiency so supplementation may be less likely to be.. | ||
Nov 28 2020 |
et al., Critical Care Explorations, doi:10.1097/CCE.0000000000000305 | Predictors of Mortality and Effect of Drug Therapies in Mechanically Ventilated Patients With Coronavirus Disease 2019: A Multicenter Cohort Study |
32% lower mortality [p=0.46]. Retrospective 247 mechanically ventilated patients showing lower mortality with HCQ, but not statistically significant on multiple Cox regression. The paper gives the p value for multiple Cox (0.46) and simple Cox (0.02), but does not spe.. | ||
Nov 28 2020 |
et al., International Journal of Antimicrobial Agents, doi:10.1016/j.ijantimicag.2020.106247 | Hydroxychloroquine lung pharmacokinetics in critically ill patients infected with COVID-19 |
HCQ lung pharmacokinetic study confirming that lung concentrations can be much higher than plasma and exceed predicted EC50 values. The median lung epithelial lining fluid concentration was 38 times higher than plasma concentrations. 22 C.. | ||
Nov 28 2020 |
et al., International Journal of Antimicrobial Agents, doi:10.1016/j.ijantimicag.2020.106249 | COVID-19 in hospitalized patients in Spain: a cohort study in Madrid |
23% lower mortality [p=0.26]. Retrospective 1255 patients in Spain showing lower mortality with HCQ. Subject to confounding by indication. | ||
Nov 27 2020 |
et al., BMC Infect Dis., doi:10.1186/s12879-020-05605-3 | Risk factors for mortality in hospitalized patients with COVID-19 at the start of the pandemic in Belgium: a retrospective cohort study |
32% lower mortality [p=0.05]. Retrospective 319 hospitalized patients in Belgium showing lower mortality with HCQ, although not reported to be statistically significant. | ||
Nov 26 2020 |
et al., Journal of Clinical Medicine, doi:10.3390/jcm9123834 | Is Machine Learning a Better Way to IdentifyCOVID-19 Patients Who Might Benefit fromHydroxychloroquineTreatment?—The IDENTIFY Trial |
59% higher mortality [p=0.12]. 290 patient observational trial in the USA, not showing a significant difference with HCQ treatment overall, but showing significantly lower mortality in a subgroup of patients where HCQ is expected to be beneficial based on a machine lea.. | ||
Nov 24 2020 |
et al., Int. J. Clin. Pract., doi:10.1111/ijcp.13856 | Assessment of COVID-19 Treatment containing both Hydroxychloroquine and Azithromycin: A Natural Clinical Trial |
Prospective study of 161 hospitalized patients in Iraq showing HCQ+AZ appears to help recovery. Most mortality was in patients that were already in critical condition on admission and died before treatment could be effective. | ||
Nov 23 2020 |
et al., Thrombosis Research, doi:10.1016/j.thromres.2020.11.020 | Low molecular weight heparin and 28-day mortality among patients with coronavirus disease 2019: A cohort study in the early epidemic era |
34% lower mortality [p=0.61]. Low molecular weight heparin study also showing results for HCQ treatment, unadjusted HCQ mortality relative risk RR 0.66, p = 0.61. | ||
Nov 21 2020 |
et al., Journal of Antimicrobial Chemotherapy, doi:10.1093/jac/dkaa477 | Hydroxychloroquine pre-exposure prophylaxis for COVID-19 in healthcare workers |
23% fewer cases [p=0.52]. Retrospective PrEP analysis with 69 healthcare workers on PrEP HCQ, and 418 control. Authors report PCR and IgG results, with no baseline results for either. Authors note they "identified 69 HCWs receiving HCQ" while providing n.. | ||
Nov 20 2020 |
et al., EClinicalMedicine, doi:10.1016/j.eclinm.2020.100645 | Randomized double-blinded placebo-controlled trial of hydroxychloroquine with or without azithromycin for virologic cure of non-severe Covid-19 |
12% lower hospitalization [p=1], 26% improved recovery [p=0.58], and 10% worse viral clearance [p=0.13]. Low risk patient RCT for HCQ+AZ and HCQ vs. control, not showing any significant differences. Authors note that the results are not applicable to higher risk patients, that positive PCR may simply reflect detection of inactive (non-infect.. | ||
Nov 19 2020 |
et al., Open Forum Infectious Diseases, doi:10.1093/ofid/ofaa563 | Role of low-molecular weight heparin in hospitalized patients with SARS-CoV-2 pneumonia: a prospective observational study |
65% lower mortality [p=0.2]. Prospective observational study of 315 hospitalized patients in Italy showing 65% lower mortality with HCQ. The median treatment delay was 6 days for survivors and 6.5 days for non-survivors. Mortality relative risk: RR 0.35, p = 0.2, pro.. | ||
Nov 18 2020 |
et al., medRxiv, doi:10.1101/2020.11.16.20232223 (Preprint) | Clinical Profile of First 1000 COVID-19 Cases Admitted at Tertiary Care Hospitals and the Correlates of their Mortality: An Indian Experience |
65% lower mortality [p<0.0001]. Retrospective 976 hospitalized patients with 834 treated with HCQ+AZ showing HCQ mortality relative risk RR 0.35, p < 0.0001. Note that in this case HCQ was recommended for mild/moderate cases, so more severe cases may not have received H.. | ||
Nov 17 2020 |
et al, Biosci. Rep., doi:10.1042/BSR20203455 | Prognostic factors and predictors of outcome in patients with COVID-19 and related pneumonia: a retrospective cohort study |
55% lower mortality [p=0.001]. Retrospective 258 hospitalized patients in Italy showing lower mortality with HCQ treatment, unadjusted relative risk RR 0.455, p<0.001. Data is in the supplementary appendix. | ||
Nov 13 2020 |
et al., Diabetes Research and Clinical Practice, doi:10.1016/j.diabres.2020.108538 | Prevalence of Diabetes, Management and Outcomes among Covid-19 Adult Patients Admitted in a Specialized Tertiary Hospital in Riyadh, Saudi Arabia |
80% lower mortality [p=0.001]. Retrospective 300 hospitalized patients in Saudi Arabia showing HCQ adjusted odds ratio aOR 0.12, p < 0.001. | ||
Nov 12 2020 |
et al., New Microbes and New Infections, doi:10.1016/j.nmni.2020.100813 | Hydroxychloroquine for prophylaxis and treatment of COVID-19 in health care workers |
94% lower hospitalization [p=0.01] and 96% improved viral clearance [p=0.001]. 100% reduction in hospitalization and cases with early treatment using HCQ+AZ+zinc. Brief report on healthcare workers in Bulgaria. 0 hospitalizations with treatment vs. 2 for control 0 PCR+ at day 14 with treatment vs. 3 for control 33 t.. | ||
Nov 12 2020 |
et al., New Microbes and New Infections, doi:10.1016/j.nmni.2020.100813 | Hydroxychloroquine for prophylaxis and treatment of COVID-19 in health care workers |
93% fewer cases [p=0.01]. 100% reduction in cases with HCQ+zinc post-exposure prophylaxis. Brief report for healthcare workers in Bulgaria. 0 cases with treatment vs. 3 for control. 156 treatment patients and 48 control patients. No serious adverse events. This pa.. | ||
Nov 12 2020 |
et al., Journal of Pharmaceutical and Biomedical Analysis, doi:10.1016/j.jpba.2020.113761 (meta analysis) | Composition analysis of falsified chloroquine phosphate samples seized during the COVID-19 pandemic |
Analysis of fake CQ tablets finding: - no CQ in six samples, substituted with metronidazole (at sub-therapeutic levels) or paracetamol. - trace levels of paracetamol and chloramphenicol in four and two samples respectively. - CQ levels to.. | ||
Nov 11 2020 |
et al., Revista Española de Geriatría y Gerontología, doi:10.1016/j.regg.2020.09.006 | Mortality and associated prognostic factors in elderly and very elderly hospitalized patients with respiratory disease COVID-19 |
67% lower mortality [p=0.1]. 67% lower mortality with HCQ. Retrospective 416 elderly patients in Spain showing adjusted HCQ mortality hazard ratio HR 0.33, p = 0.1. | ||
Nov 9 2020 |
et al., International Journal of Infectious Diseases, doi:10.1016/j.ijid.2020.11.008 | Randomized Controlled Open Label Trial on the Use of Favipiravir Combined with Inhaled Interferon beta-1b in Hospitalized Patients with Moderate to Severe COVID-19 Pneumonia |
Small 89 patient RCT comparing favipiravir and inhaled interferon with HCQ for moderate to severe COVID-19 pneumonia, not finding significant differences. | ||
Nov 9 2020 |
et al., Medicina Intensiva, doi:10.1016/j.medine.2020.05.005 | Severe infection due to the SARS-CoV-2 coronavirus: Experience of a tertiary hospital with COVID-19 patients during the 2020 pandemic |
59% lower mortality [p=0.23]. Small prospective study of 43 hospitalized patients with 39 taking HCQ, showing unadjusted mortality relative risk RR 0.41, p=0.23. | ||
Nov 9 2020 |
et al., JAMA, doi:10.1001/jama.2020.22240 | Effect of Hydroxychloroquine on Clinical Status at 14 Days in Hospitalized Patients With COVID-19: A Randomized Clinical Trial |
6% higher mortality [p=0.85] and 3% worse 7-point scale results [p=0.87]. Early terminated very late stage (65% on supplemental oxygen) RCT with 242 HCQ and 237 control patients showing no significant difference in outcomes. For the subgroup not on supplemental oxygen at baseline (relatively early treatment), t.. | ||
Nov 9 2020 |
et al., Annals of the American Thoracic Society, doi:10.1513/AnnalsATS.202008-940OC | Hydroxychloroquine vs. Azithromycin for Hospitalized Patients with COVID-19 (HAHPS): Results of a Randomized, Active Comparator Trial |
Small early terminated very late stage (86% on oxygen, 44% enrolled in the ICU) RCT comparing HCQ vs. AZ, not finding a significant difference between the two treatments. There is no comparison with a control group. HCQ patients not in th.. | ||
Nov 9 2020 |
et al., Intern. Emerg. Med., doi:10.1007/s11739-020-02543-5 | Mortality risk assessment in Spain and Italy, insights of the HOPE COVID-19 registry |
8% lower mortality [p=0.005]. Retrospective database study of 1,021 patients in Ecuador, Germany, Italy, and Spain, showing HCQ propensity score adjusted mortality odds ratio aOR 0.88, p=0.005. | ||
Nov 6 2020 |
et al., J. Marine Medical Society, doi:10.4103/jmms.jmms_115_20 | Hydroxychloroquine as pre-exposure prophylaxis against COVID-19 in health-care workers: A single-center experience |
90% fewer cases [p<0.0001]. 90% reduction in cases with HCQ pre-exposure prophylaxis. Retrospective 604 healthcare workers. | ||
Nov 6 2020 |
et al., Journal of Vaccines & Vaccination, S6:1000002 | No Role of HCQ in COVID-19 Prophylaxis: A Survey amongst Indian Doctors |
22% fewer cases [p=0.47]. Survey of Indian doctors not finding a significant effect of HCQ prophylaxis. | ||
Nov 6 2020 |
et al., International Journal of Antimicrobial Agents, doi:10.1016/j.ijantimicag.2020.106224 | Post Exposure Prophylaxis with Hydroxychloroquine (HCQ) for the Prevention of COVID-19, a Myth or a Reality? The PEP-CQ Study |
44% fewer symptomatic cases [p=0.21] and 50% fewer cases [p=0.04]. Low dose prospective PEP study with 132 HCQ patients and 185 control patients, showing significantly lower COVID-19 cases with treatment. There were no serious adverse events. HCQ 800mg on day one followed by 400mg once weekly for 3 weeks. | ||
Nov 5 2020 |
et al., Nefrología, doi:10.1016/j.nefro.2020.09.002 | COVID-19 incidence and outcomes in a home dialysis unit in Madrid (Spain) at the height of the pandemic |
91% lower mortality [p=0.17]. Very small retrospective of 12 dialysis patients showing 1/11 deaths with HCQ and 1/1 without HCQ. | ||
Nov 5 2020 |
et al., Mayo Clinic Proceedings: Innovations, Quality & Outcomes | Clinical characteristics and risk factors for mortality of hospitalized patients with COVID-19 in a community hospital: A retrospective cohort study |
6% higher mortality [p=0.77]. Retrospective 313 patients, mostly critical stage and mostly requiring respiratory support, showing unadjusted RR 1.06, p = 0.77. Confounding by indication likely. | ||
Nov 4 2020 |
et al., The American Journal of Pathology, doi:10.1016/j.ajpath.2020.10.008 | Significantly Decreased Mortality in a Large Cohort of Coronavirus Disease 2019 (COVID-19) Patients Transfused Early with Convalescent Plasma Containing High-Titer Anti–Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Spike Protein IgG |
37% higher mortality [p=0.28]. Convalescent plasma study also showing mortality based on HCQ treatment, unadjusted hazard ratio uHR 1.37, p = 0.28. Confounding by indication is likely. | ||
Nov 4 2020 |
et al., New Microbes and New Infections, doi:10.1016/j.nmni.2021.100915 (date from earlier preprint) | Early COVID-19 Therapy with azithromycin plus nitazoxanide, ivermectin or hydroxychloroquine in Outpatient Settings Significantly Improved COVID-19 outcomes compared to Known outcomes in untreated patients |
81% lower mortality [p=0.21], 95% lower ventilation [p=0.0008], and 98% lower hospitalization [p<0.0001]. Comparison of HCQ, nitazoxanide, and ivermectin showing similar effectiveness for overall clinical outcomes in COVID-19 when used before seven days of symptoms, and overwhelmingly superior compared to the untreated COVID-19 population, ev.. | ||
Nov 3 2020 |
et al., PLoS ONE, doi:10.1371/journal.pone.0247163 (date from earlier preprint) | Role of ivermectin in the prevention of SARS-CoV-2 infection among healthcare workers in India: A matched case-control study |
28% fewer cases [p=0.29]. Retrospective matched case-control prophylaxis study for HCQ, ivermectin, and vitamin C with 372 healthcare workers, showing lower COVID-19 incidence for all treatments, with statistical significance reached for ivermectin. HCQ OR 0.56, p.. | ||
Nov 2 2020 |
et al., Annals of Pediatrics, doi:10.1016/j.anpedi.2020.10.017 | Telemedicine follow-ups for COVID-19: experience in a tertiary hospital |
64% lower progression [p=0.02]. Retrospective 72 pediatric patients showing HCQ associated with a shorter duration of fever (p=0.023), less progression (p=0.016), and fewer return visits to the ER (p=0.017). | ||
Nov 1 2020 |
et al., Advances in Respiratory Medicine, doi:10.5603/ARM.a2020.0139 | Clinical outcome, viral response and safety profile of chloroquine in COVID-19 patients — initial experience |
29% faster recovery [p=0.008]. Retrospective 12 hospitalized patients in India treated with CQ and 17 controls, showing faster recovery with treatment. There was no significant difference in viral clearance. The CQ group mean age was 41.3 vs. 47.6 for controls. | ||
Oct 31 2020 |
et al., Travel Medicine and Infectious Disease, doi:10.1016/j.tmaid.2020.101906 | Risk of Hospitalization for Covid-19 Outpatients Treated with Various Drug Regimens in Brazil: Comparative Analysis |
64% lower hospitalization [p=0.0008]. 64% lower hospitalization with HCQ. Retrospective 717 patients in Brazil with early treatment, adjusted OR 0.32, p=0.00081, for HCQ versus no medication, and OR 0.45, p=0.0065, for HCQ vs. anything else. | ||
Oct 30 2020 |
et al., International Journal of Infectious Diseases, doi:10.1016/j.ijid.2020.10.071 | Risk factors for mortality in adult COVID-19 patients: frailty predicts fatal outcome in older patients |
13% lower mortality [p=0.63]. Retrospective 255 hospitalized patients, 65 treated with HCQ, showing unadjusted RR 0.87, p=0.63. Confounding by indication is likely. | ||
Oct 27 2020 |
et al., medRxiv, doi:10.1101/2020.10.26.20219154 (Preprint) | Clinical Course and Outcomes of coronavirus disease 2019 (COVID-19) in Rheumatic Disease Patients on Immunosuppression: A case Cohort Study at a Single Center with a Significantly Diverse Population |
50% lower mortality [p=0.67]. Retrospective hospitalized rheumatic disease patients showing 50% lower mortality for patients on HCQ. | ||
Oct 27 2020 |
et al., International Journal of Infectious Diseases, doi:10.1016/j.ijid.2020.10.062 | Comparison of antiviral effect for mild-to-moderate COVID-19 cases between lopinavir/ritonavir versus hydroxychloroquine: A nationwide propensity score-matched cohort study |
22% slower viral clearance [p=0.0001]. Health insurance database analysis failing to adjust for disease severity and not finding a significant difference in time to PCR- for LPV/r and HCQ. There are large differences in severity across groups. Authors did PSM but chose not to .. | ||
Oct 26 2020 |
et al., Research Square, doi:10.21203/rs.3.rs-94509/v1 (Preprint) | Treatment with Zinc is Associated with Reduced In-Hospital Mortality Among COVID-19 Patients: A Multi-Center Cohort Study |
37% lower mortality [p=0.02]. Retrospective 3,473 hospitalized patients showing lower mortality with HCQ+zinc. | ||
Oct 24 2020 |
et al., SSRN, doi:10.2139/ssrn.3689618 (Preprint) | Seroprevalence of COVID-19 Amongst Health Care Workers in a Tertiary Care Hospital of a Metropolitan City from India |
87% lower IgG positivity [p=0.03]. Study of SARS-CoV-2-IgG antibodies in 1122 health care workers in India finding 87% lower positives for adequate HCQ prophylaxis, 1.3% HCQ versus 12.3% for no HCQ prophylaxis. Adequate prophylaxis is defined as 400mg 1/wk for >6 weeks. | ||
Oct 23 2020 |
et al., American Journal of Transplantation, doi:10.1111/ajt.16369 | Covid-19 in transplant recipients: the spanish experience |
46% lower mortality [p<0.0001]. Retrospective 652 transplant recipient patients in Spain showing 46% lower mortality for patients treated with HCQ, unadjusted relative risk RR 0.54, p<0.0001. | ||
Oct 21 2020 |
et al., Clinical Kidney Journal, 13:5, October 2020, 878–888, doi:10.1093/ckj/sfaa199 | Risk factors for severity of COVID-19 in chronic dialysis patients from a multicentre French cohort |
33% lower mortality [p=0.28] and 39% lower combined mortality/ICU admission [p=0.23]. 33% lower mortality with HCQ+AZ, p=0.28. Retrospective 122 French dialysis patients. 69% lower combined mortality/ICU, p=0.11, for the subgroup not requiring O2 on diagnosis (slightly earlier treatment). | ||
Oct 21 2020 |
et al., Clinical Microbiology and Infection, doi:10.1016/j.cmi.2021.03.005 (date from earlier preprint) | Hydroxychloroquine in mild-to-moderate COVID-19: a placebo-controlled double blind trial |
46% lower mortality [p=0.21] and 26% lower combined mortality/intubation [p=0.48]. Small early terminated late stage (60% on oxygen) RCT in France showing 46% lower mortality. mortality at 28 days relative risk RR 0.54 [0.21-1.42] combined mortality/intubation at 28 days relative risk RR 0.74 [0.33-1.70] If not stopped .. | ||
Oct 21 2020 |
et al., Heart & Lung, doi:10.1016/j.hrtlng.2020.10.013 | Outcomes of patients with COVID-19 in the Intensive Care Unit in Mexico: A multicenter observational study |
32% lower mortality [p=0.19]. Retrospective 164 ICU patients in Mexico showing 32% lower mortality with HCQ+AZ and 37% lower with CQ. HCQ+AZ vs. neither HCQ or CQ relative risk RR 0.68, p = 0.03 CQ vs. neither HCQ or CQ relative risk RR 0.63, p = 0.02 HCQ+AZ or CQ vs... | ||
Oct 20 2020 |
(Preprint) (meta analysis) | Meta-analysis on chloroquine derivatives and COVID-19 mortality |
Updated meta analysis of 41 studies showing CQ/HCQ OR 0.57, p<0.0001 from clinical studies. For big data studies authors find inconsistent results and OR 0.83, p=0.0014, and for all studies combined OR 0.72, p<0.0001. | ||
Oct 20 2020 |
et al., medRxiv, doi:10.1101/2020.10.16.20214130 (Preprint) | Clinical course and outcome of COVID-19 acute respiratory distress syndrome: data from a national repository |
18% higher mortality [p=0.17]. Retrospective database analysis of 7,816 Veterans Affairs hospitalized patients analyzing progression to ARDS and 30-day mortality from ARDS. Confounding by indication is likely. Chronological bias is likely, with HCQ more likely to be us.. | ||
Oct 17 2020 |
et al., International Journal of Infectious Diseases, doi:10.1016/j.ijid.2020.10.031 (date from earlier preprint) | Hydroxychloroquine Safety Outcome within Approved Therapeutic Protocol for COVID-19 Outpatients in Saudi Arabia |
Safety study of 2,733 patients in Saudi Arabia showing HCQ in mild to moderate cases in an outpatient setting, within the protocol recommendation and inclusion/exclusion criteria, is safe, highly tolerable, and has minimal side effects. N.. | ||
Oct 15 2020 |
Clinical characteristics and outcomes among hospitalized adults with severe COVID-19 admitted to a tertiary medical center and receiving antiviral, antimalarials, glucocorticoids, or immunomodulation with tocilizumab or cyclosporine: A retrospective observational study (COQUIMA cohort) | |
20% lower mortality [p=0.36]. Retrospective 607 patients reporting results for early outpatient HCQ use with mortality odds ratio OR 0.092 [0.022-0.381], p = 0.001 (65 patients), and for hospital use, mortality odds ratio OR 0.737 [0.38-1.41], p = 0.36 (558 patients)... | ||
Oct 15 2020 |
Trial Consortium, NEJM, doi:10.1056/NEJMoa2023184 (date from earlier preprint) | Repurposed antiviral drugs for COVID-19; interim WHO SOLIDARITY trial results |
19% higher mortality [p=0.23]. WHO SOLIDARITY open-label trial with 954 very late stage (64% on oxygen/ventilation) HCQ patients, mortality relative risk RR 1.19 [0.89-1.59], p=0.23. HCQ dosage very high as in RECOVERY, 1.6g in the first 24 hours, 9.6g total over 10 da.. | ||
Oct 12 2020 |
et al., Pharmacotherapy, doi:10.1002/phar.2467 | Hydroxychloroquine in hospitalized COVID-19 patients: Real world experience assessing mortality |
4% lower mortality [p=0.83]. Retrospective database analysis with PSM not including COVID-19 severity, finding mortality OR 0.95 [0.62-1.46] for HCQ, and 1.24 [0.70-2.22] for HCQ+AZ. Confounding by indication likely. | ||
Oct 11 2020 |
et al., medRxiv, doi:10.1101/2020.10.09.20209775 (Preprint) | Factors associated with progression to critical illness in 28 days among COVID-19 patients: results from a tertiary care hospital in Istanbul, Turkey |
Analysis of hospitalized patients in Turkey showing HCQ was given to 99.2% of patients and the incidence of critical illness was lower than most studies. Authors note "whether HCQ administration lowered the rates of critical illness .. | ||
Oct 8 2020 |
et al., medRxiv, doi:10.1101/2020.10.06.20207092 (Preprint) | Low-density lipoprotein cholesterol levels are associated with poor clinical outcomes in COVID-19 |
63% lower mortality [p=0.008]. Retrospective 654 hospitalized patients focused on low-density lipoprotein cholesterol levels, also showing results for HCQ with 605 HCQ patients, unadjusted 30 day mortality relative risk RR 0.37, p = 0.008. | ||
Oct 8 2020 |
et al., medRxiv, doi:10.1101/2020.10.06.20208066 (Preprint) | Real-World Effectiveness of hydroxychloroquine, azithromycin, and ivermectin among hospitalized COVID-19 patients: Results of a target trial emulation using observational data from a nationwide Healthcare System in Peru |
18% lower mortality [p<0.0001]. Retrospective database study of 5683 patients, 692 received HCQ/CQ+AZ, 200 received HCQ/CQ, 203 received ivermectin, 1600 received AZ, 358 received ivermectin+AZ, and 2630 received standard of care. This study includes anyone with ICD-10 .. | ||
Oct 6 2020 |
et al., medRxiv, doi:10.1101/2022.02.16.22271064 (Preprint) | An open-label randomized, controlled trial of the effect of lopinavir/ritonavir, lopinavir/ritonavir plus IFN-beta-1a and hydroxychloroquine in hospitalized patients with COVID-19 - Final results from the DisCoVeRy trial |
15% higher mortality [p=0.7] and 24% improved viral clearance [p=0.68]. Early terminated very late stage (95% on oxygen at baseline) DISCOVERY trial. 4% more patients were on ventilation at baseline in the HCQ group. This preprint presents more recent results than the earlier journal article. | ||
Oct 5 2020 |
et al., Journal of Microbiology, Immunology and Infection, doi:10.1016/j.jmii.2020.09.003 | Triple therapy with hydroxychloroquine, azithromycin, and ciclesonide for COVID-19 pneumonia |
Small case study of 5 patients in Japan showing improvement with HCQ+AZ+ciclesonide. | ||
Oct 5 2020 |
et al., New Microbes and New Infections, doi:10.1016/j.nmni.2020.100776 (meta analysis) | Hydroxychloroquine is effective, and consistently so used early, for Covid-19: A systematic review |
Meta analysis of 43 studies reporting: "HCQ was found consistently effective against COVID-19 when used early, in the outpatient setting. It was found overall effective also including inpatient studies. No unbiased study found worse .. | ||
Oct 2 2020 |
et al., The American Journal of Tropical Medicine and Hygiene, doi:10.4269/ajtmh.20-1240 | Clinical Characteristics and Outcomes of Patients Hospitalized for COVID-19 in Africa: Early Insights from the Democratic Republic of the Congo |
28% lower mortality [p=0.17] and 26% greater improvement [p=0.13]. Retrospective 766 hospitalized patients in DRC showing mortality reduced from 29% to 11%, and improvement at 30 days increased from 65% to 84%. Mortality cox regression adjusted hazard ratio aHR 0.26, p < 0.001 Risk of no improvement adju.. | ||
Oct 1 2020 |
et al., Saudi Pharmaceutical Journal, doi:10.1016/j.jsps.2020.09.019 | Comparing the impact of Hydroxychloroquine based regimens and standard treatment on COVID-19 patient outcomes: A retrospective cohort study |
65% lower ventilation [p=0.16] and 21% lower ICU admission [p=0.78]. Retrospective 161 hospitalized patients in Saudi Arabia showing lower ventilation and ICU admission with HCQ, but not statistically significant with the small sample sizes. | ||
Sep 30 2020 |
et al., ResearchGate, doi:10.13140/RG.2.2.34411.77603 (Preprint) | Sero-survey for health-care workers provides corroborative evidence for the effectiveness of Hydroxychloroquine prophylaxis against COVID-19 infection |
82% lower hospitalization [p=0.01] and 42% fewer cases [p=0.05]. ICMR seroprevalence survey of 500 healthcare workers in India, 279 taking HCQ prophylaxis, showing a significantly lower risk with treatment, and lower severity. | ||
Sep 30 2020 |
et al., Medical Journal of Bakirkoy, 16:3, 280-6, doi:10.5222/BMJ.2020.50469 | Hydroxychloroquine Use on Healthcare Workers Exposed to COVID-19 - A Pandemic Hospital Experience |
57% fewer cases [p=0.03]. Small prophylaxis study of 208 healthcare workers in Turkey, 138 with high risk exposure received HCQ, while 70 with low and medium risk exposure did not. COVID-19 cases were lower in the treatment group, relative risk RR 0.43, p = 0.026... | ||
Sep 30 2020 |
et al., Internal and Emergency Medicine, doi:0.1007/s11739-020-02505-x | The association of treatment with hydroxychloroquine and hospital mortality in COVID-19 patients |
52% lower mortality [p=0.001]. 2075 hospital patients in Spain showing HCQ reduces mortality 52%, odds ratio OR 0.39, p<0.001, after adjustment for age, gender, temperature > 37 °C, and saturation of oxygen < 90% treatment with azithromycin, steroids, heparin, tocilizu.. | ||
Sep 30 2020 |
et al., medRxiv, doi:10.1101/2020.09.30.20204693 (Preprint) (meta analysis) | Randomized Controlled Trials of Early Ambulatory Hydroxychloroquine in the Prevention of COVID-19 Infection, Hospitalization, and Death: Meta-Analysis |
24% lower combined death/hospitalization/cases [p=0.03]. Meta analysis of prophylactic and early treatment RCTs, 24% reduction in cases, hospitalization or death with HCQ, RR 0.76, p=0.025. No serious adverse cardiac events were reported. 5,577 patients. The Boulware study provides a breakdown .. | ||
Sep 30 2020 |
et al., JAMA Internal Medicine, doi:doi:10.1001/jamainternmed.2020.6319 | Efficacy and Safety of Hydroxychloroquine vs Placebo for Pre-exposure SARS-CoV-2 Prophylaxis Among Health Care Workers |
5% fewer cases [p=1]. Very small early-terminated underpowered PrEP RCT with 64/61 HCQ/control patients and only 8 infections, HCQ infection rate 6.3% versus control 6.6%, RR 0.95 [0.25 - 3.64]. There was no hospitalization or death, no significant difference .. | ||
Sep 29 2020 |
et al., Int. J. Infectious Diseases, doi:10.1016/j.ijid.2020.09.1460 | Early hydroxychloroquine but not chloroquine use reduces ICU admission in COVID-19 patients |
32% lower combined mortality/ICU admission [p=0.02]. Observational study 1,064 hospitalized patients in the Netherlands, 53% reduced risk of transfer to the ICU for mechanical ventilation with HCQ treatment starting on the first day of admission. Weighted propensity score adjusted hazard ra.. | ||
Sep 29 2020 |
et al., Scientific Reports, doi:10.1038/s41598-021-85227-0 (date from earlier preprint) | Safety and efficacy of favipiravir versus hydroxychloroquine in management of COVID-19: A randomised controlled trial |
This paper has been retracted [nature.com]. | ||
Sep 28 2020 |
, J., Trends Med, doi:10.15761/TiM.1000268 (meta analysis) | Hydroxychloroquine as post-exposure prophylaxis for Covid-19: Why simple data analysis can lead to the wrong conclusions from well-designed studies |
Reanalysis of Boulware et al. PEP trial data showing statistically significant improvements with HCQ. | ||
Sep 24 2020 |
et al., EP Europace, doi:10.1093/europace/euaa216 | Arrhythmic safety of hydroxychloroquine in COVID-19 patients from different clinical settings |
Safety study of 649 patients finding that HCQ administration is safe for short-term treatment for patients with COVID-19 infection regardless of the clinical setting of delivery, causing only modest QTc prolongation and no directly attrib.. | ||
Sep 24 2020 |
et al., medRxiv, doi:10.1101/2020.09.23.20199463 (Preprint) | Comparative Effectiveness of Famotidine in Hospitalized COVID-19 Patients |
15% lower mortality [p=0.001]. Retrospective database analysis focused on Famotidine but also showing results for HCQ users, with unadjusted mortality RR 0.85, p<0.001 (13.6% vs. 16.1%). | ||
Sep 23 2020 |
et al., Open Forum Infectious Diseases, doi:10.1093/ofid/ofaa446 | Treating Covid-19 With Hydroxychloroquine (TEACH): A Multicenter, Double-Blind, Randomized Controlled Trial in Hospitalized Patients |
6% higher mortality [p=1]. Small RCT on very late stage use of HCQ, with 48% on oxygen at baseline. 67 HCQ patients, 61 control. Baseline states were not comparable - 82% more HCQ patients had the highest severity at baseline, there was 32% more male HCQ patients, .. | ||
Sep 22 2020 |
et al., Ann. Oncol., 2020, Sep, 31, S1026, doi:10.1016/j.annonc.2020.08.1830 | COVID-19 and lung cancer: What do we know? |
43% lower mortality [p=0.15]. Small retrospective study of 22 lung cancer patients, 14 treated with HCQ+AZ, showing HCQ+AZ mortality relative risk RR 0.57, p = 0.145. | ||
Sep 21 2020 |
et al., Lancet Rheumatology, doi:10.1016/S2665-9913(20)30305-2 | Long-term hydroxychloroquine use in patients with rheumatic conditions and development of SARS-CoV-2 infection: a retrospective cohort study |
91% lower mortality [p=0.1] and 21% fewer cases [p=0.27]. Retrospective patients with rheumatologic conditions showing zero of 10,703 COVID-19 deaths for HCQ patients versus 7 of 21,406 propensity matched control patients (not statistically significant). The average age of HCQ patients is slight.. | ||
Sep 21 2020 |
et al., medRxiv, doi:10.1101/2020.09.18.20197327 | Hydroxychloroquine as pre-exposure prophylaxis for COVID-19 in healthcare workers: a randomized trial |
27% fewer cases [p=0.12]. PrEP RCT showing HR 0.73, p = 0.12. Trial halted after 47% enrollment, p < 0.05 will be reached at ~75% enrollment if similar results continue. HR 0.66/0.68 for full medication adherence, 0.72/0.74, p = 0.18/0.22 overall (1x/2x dosing). E.. | ||
Sep 21 2020 |
et al., Trials, doi:10.1186/s13063-021-05758-9 | Pre-exposure prophylaxis with hydroxychloroquine for COVID-19: a double-blind, placebo-controlled randomized clinical trial |
11% fewer cases [p=1]. Small PrEP RCT showing that PrEP with HCQ is safe at the dosage used. There were no deaths, hospitalizations, or serious adverse events. The paper states: "Among all trial participants at the end of the first month (n=253), only one .. | ||
Sep 21 2020 |
et al., Open Forum Infectious Diseases, doi:10.1093/ofid/ofaa500 (date from earlier preprint) | Safety of Hydroxychloroquine among Outpatient Clinical Trial Participants for COVID-19 |
Analysis of 2,795 outpatients not showing significant safety concerns with HCQ. No deaths were related to HCQ. There was one serious event requiring hospitalization, identical to the frequency with placebo. | ||
Sep 18 2020 |
et al., Nature, doi:10.1038/s41467-021-22446-z (meta analysis) | Mortality outcomes with hydroxychloroquine and chloroquine in COVID-19 from an international collaborative meta-analysis of randomized trials |
Meta analysis assigning 89% weight to the RECOVERY and SOLIDARITY trials, producing the same result. These trials used excessively high non-patient-customized dosage in very sick late stage patients, results are not generalizable to typic.. | ||
Sep 16 2020 |
et al., Xenobiotica | Optimization of hydroxychloroquine dosing scheme based on COVID-19 patients’ characteristics: a review of the literature and simulations |
Analysis of HCQ dosing, suggesting that high initial doses followed by low and sparse doses may offer significant benefits to patients by decreasing the viral load without reaching levels considered to produce adverse effects. For instanc.. | ||
Sep 15 2020 |
et al., Pan African Medical Journal, 37:1, doi:10.11604/pamj.supp.2020.37.1.25718 | Clinical characteristics, treatment regimen and duration of hospitalization among COVID-19 patients in Ghana: a retrospective cohort study |
33% shorter hospitalization [p=0.03]. Retrospective 307 hospital patients in Ghana showing 33% reduction in hospitalization time with HCQ, 29% reduction with HCQ+AZ, and 37% reduction with CQ+AZ. | ||
Sep 14 2020 |
et al., Clinical and Translational Science, doi:10.1111/cts.12860 | Effect of combination therapy of hydroxychloroquine and azithromycin on mortality in COVID-19 patients |
74% lower mortality [p=0.001]. Retrospective 377 patients, 73% reduction in mortality with HCQ+AZ, adjusted hazard ratio HR 0.27 [0.17-0.41]. Mean age 71.8. No serious adverse events. Subject to incomplete adjustment for confounders. | ||
Sep 13 2020 |
et al., medRxiv, doi:10.1101/2020.09.09.20184143 (Preprint) | The Effect of Early Hydroxychloroquine-based Therapy in COVID-19 Patients in Ambulatory Care Settings: A Nationwide Prospective Cohort Study |
64% lower mortality [p=0.01] and 39% lower hospitalization [p=0.001]. Observational prospective 5,541 patients, adjusted HCQ mortality odds ratio OR 0.36, p = 0.012. Adjusted hospitalization OR 0.57, p < 0.001. Zinc supplementation was used in all cases. Early treatment in ambulatory fever clinics in Saudi .. | ||
Sep 12 2020 |
et al., IJC Heart & Vasculature, doi:10.1016/j.ijcha.2020.100638 | Implications of myocardial injury in Mexican hospitalized patients with coronavirus disease 2019 (COVID-19) |
54% lower mortality [p=0.04] and 65% lower ventilation [p=0.008]. Observational prospective 254 hospitalized patients, HCQ+AZ mortality odds ratio OR 0.36, p = 0.04. Ventilation OR 0.20, p = 0.008. | ||
Sep 9 2020 |
et al., Tohoku J. Exp. Med., 2020, 252, 73-84, doi:10.1620/tjem.252.73 | Mortality Risk Factors among Hospitalized COVID-19 Patients in a Major Referral Center in Iran |
55% lower mortality [p=0.03]. Retrospective 459 patients in Iran with 93% treated with HCQ, showing HCQ mortality RR 0.45, p = 0.028. HCQ was the only antiviral that showed a significant difference. There was relatively few control patients and the result is subject t.. | ||
Sep 9 2020 |
et al., BMJ Open Respiratory Research, doi:10.1136/bmjresp-2020-000646 | Characteristics and outcomes of admitted patients infected with SARS-CoV-2 in Uganda |
26% faster recovery [p=0.2]. Prospective 56 patients in Uganda, 29 HCQ and 27 control, showing 25.6% faster recovery with HCQ, 6.4 vs. 8.6 days (p = 0.20). There was no ICU admission, mechanical ventilation, or death. Treatment delay is not specified but at least a p.. | ||
Sep 9 2020 |
et al., The Lancet Rheumatology, doi:10.1016/S2665-9913(20)30378-7 (date from earlier preprint) | Effect of pre-exposure use of hydroxychloroquine on COVID-19 mortality: a population-based cohort study in patients with rheumatoid arthritis or systemic lupus erythematosus using the OpenSAFELY platform |
3% higher mortality [p=0.83]. Observational database study of RA/SLE patients in the UK, 194,637 RA/SLE patients with 30,569 having >= 2 HCQ prescriptions in the prior 6 months, HCQ HR 1.03 [0.80-1.33] (HR 0.78 before adjustments). 70 patients with HCQ prescriptions d.. | ||
Sep 9 2020 |
et al., PLOS ONE, doi:10.1371/journal.pone.0243598 | Lack of protective effect of chloroquine derivatives on COVID-19 disease in a Spanish sample of chronically treated patients |
56% more cases [p=0.24]. Survey of 319 autoimmune disease patients taking CQ/HCQ with 5.3% COVID-19 incidence, compared to a control group from the general population (matched on age, sex, and region, but not adjusted for autoimmune disease), with 3.4% incidence... | ||
Sep 7 2020 |
, Expert Review of Clinical Immunology (Review) | Natural history and therapeutic options for COVID-19 |
Review of the current state of knowledge regarding the natural history of and therapeutic options for COVID-19. Treatment with an oral combination of hydroxychloroquine, azithromycin and zinc may represent the best current therapeutic opt.. | ||
Sep 5 2020 |
et al., medRxiv, doi:10.1101/2020.09.05.20184655 (Preprint) | The Activin/Follistatin-axis is severely deregulated in COVID-19 and independently associated with in-hospital mortality |
24% lower mortality [p=0.27]. Retrospective 117 patients, 58 HCQ showing lower mortality for HCQ patients. Version 1 of this paper stated: "HCQ, AZ, [and ...] were found to be independently associated with survival when treatment commenced at FACTCLINYCoD scores .. | ||
Sep 4 2020 |
et al., The Lancet, doi:10.1016/S0140-6736(20)31862-6 | Azithromycin in addition to standard of care versus standard of care alone in the treatment of patients admitted to the hospital with severe COVID-19 in Brazil (COALITION II): a randomised clinical trial |
Small RCT comparing the addition of AZ for very late stage patients on ventilation or oxygen. No significant difference was found, OR 1.36, p=0.11. One notable result is that even within this extremely late stage population, results sugge.. | ||
Sep 2 2020 |
et al., Phytomedicine, doi:10.1016/j.phymed.2020.153333 (In Vitro) | Chloroquine and hydroxychloroquine as ACE2 blockers to inhibit viropexis of 2019-nCoV Spike pseudotyped virus |
In Vitro study providing novel insights into the molecular mechanism of CQ/HCQ treatment, showing that CQ and HCQ both inhibit the entrance of 2019-nCoV into cells by blocking the binding of the virus with ACE2. | ||
Sep 2 2020 |
et al., European Geriatric Medicine, doi:10.1007/s41999-020-00432-w (date from earlier preprint) | COVID-19 mortality risk factors in older people in a long-term care center |
96% lower mortality [p=0.004]. Retrospective 100 COVID+ elderly nursing home patients, HCQ+AZ mortality 11.4% vs. control 61.9%, RR 0.18, p<0.001. Median age 85. | ||
Sep 2 2020 |
et al., medRxiv, doi:10.1101/2020.08.31.20185314 (Preprint) | Hydroxicloroquine for pre-exposure prophyylaxis for SARS-CoV-2 |
43% more cases [p=0.15]. Analysis of autoimmune disease patients on HCQ, compared to a control group from the general population (matched on age and sex, but not adjusted for autoimmune disease), showing non-significant differences between groups. Other research .. | ||
Sep 1 2020 |
et al., Pharmaceuticals, 13:9, 228, doi:10.3390/ph13090228 (Review) | Zinc(II)—The Overlooked Éminence Grise of Chloroquine’s Fight against COVID-19? |
Review of zinc as an inhibitor of SARS-CoV-2′s RNA-dependent RNA polymerase, and zinc ionophores including CQ/HCQ, showing the latest evidence for zinc and CQ/HCQ having antiviral, and in particular anticoronaviral action. | ||
Sep 1 2020 |
et al., New Microbes and New Infections, doi:10.1016/j.nmni.2020.100749 | Pandemic and social changes, political fate |
Analysis of US states and countries. Country analysis shows a significant correlation between the dates of decisions to adopt/decline HCQ, and corresponding trend changes in CFR. US state analysis shows a significant correlation between C.. | ||
Aug 30 2020 |
et al., J, Clinical Medicine, doi:10.3390/jcm9092800 | Impact of Azithromycin and/or Hydroxychloroquine on Hospital Mortality in COVID-19 |
18% lower mortality [p=0.15] and 9% higher ICU admission [p=0.7]. Retrospective 1376 hospitalized patients in Italy, 211 treated with HCQ and 166 with HCQ+AZ. | ||
Aug 29 2020 |
et al., Journal of Steroid Biochemistry and Molecular Biology, 203, October 2020, doi:10.1016/j.jsbmb.2020.105751 | Effect of calcifediol treatment and best available therapy versus best available therapy on intensive care unit admission and mortality among patients hospitalized for COVID-19: A pilot randomized clinical study |
RCT on calcifediol (25-hydroxyvitamin D) treatment for hospitalized COVID-19 patients showing significantly reduced intensive care unit admissions. All patients received standard care including HCQ+AZ. Significantly lower ICU admission wi.. | ||
Aug 28 2020 |
et al., Clinical Infectious Disease, doi:10.1093/cid/ciaa1268 | Patient Characteristics and Outcomes of 11,721 Patients with COVID19 Hospitalized Across the United States |
27% higher mortality [p=0.001]. Database analysis of 11,721 hospitalized patients, 4,232 on HCQ. Strong evidence for confounding by indication and compassionate use of HCQ. 24.9% of HCQ patients were on mechanical ventilation versus 12.2% control. Ventilation mortality .. | ||
Aug 27 2020 |
at al., Clinical Rheumatology, doi:0.1007/s10067-020-05334-7 | COVID-19 and rheumatic autoimmune systemic diseases: report of a large Italian patients series |
63% fewer cases [p=0.02]. Analysis of 1641 systemic autoimmune disease patients showing csDMARD (HCQ etc.) RR 0.37, p=0.015. csDMARDs include HCQ, CQ, and several other drugs, so the effect of HCQ/CQ alone could be higher. This study also confirms that the risk of.. | ||
Aug 26 2020 |
et al., Clinical Microbiology and Infection (meta analysis) | Effect of hydroxychloroquine with or without azithromycin on the mortality of COVID-19 patients: a systematic review and meta-analysis |
Meta analysis of late stage studies (and one early treatment study with only 2 deaths), showing HCQ RR 0.83 [0.65-1.06], before exclusions RR 0.80 [0.65-1.0]. Authors claim "HCQ alone is not effective", but the result directly c.. | ||
Aug 25 2020 |
et al., BMC Infectious Diseases, doi:10.1186/s12879-021-05773-w (date from earlier preprint) | Hydroxychloroquine in the treatment of outpatients with mildly symptomatic COVID-19: A multi-center observational study |
55% lower mortality [p=0.43] and 37% lower hospitalization [p=0.04]. Retrospective 1,274 outpatients, 47% reduction in hospitalization with HCQ with propensity matching, HCQ OR 0.53 [0.29-0.95]. Sensitivity analyses revealed similar associations. Adverse events were not increased (2% QTc prolongation event.. | ||
Aug 25 2020 |
et al., European J. Internal Medicine, doi:10.1016/j.ejim.2020.08.019 | Use of hydroxychloroquine in hospitalised COVID-19 patients is associated with reduced mortality: Findings from the observational multicentre Italian CORIST study |
30% lower mortality [p<0.0001]. Retrospective 3,451 hospitalized patients, 30% reduction in mortality with HCQ after propensity adjustment, HR 0.70 [0.59 - 0.84]. | ||
Aug 24 2020 |
et al., Int. J. Antimicrobial Agents, doi:10.1016/j.ijantimicag.2020.106144 | Low-dose Hydroxychloroquine Therapy and Mortality in Hospitalized Patients with COVID-19: A Nationwide Observational Study of 8075 Participants |
32% lower mortality [p<0.0001]. Retrospective 8,075 hospitalized patients, 4,542 low-dose HCQ, 3,533 control. 35% lower mortality for HCQ (17.7% vs. 27.1%), adjusted HR 0.68 [0.62–0.76]. Low-dose HCQ monotherapy was independently associated with lower mortality in hospi.. | ||
Aug 23 2020 |
et al., Journal of Antimicrobial Chemotherapy, doi:10.1093/jac/dkaa321 | Effectiveness of remdesivir in patients with COVID-19 under mechanical ventilation in an Italian ICU |
16% lower mortality [p=0.34]. Retrospective 51 ICU patients under mechanical ventilation, 33 treated with HCQ, showing unadjusted lower mortality with treatment. | ||
Aug 21 2020 |
et al., International Journal of Antimicrobial Agents, doi:10.1016/j.ijantimicag.2020.106219 (date from earlier preprint) | Pattern of SARS-CoV-2 infection among dependant elderly residents living in retirement homes in Marseille, France, March-June 2020 |
56% lower mortality [p=0.02]. Retrospective analysis of retirement homes, HCQ+AZ >= 3 days mortality OR 0.37, p=0.02. 1690 elderly residents (mean age 83), 226 infected residents, 116 treated with HCQ+AZ >= 3 days. Detection via mass screening also showed significant .. | ||
Aug 21 2020 |
et al., The Lancet Rheumatology, doi:10.1016/S2665-9913(20)30276-9 | Risk of hydroxychloroquine alone and in combination with azithromycin in the treatment of rheumatoid arthritis: a multinational, retrospective study |
Retrospective study of RA patients using HCQ vs. sulfasalazine (another DMARD). HCQ treatment showed no increased risk in the short term (up to 30 days) among patients with RA. Long term use was associated with excess cardiovascular morta.. | ||
Aug 21 2020 |
et al., medRxiv, doi:10.1101/2020.08.18.20172874 (Preprint) | The Prognostic Value of Eosinophil Recovery in COVID-19: A Multicentre, Retrospective Cohort Study on Patients Hospitalised in Spanish Hospitals |
27% lower mortality [p=0.06]. Retrospective study focused on eosinophil recovery with 9,644 hospitalized patients in Spain, showing lower mortality for HCQ (14.7% vs 29.2%, p<0.001), and AZ (15.3% vs. 18.4%, p<0.001). With a multivariate model including potential conf.. | ||
Aug 20 2020 |
et al., J. Global Antimicrobial Resistance, doi:10.1016/j.jgar.2020.08.001 | A comprehensive strategy for the early treatment of COVID-19 with azithromycin/hydroxychloroquine and/or corticosteroids: results of a retrospective observational study in the French overseas department of Reunion Island |
88% lower ICU admission [p=0.008]. Retrospective analysis of 36 hospitalized patients showing HCQ/AZ associated with lower ICU admission, p=0.008. Median age 66, no mortality. Confounding by indication, however it was patients with hypoxemic pneumonia that were treated wit.. | ||
Aug 20 2020 |
, C., New Microbes and New Infections, doi:10.1016/j.nmni.2020.100747 | Hydroxychloroquine is protective to the heart, not harmful: A systematic review |
Review concluding that HCQ/AZ does not cause Torsade de Pointes or related deaths, HCQ decreases cardiac events, and HCQ should not be restricted in use for COVID-19 patients because of fear of cardiac mortality. | ||
Aug 18 2020 |
et al., Cancer Discovery, doi:10.1158/2159-8290.CD-20-0773 | Clinical portrait of the SARS-CoV-2 epidemic in European cancer patients |
59% lower mortality [p=0.0001]. Restrospective 890 cancer patients with COVID-19, adjusted mortality HR for HCQ/CQ 0.41, p<0.0001. Confirmed SARS-CoV-2 infection was required, which may help focus on more severe cases. Analysis with Cox proportional hazard model. Potent.. | ||
Aug 15 2020 |
et al., Clinical Microbiology and Infection, doi:10.1016/j.cmi.2020.10.004 (date from earlier preprint) | Outcomes of Persons With COVID-19 in Hospitals With and Without Standard Treatment With (Hydroxy)chloroquine |
9% higher mortality [p=0.57]. Retrospective study of HCQ use in 9 hospitals in the Netherlands, showing no significant difference in mortality with HCQ/CQ or dexamethasone. Late stage (admitted to hospital with positive test or CT scan abnormalities). 4 of 7 hospitals.. | ||
Aug 14 2020 |
et al., American Journal of Tropical Medicine and Hygiene, doi:10.4269/ajtmh.20-0873 | Hydroxychloroquine in the Treatment of COVID-19: A Multicenter Randomized Controlled Study |
This study was retracted. | ||
Aug 13 2020 |
et al., J. Medical Internet Research, doi:10.2196/21758 | Efficacy of hydroxychloroquine and tocilizumab in patients with COVID-19: A single-center retrospective chart review |
38% higher mortality [p=0.54]. Retrospective 176 hospitalized patients (144 HCQ, 32 control) showing no significant differences with HCQ or TCZ. Confounding by indication. | ||
Aug 12 2020 |
et al., Annals of the Rheumatic Diseases, doi:10.1136/annrheumdis-2020-218296 | Clinical outcomes of hospitalised patients with COVID-19 and chronic inflammatory and autoimmune rheumatic diseases: a multicentric matched cohort study |
126% higher severe cases [p=0.002]. Retrospective 228 rheumatic disease and 228 non-rheumatic disease hospitalized COVID-19 patients in Spain, showing higher risk of severe COVID-19 with HCQ treatment. | ||
Aug 11 2020 |
et al., European Journal of Drug Metabolism and Pharmacokinetics, doi:10.1007/s13318-020-00640-6 | Pharmacokinetic Basis of the Hydroxychloroquine Response in COVID-19: Implications for Therapy and Prevention |
In Silico analysis of HCQ treatment showing concluding that HCQ may affect viral clearance if administered early enough when the virus is still confined to the pharyngeal cavity; HCQ's effects against SARS-CoV-2 might be exerted more thro.. | ||
Aug 11 2020 |
et al., J. Electrocardiology, doi:10.1016/j.jelectrocard.2020.08.008 | The effect of 5-day course of hydroxychloroquine and azithromycin combination on QT interval in non-ICU COVID19(+) patient |
Safety study of 109 patients showing 5 days of HCQ+AZ did not lead to clinically significant QT prolongation or other conduction delays compared to baseline ECG in non-ICU patients. | ||
Aug 11 2020 |
et al., medRxiv, doi:10.1101/2020.08.05.20151027 (Preprint) | Time to negative PCR from symptom onset in COVID-19 patients on Hydroxychloroquine and Azithromycin - A real world experience |
21% slower viral clearance [p=0.05]. Retrospective 65 HCQ+AZ, 20 control patients, showing median time to negative PCR of 23 days for HCQ+AZ vs. 19 days for control. Confounding by indication. 100% of non-HCQ group had mild disease vs. 63% of the HCQ+AZ group. More comorbidi.. | ||
Aug 8 2020 |
et al., Int. J. Antimicrob. Agents, doi:/j.ijantimicag.2020.106136 | Effects of Hydroxychloroquine on Covid-19 in Intensive Care Unit Patients: Preliminary Results |
Small retrospective study of 29 ICU patients comparing those with HCQ plasma concentration within target to those with a concentration below the target value, with no significant differences found. Mortality in the on-target group was 0% .. | ||
Aug 6 2020 |
et al., Arthritis & Rheumatology, doi:10.1002/art.41475 | Susceptibility to COVID-19 in Patients Treated With Antimalarials: A Population-Based Study in Emilia-Romagna, Northern Italy |
6% fewer cases [p=0.75]. Comparison of CQ/HCQ users with the general population in a region of Italy, showing no significant difference in the probability of COVID-19. CQ/HCQ users were mostly systemic autoimmune disease patients and authors do not adjust for the.. | ||
Aug 6 2020 |
et al., The American Journal of Medicine, doi:10.1016/j.amjmed.2020.07.003 (Review) | Pathophysiological Basis and Rationale for Early Outpatient Treatment of SARS-CoV-2 (COVID-19) Infection |
Review of pathophysiological principles related to early outpatient treatment and therapeutic approaches including reduction of reinoculation, combination antiviral therapy, immunomodulation, antiplatelet/antithrombotic therapy, and admin.. | ||
Aug 6 2020 |
et al., Open Letter (Preprint) (meta analysis) | Concerns regarding the misinterpretation of statistical hypothesis testing in clinical trials for COVID-19 |
Open letter signed by 38 professors and doctors regarding misinterpretation of statistics in HCQ RCTs. Authors note [veja.abril.com.br] that data from RCTs for early treatment in outpatients to date actually show favorable effects, especi.. | ||
Aug 5 2020 |
et al., Annals of the Rheumatic Diseases, doi:10.1136/annrheumdis-2020-218500 | Hydroxychloroquine ineffective for COVID-19 prophylaxis in lupus and rheumatoid arthritis |
9% more cases [p=0.62]. Comparison of the percentage of SLE/RA patients on immunosuppressants that were taking HCQ, for COVID-19 diagnosis versus other infections or outpatient visits, finding a similar percentage in each case. No mortality of severity informati.. | ||
Aug 5 2020 |
et al., Journal of Global Antimicrobial Resistance, doi:10.1016/j.jgar.2020.07.018 | Hydroxychloroquine use in hospitalised patients with COVID-19: An observational matched cohort study |
67% higher mortality [p=0.57]. Small retrospective database analysis of 36 patients receiving HCQ not showing significant differences. Confounding by indication is likely. | ||
Aug 4 2020 |
et al., medRxiv, doi:10.1101/2020.07.30.20165365 (Preprint) | Clearing the fog: Is HCQ effective in reducing COVID-19 progression: A randomized controlled trial |
5% lower progression [p=1] and 26% improved viral clearance [p=0.001]. Study of 349 low-risk hospitalized patients with 151 non-consenting or ineligible patients used as controls. SOC included zinc, vitamin C and vitamin D. A statistically significant improvement in PCR negativity is shown at day 7 with HCQ .. | ||
Aug 3 2020 |
et al., Clinical Microbiology and Infection, doi:10.1016/j.cmi.2020.07.024 | Characteristics and predictors of death among 4035 consecutively hospitalized patients with COVID-19 in Spain |
18% lower mortality [p=0.0001]. Retrospective 4035 hospitalized patients in Spain showing reduced mortality with HCQ (data is in the supplementary appendix). | ||
Aug 3 2020 |
et al., Science China Life Sciences, 2020 Aug 3, doi:10.1007/s11427-020-1782-1 | Beneficial effects exerted by hydroxychloroquine in treating COVID-19 patients via protecting multiple organs |
83% lower progression [p=0.05] and 85% lower mortality [p=0.02]. Retrospective 2,882 patients in China, median age 62, 278 receiving HCQ, median 10 days post hospitalization, showing that HCQ treatment can reduce systemic inflammation and inhibit the cytokine storm, thus protecting multiple organs from.. | ||
Aug 2 2020 |
et al., Int. J. Antimicrobial Agents, 2020, doi:10.1016/j.ijantimicag.2020.106129 | Impact of medical care including anti-infective agents use on the prognosis of COVID-19 hospitalized patients over time |
55% lower combined intubation/hospitalization [p=0.04]. Retrospective of 132 hospitalized patients. HCQ+AZ(52)/AZ(28) significantly reduced death/ICU, HR=0.45, p=0.04. Adjusted for Charlson Comorbidity Index (including age), obesity, O2, lymphocyte count, and treatments. Mean delay from admiss.. | ||
Aug 2 2020 |
, R., bioRxiv, doi:10.1101/2020.08.02.232892 (Preprint) (In Vitro) | A New Model of SARS-CoV-2 Infection Based on (Hydroxy)Chloroquine Activity |
In Vitro study presenting a new theory on SARS-CoV-2 infection and why HCQ/CQ provides benefits, which potentially explains the observed relationships with smoking, diabetes, obesity, age, and treatment delay, and confirms the importance .. | ||
Aug 1 2020 |
et al., J. Gerontol. A Biol. Sci. Med. Sci., doi:10.1093/gerona/glaa192 | Effectiveness of a On-Site Medicalization Program for Nursing Homes with COVID-19 Outbreaks |
59% lower mortality [p=0.03]. Retrospective 272 nursing home residents showing significantly improved survival after establishing a treatment program including HCQ with or without lopinavir/ritonavir and with the addition of adjuvant and antimicrobial treatments depen.. | ||
Jul 31 2020 |
et al., Travel Medicine and Infectious Disease, 37, doi:10.1016/j.tmaid.2020.101826 | Apparent inefficacy of hydroxychloroquine combined with azithromycin on SARS-CoV-2 clearance in an incident cohort of geriatric patients with COVID-19 |
Report on HCQ+AZ use in 41 elderly high-risk patients. 29 of 30 patients with treatment >= 5 days survived. Only 10% were PCR negative after one week, however the Ct value is not specified. | ||
Jul 29 2020 |
et al., Int. J. Infectious Diseases, doi:10.1016/j.ijid.2020.07.056 | Effectiveness of Hydroxychloroquine in COVID-19 disease: A done and dusted situation? |
34% lower mortality [p=0.12]. HCQ+AZ adjusted death HR 0.44, p=0.009. Propensity scores include baseline COVID-19 disease severity, age, gender, number of comorbidities, cardio-vascular disease, duration of symptoms, date of admission, baseline plasma CRP. IPW censori.. | ||
Jul 28 2020 |
et al., Turk. J. Med. Sci., doi:10.3906/sag-2006-173 | Outcome of Non-Critical COVID-19 Patients with Early Hospitalization and Early Antiviral Treatment Outside the ICU |
Observational study of 174 hospitalized patients in Turkey, median age 45.4, 23 treated with HCQ, 113 with HCQ+AZ, and 32 with regimens including favipiravir. 75% reduction in the median time to clinical improvement for HCQ+AZ vs. FAV, RR.. | ||
Jul 27 2020 |
et al., Clinical Rheumatology, doi:10.1007/s10067-020-05301-2 | Determinants of COVID-19 disease severity in patients with underlying rheumatic disease |
92% lower mortality [p=0.19]. Prospective study of 38 hospitalized rheumatic disease patients with COVID-19 in Spain, showing no mortality with existing HCQ use compared to 32% without, not reaching statistical significance. | ||
Jul 26 2020 |
et al., NEJM, doi:10.1056/NEJMoa2021801 (date from earlier preprint) | A Cluster-Randomized Trial of Hydroxychloroquine as Prevention of Covid-19 Transmission and Disease |
46% lower mortality [p=0.39], 17% lower hospitalization [p=0.71], and 32% fewer cases [p=0.27]. For positive symptomatic cases, a greater effect is seen for nursing home residents, RR=0.49 [0.21 - 1.17], vs. overall 0.89, possibly because the exposure events are identified faster in this context, versus home exposure where testing o.. | ||
Jul 24 2020 |
et al., medRxiv, doi:10.1101/2020.07.21.20159301 (Preprint) | Prevalence and clinical correlates of COVID-19 outbreak among healthcare workers in a tertiary level hospital |
51% fewer cases [p=0.02]. Study of hospital health care workers showing HCQ prophylaxis reduces COVID-19 significantly, OR 0.30, p=0.02. 94 positive health care workers with a matched sample of 87 testing negative. Full course prophylaxis was important in this stu.. | ||
Jul 23 2020 |
et al., NEJM, July 23, 2020, doi:10.1056/NEJMoa2019014 | Hydroxychloroquine with or without Azithromycin in Mild-to-Moderate Covid-19 |
16% lower mortality [p=0.77] and 28% higher hospitalization [p=0.3]. Late stage RCT of 667 hospitalized patients with up to 14 days of symptoms at enrollment and receiving up to 4 liters per minute supplemental oxygen, not finding a significant effect after 15 days. Authors note: "the trial cannot def.. | ||
Jul 22 2020 |
et al., Journal of Family Medicine and Primary Care, doi:10.4103/jfmpc.jfmpc_1177_21 | Hydroxychloroquine pre-exposure prophylaxis for COVID-19 among healthcare workers: Initial experience from India |
62% fewer cases [p=0.01]. Prophylaxis study with 334 low-risk healthcare workers in India, showing significantly lower risk of cases with treatment. Symptomatic patients received PCR results, but only some asymptomatic patients did, so there may have been addition.. | ||
Jul 22 2020 |
et al., PLOS Pathogens, doi:10.1371/journal.ppat.1009212 (date from earlier preprint) (In Vitro) | Hydroxychloroquine-mediated inhibition of SARS-CoV-2 entry is attenuated by TMPRSS2 |
In Vitro analysis showing that HCQ efficiently blocks viral entry mediated by cathepsin L, but not by TMPRSS2, and that a combination of HCQ and a TMPRSS2 inhibitor prevents SARS-CoV-2 infection more potently than either drug alone. | ||
Jul 22 2020 |
et al., Nature, (2020), doi:10.1038/s41586-020-2575-3 (In Vitro) | Chloroquine does not inhibit infection of human lung cells with SARS-CoV-2 |
The title of this paper does not appear to match the results. Fig. 1b @100uM shows CQ results in a ~4.5 fold decrease (on a linear scale) in extracellular virus, p=0.05, after 24 hours (we do not see the supplementary data at this time so.. | ||
Jul 22 2020 |
et al., Cancer Discovery, doi:10.1158/2159-8290.CD-20-0941 | Utilization of COVID-19 Treatments and Clinical Outcomes among Patients with Cancer: A COVID-19 and Cancer Consortium (CCC19) Cohort Study |
2% higher mortality [p=0.92]. Retrospective cancer patients, showing adjusted OR 1.03 [0.62-1.73] for HCQ. The study reports the number of HCQ+AZ patients but they do not provide results for HCQ+AZ (only HCQ + any other treatment). Significant confounding by indicatio.. | ||
Jul 22 2020 |
et al., British Journal of Clinical Pharmacology, doi:10.1111/bcp.14482 | Clinical outcomes and adverse events in patients hospitalised with COVID-19, treated with off-label hydroxychloroquine and azithromycin |
143% higher mortality [p=0.03]. Retrospective 82 hospitalized patients HCQ/AZ, 52 SOC, not finding statistically significant differences. Confounding by indication - authors note that the HCQ/AZ patients were more severely ill, and do not attempt to adjust for confounde.. | ||
Jul 21 2020 |
et al., medRxiv, doi:10.1101/2020.07.17.20155960 (Preprint) | Observational Study of the Efficiency of Treatments in Patients Hospitalized with Covid-19 in Madrid |
17% lower mortality [p<0.0001]. HCQ HR 0.83 [0.77-0.89] based on propensity score matched retrospective analysis of 1,645 hospitalized patients. Prednisone HR 0.85 [0.82-0.88], 14 other medications showed either no signicant benefit or a negative effect. | ||
Jul 20 2020 |
et al., J Clin Anesth., doi:10.1016/j.jclinane.2020.110005 | Clinical comorbidities, characteristics, and outcomes of mechanically ventilated patients in the State of Michigan with SARS-CoV-2 pneumonia |
20% lower mortality [p=0.48]. Retrospective 152 mechanically ventilated patients in the USA showing unadjusted lower mortality with vitamin C, vitamin D, HCQ, and zinc treatment, statistically significant only for vitamin C. | ||
Jul 20 2020 |
et al., Research Square, doi:10.21203/rs.3.rs-41653/v1 (Preprint) | Prevalence and clinical features of COVID-19 in a large cohort of 199 patients with sarcoidosis |
17% fewer cases [p=1]. Retrospective 199 sarcoidosis patients showing non-statistically significant HCQ RR 0.83, p=1.0. | ||
Jul 20 2020 |
, H., American Journal of Epidemiology, July 20, 2020, doi:10.1093/aje/kwaa152 (meta analysis) | Response to: “Early Outpatient Treatment of Symptomatic, High-Risk Covid-19 Patients” and “Re: Early Outpatient Treatment of Symptomatic, High-Risk Covid-19 Patients that Should be Ramped-Up Immediately as Key to the Pandemic Crisis” |
Updated meta analysis including 7 new studies of high-risk outpatients, for a total of 12 studies, all showing significant benefit. | ||
Jul 18 2020 |
, M., arXiv.org, arXiv:2007.09477 (Preprint) (meta analysis) | Efficacy of Hydroxychloroquine as Prophylaxis for Covid-19 |
Secondary analysis of Boulware et al.'s PEP trial and treatment delay-response data, confirming that HCQ is effective when used early, p<0.01. The effectiveness found is especially notable considering the limitations of the study. Treatme.. | ||
Jul 19 2020 |
et al., medRxiv, doi:10.1101/2020.07.17.20156521 (Preprint) | COVID-19 Case Series at UnityPoint Health St. Luke’s Hospital in Cedar Rapids, IA |
70% higher mortality [p=0.69]. HCQ+AZ early in the epidemic had a fairly good success rate with few complications, 86% of HCQ patients survived and 92% of HCQ+AZ patients. Patients not receiving either had 93% survival but were not considered comparable because the tre.. | ||
Jul 17 2020 |
et al., Nature Communications, doi:10.1038/s41467-020-19056-6 | A pragmatic randomized controlled trial reports lack of efficacy of hydroxychloroquine on coronavirus disease 2019 viral kinetics |
4% lower mortality [p=1] and 71% improved viral reduction rate [p=0.51]. Small RCT of nasopharyngeal viral load not showing significant differences. The rate of reduction for HCQ was 0.24 [0.03-0.46] RNA copies/mL/24h, and 0.14 [-0.10-0.37] for the control group (71% faster with HCQ but not statistically signi.. | ||
Jul 16 2020 |
et al., Infect. Chemother., 2020, doi:10.3947/ic.2020.52.e43 | Early Hydroxychloroquine Administration for Rapid Severe Acute Respiratory Syndrome Coronavirus 2 Eradication |
65% improved viral clearance [p=0.001]. HCQ 1-4 days from diagnosis was the only protective factor against prolonged viral shedding found, OR 0.111, p=0.001. 57.1% viral clearance with 1-4 days delay vs. 22.9% for 5+ days delayed treatment. Authors report that early administrat.. | ||
Jul 16 2020 |
et al., Annals of Internal Medicine, doi:10.7326/M20-4207 | Hydroxychloroquine in Nonhospitalized Adults With Early COVID-19: A Randomized Trial |
37% lower combined mortality/hospitalization [p=0.58], 49% lower hospitalization [p=0.38], and 20% improved recovery [p=0.21]. Update: we have not received details for treatment delay. An author reports that treatment initiation time was not recorded: [osf.io]. Conflicting estimates are provided in a comment of the article and independent analysis, with reports i.. | ||
Jul 16 2020 |
et al., Clinical Infectious Diseases, ciaa1009, doi:10.1093/cid/ciaa1009 | Hydroxychloroquine for Early Treatment of Adults with Mild Covid-19: A Randomized-Controlled Trial |
16% lower hospitalization [p=0.64], 34% improved recovery [p=0.38], and 2% improved viral clearance. This paper has conflicting values, table S2 shows 12 control hospitalizations, while table 2 shows 11. The original report for this paper had more conflicting values, with values reported in Table 2 and the abstract corresponding to 12 co.. | ||
Jul 15 2020 |
et al., JAMA Intern. Med., doi:10.1001/jamainternmed.2020.3596 | Factors Associated With Death in Critically Ill Patients With Coronavirus Disease 2019 in the US |
6% higher mortality [p=0.41]. Analysis of 2215 intensive care unit patients showing no significant differences with this very late stage use of HCQ. HCQ+AZ mortality relative risk RR 0.96, p=0.53, HCQ and HCQ+AZ combined RR 1.06, p=0.409. | ||
Jul 15 2020 |
et al., Med. Hypotheses, doi:10.1016/j.mehy.2020.110110 | Inhaled hydroxychloroquine to improve efficacy and reduce harm in the treatment of COVID-19 |
Proposal to use an inhaled formulation of HCQ which has passed safety studies in clinical trials for the treatment of asthma. Authors advocate for early treatment or prophylaxis of COVID-19, using HCQ as an inhaled aerosol, to deliver the.. | ||
Jul 14 2020 |
et al., Research Square, doi:10.21203/rs.3.rs-39421/v1 (Preprint) | High in-hospital mortality due to COVID-19 in a community hospital in Spain: a prospective observational study |
36% lower mortality [p=0.12]. Retrospective 100 hospitalized patients in Spain showing lower mortality with HCQ+AZ. | ||
Jul 14 2020 |
et al., Eurasian Journal of Medicine and Oncology, doi:10.14744/ejmo.2021.16263 | A Randomized Trial of Ivermectin-Doxycycline and Hydroxychloroquine-Azithromycin therapy on COVID19 patients |
Small 116 patient RCT comparing ivermectin+doxycycline and HCQ+AZ, not showing a significant difference in time to PCR negative or symptom resolution. Time to symptomatic recovery was 5.93 days for ivermectin+doxycycline vs. 6.99 days for.. | ||
Jul 11 2020 |
et al., Critical Care, 24:418, 2020, doi:10.1186/s13054-020-03117-9 | Comparison of hydroxychloroquine, lopinavir/ritonavir, and standard of care in critically ill patients with SARS-CoV-2 pneumonia: an opportunistic retrospective analysis |
42% lower mortality [p=0.24], 6% lower treatment escalation [p=0.73], and 15% improved viral clearance [p=0.61]. Retrospective 80 ICU patients, 22 SOC, 20 lopinavir/ritonavir, 38 HCQ. 28 day mortality 24% (HCQ) versus 41% (SOC), a 41% decrease, but not statistically significant due to very small sample sizes. No statistically significant differences.. | ||
Jul 10 2020 |
et al., American Journal of Transplantation, doi:10.1111/ajt.16185 | COVID-19 and kidney transplantation: Results from the TANGO International Transplant Consortium |
53% higher mortality [p=0.17]. Analysis of 144 hospitalized kidney transplant patients showing HCQ mortality HR 1.53, p = 0.17. Subject to confounding by indication. | ||
Jul 10 2020 |
et al., PLoS ONE, doi:10.1371/journal.pone.0242763 | A Multicenter, randomized, open-label, controlled trial to evaluate the efficacy and tolerability of hydroxychloroquine and a retrospective study in adult patients with mild to moderate Coronavirus disease 2019 (COVID-19) |
24% improved viral clearance [p=0.71]. 2 very small studies with hospitalized patients in Taiwan. RCT with 21 treatment and 12 SOC patients. No mortality, or serious adverse effects. Median time to negative RNA 5 days versus 10 days SOC, p=0.4. Risk of PCR+ at day 14, RR 0.76,.. | ||
Jul 9 2020 |
et al., Medicina Clínica, doi:10.1016/j.medcli.2020.06.025 | Agentes terapéuticos utilizados en 238 pacientes hospitalizados por COVID-19 y su relación con la mortalidad |
19% lower mortality [p=0.75]. Retrospective 238 hospitalized patients in Spain showing lower mortality with HCQ, adjusted hazard ratio aHR 0.81 [0.24-2.76]. | ||
Jul 9 2020 |
et al., Preprint (Preprint) (meta analysis) | Hydroxychloroquine and Azithromycin as a Treatment of COVID-19: Results of an Open-Label Non-Randomized Clinical Trial: Response to David Spencer (Elsevier) |
Updated meta analysis showing significant reductions in mortality and viral shedding. Mortality OR 0.53 [0.4-0.71] for clinical studies, 0.92 big data studies, 18,211 patients. Persistent viral shedding OR 0.47 [0.28-0.79], 4,540 patients. | ||
Jul 8 2020 |
et al., Antimicrobial Agents and Chemotherapy, doi:10.1128/AAC.01177-20 | Effect of Systemic Inflammatory Response to SARS-CoV-2 on Lopinavir and Hydroxychloroquine Plasma Concentrations |
Study of Lopinivar and HCQ plasma concentrations and CRP levels in late stage (treatment initiation median 8 days from onset) COVID-19 patients. The median HCQ plasma concentration was 171 ng/ml, which authors suggest indicates that HCQ l.. | ||
Jul 8 2020 |
et al., Cell Death & Disease volume 11, doi:10.1038/s41419-020-2721-8 (Review) | Is hydroxychloroquine beneficial for COVID-19 patients? |
Review of the anti-inflammatory, antiviral, and protective vascular effects of CQ and HCQ, noting that HCQ may be preferable for COVID-19 due to fewer side effects. | ||
Jul 7 2020 |
, L., Preprint, July 7, 2020 (Review) (Preprint) | Hydroxychloroquine-based COVID-19 Treatment, A Systematic Review of Clinical Evidence and Expert Opinion from Physicians’ Surveys |
85% of globally surveyed physicians recognized HCQ as at least partially effective in treating COVID-19, according to Sermo W3. More than half of the surveyed US physicians would take the drug or give it to family members early or even be.. | ||
Jul 7 2020 |
et al., medRxiv, doi:10.1101/2020.07.04.20146548 (Preprint) | Treatment Response to Hydroxychloroquine and Antibiotics for mild to moderate COVID-19: a retrospective cohort study from South Korea |
3% faster viral clearance [p=0.92]. Retrospective of hospitalized patients with 31 HCQ patients and 195 standard treatment patients, not showing a significant difference in terms of viral clearance or recovery. There was no mortality in either group. "It is notable tha.. | ||
Jul 3 2020 |
et al., International Journal of Antimicrobial Agents, doi:10.1016/j.ijantimicag.2020.106214 (date from earlier preprint) | COVID-19 Outpatients – Early Risk-Stratified Treatment with Zinc Plus Low Dose Hydroxychloroquine and Azithromycin: A Retrospective Case Series Study |
79% lower mortality [p=0.12] and 82% lower hospitalization [p=0.001]. 79% lower mortality and 82% lower hospitalization with early HCQ+AZ+Z. No cardiac side effects. Retrospective 518 patients (141 treated, 377 control). | ||
Jul 3 2020 |
et al., Lancent Rheumatology, doi:10.1016/S2665-9913(20)30227-7 | COVID-19 in patients with rheumatic disease in Hubei province, China: a multicentre retrospective observational study |
91% fewer cases [p=0.04]. Rheumatic disease patients on HCQ had a lower risk of COVID-19 than those on other disease-modifying anti-rheumatic drugs, OR 0.09 (0.01–0.94), p=0.044 after adjusting for age, sex, smoking, systemic lupus erythematosus, infection in othe.. | ||
Jul 1 2020 |
et al., Int. J. Infect. Dis., July 1 2020, doi:10.1016/j.ijid.2020.06.099 | Treatment with Hydroxychloroquine, Azithromycin, and Combination in Patients Hospitalized with COVID-19 |
51% lower mortality [p=0.009]. HCQ decreases mortality from 26.4% to 13.5% (HCQ) or 20.1% (HCQ+AZ). Propensity matched HCQ HR 0.487, p=0.009. Michigan 2,541 patients retrospective. Before propensity matching the HCQ group average age is 5 years younger and the percenta.. | ||
Jul 1 2020 |
et al., Heart Rhythm, doi:10.1016/j.hrthm.2020.06.033 | Incidence of arrhythmias and electrocardiographic abnormalities in symptomatic pediatric patients with PCR positive SARS-CoV-2 infection including drug induced changes in the corrected QT interval (QTc) |
In pediatric patients with PCR positive active COVID-19 infection, significant arrhythmias are infrequent, but occur at an incidence higher than expected in a general pediatric population. Comorbidities are not more common in patients wit.. | ||
Jun 30 2020 |
et al., Blood Cancer Journal, doi:10.1038/s41408-020-00372-5 | Multiple Myeloma and SARS-CoV-2 Infection: Clinical Characteristics and Prognostic Factors of Inpatient Mortality |
33% lower mortality [p=0.2]. Retrospective 167 multiple myeloma patients in Spain, showing no significant difference in mortality with HCQ treatment in unadjusted results without group details. | ||
Jun 30 2020 |
et al., J. Gen. Intern. Med., doi:10.1007/s11606-020-05983-z | Risk Factors for Mortality in Patients with COVID-19 in New York City |
47% lower mortality [p<0.0001]. HCQ decreases mortality, HR 0.53 (CI 0.41–0.67). IPTW adjustment does not significantly change HR 0.53 (0.41-0.68). Retrospective 6,000 patients in New York City. | ||
Jun 30 2020 |
et al., medRxiv, doi:10.1101/2020.06.30.20143289 (Preprint) | Hydroxychloroquine has no effect on SARS-CoV-2 load in nasopharynx of patients with mild form of COVID-19 |
25% worse viral load [p=0.45]. Small late stage (7-10 days post symptoms) study of nasal swab RNA with 12 control and 33 patients, showing no significant differences (significant reduction in viral load is seen in both groups). The groups are not comparable, with signi.. | ||
Jun 29 2020 |
et al., Cir Cir. 2020, 88:5, 569-575, doi:10.24875/CIRU.20000675 | Experience in the management of severe COVID-19 patients in an intensive care unit |
11% higher mortality [p=1]. Small retrospective study of 56 ICU patients in Mexico showing HCQ RR 1.1, p = 1.0. | ||
Jun 29 2020 |
et al., J. Medical Virology, July 9, 2020, doi:10.1002/jmv.26286 (date from earlier preprint) | Chronic treatment with hydroxychloroquine and SARS-CoV-2 infection |
47% fewer cases [p<0.0001]. Chronic treatment with HCQ provides protection against COVID, odds ratio 0.51 (0.37-0.70). The actual benefit is likely to be larger becasue research shows that the risk of COVID-19 for systemic autoimmune disease patients is much higher .. | ||
Jun 29 2020 |
et al. (Preprint) | Electrocardiographic safety of daily Hydroxychloroquine 400mg plus Azithromycin 250mg as an ambulatory treatment for COVID-19 patients in Cameroon |
No life-threatening modifications of the QT interval was observed in non-severe COVID-19 patients treated ambulatory with HCQ+AZ. 51 relatively young patients 39 +/- 11. | ||
Jun 25 2020 |
et al., Annals of the Rheumatic Diseases, doi:10.1136/annrheumdis-2020-218244 | Systematic analysis of COVID-19 infection and symptoms in a systemic lupus erythematosus population: correlation with disease characteristics, hydroxychloroquine use and immunosuppressive treatments |
4% fewer cases [p=0.93]. Small study of SLE patients taking HCQ with a phone survey for COVID-19 suggestive symptoms. There was 2 hospitalizations (group not identified) and no ICU or death cases. A similar percentage of suspected infections were reported for HCQ.. | ||
Jun 25 2020 |
et al., Travel Med. Infect. Dis. 101791, Jun 25, 2020, doi:10.1016/j.tmaid.2020.101791 | Outcomes of 3,737 COVID-19 patients treated with hydroxychloroquine/azithromycin and other regimens in Marseille, France: A retrospective analysis |
59% lower mortality [p=0.05]. Early treatment leads to significantly better clinical outcome and faster viral load reduction. Matched sample mortality HR 0.41 p-value 0.048. Retrospective 3,737 patients. This study includes both outpatients and hospitalized patients. | ||
Jun 23 2020 |
et al., Aging, 12:12, 11306-11313, doi:10.18632/aging.103583 | ADL-dependency, D-Dimers, LDH and absence of anticoagulation are independently associated with one-month mortality in older inpatients with Covid-19 |
43% lower mortality [p=0.15]. Observational prospective 108 hospitalized patients 65 and older, showing HCQ mortality OR 0.49, p = 0.15. | ||
Jun 22 2020 |
et al., medRxiv, doi:10.1101/2020.06.19.20135475 (Preprint) | Chloroquine, but not hydroxychlorquine, prolongs the QT interval in a primary care population |
Safety analysis in patients without COVID-19, finding a small increase in QTc associated with use of CQ, but not HCQ. Authors also study mortality (n=3,368), with HCQ hazard ratio 0.67 [0.43-1.05]. | ||
Jun 22 2020 |
et al., Clinical Kidney Journal, 13:3, 334–339, doi:10.1093/ckj/sfaa084 | SARS-CoV-2 infection in dialysis patients in northern Italy: a single-centre experience |
50% lower mortality [p=0.53]. Very small observational study of 15 dialysis patients showing HCQ mortality RR 0.50, p = 0.53. | ||
Jun 22 2020 |
et al., medRxiv, doi:10.1101/2020.06.19.20136093 (Preprint) | Efficacy and safety of chloroquine or hydroxychloroquine in moderate type of COVID-19: a prospective open-label randomized controlled study |
20% faster recovery [p=0.51] and 71% faster viral clearance [p=0.0004]. RCT 48 hospitalized patients in China showing faster clinical recovery and viral clearance with CQ/HCQ. | ||
Jun 21 2020 |
et al., Braz J Microbiol, doi:10.1007/s42770-020-00395-x (date from earlier preprint) | No benefit of hydroxychloroquine on SARS-CoV-2 viral load reduction in non-critical hospitalized patients with COVID-19 |
81% improved viral reduction rate [p=0.4]. Viral load comparison for 34 HCQ and 32 control patients hospitalized with moderate COVID-19. All patients recovered limiting the room for beneficial effects. While not achieving statistical significance, results show faster recovery with.. | ||
Jun 19 2020 |
Sawai Man Singh Hospital, India (News) | HCQ beneficial as preventive drug: SMS doctors told ICMR |
PrEP with 4,300 very high risk healthcare workers in a hospital with up to 500+ COVID patients at a time, only 1% cases, all recovered. | ||
Jun 19 2020 |
, study not available yet (News) | NIH halts clinical trial of hydroxychloroquine |
NIH halts late stage trial reporting no harm and no benefit. 470 patients. | ||
Jun 19 2020 |
et al., medRxiv, doi:10.1101/2020.06.16.20132597 (Preprint) | Hydroxychloroquine with or without azithromycin and in-hospital mortality or discharge in patients hospitalized for COVID-19 infection: a cohort study of 4,642 in-patients in France |
5% higher mortality [p=0.74] and 20% higher hospital discharge [p=0.002]. Retrospective of 4,642 hospitalized patients in France showing significantly faster discharge with HCQ and HCQ+AZ. No significant effect is seen on 28-day mortality, however many more control patients are still in hospital at 28 days. Oth.. | ||
Jun 19 2020 |
et al., bioRxiv, doi:10.1101/2020.06.19.159053 | Favipiravir at high doses has potent antiviral activity in SARS-CoV-2−infected hamsters, whereas hydroxychloroquine lacks activity |
Animal study with Syrian hamsters, showing treatment of SARS-CoV-2-infected hamsters with favipiravir or HCQ (with and without AZ). Treatment with HCQ alone resulted in a very modest reduction of 0.3 log10 viral RNA copies/mg lung, and no.. | ||
Jun 18 2020 |
et al., Clinical Infectious Diseases, doi:10.1093/cid/ciaa791 | Compassionate use of hydroxychloroquine in clinical practice for patients with mild to severe Covid-19 in a French university hospital |
11% lower mortality [p=0.88]. Retrospective of 89 hospitalized patients, survival HR 0.89 [0.23-3.47], not statistically significant. Authors note that unmeasured confounders may have persisted and the study may be underpowered. | ||
Jun 17 2020 |
et al., J. Cardiovasc. Med. 21, 922–923, doi:10.2459/JCM.0000000000001061 | Low hospitalization rate without severe arrhythmias: a prospective survey on 350 patients early home treated with hydroxychloroquine during COVID-19 pandemic |
Prospective analysis of early treatment of 350 patients in Italy (without waiting for PCR results), showing low hospitalization rates and no serious adverse events. From 274 patients treated with HCQ, 16 required hospitalization (5.8%). M.. | ||
Jun 17 2020 |
et al., J. Med. Virology, June 17, 2020, doi:10.1002/jmv.26193 | Hydroxychloroquine treatment in COVID-19: a descriptive observational analysis of 30 cases from a single center in Wuhan, China |
30 hospitalized patients. Early use of HCQ is more effective, 43% reduction in progression from moderate to severe. "Early" is relative here, within 7 days of hospitalization. | ||
Jun 17 2020 |
et al., Annals of Oncology, 31:10, 1386-1396, doi:10.1016/j.annonc.2020.06.007 | COVID-19 in patients with lung cancer |
2% higher mortality [p=0.99]. Analysis of hospitalized lung cancer patients with 35 of 48 taking HCQ, mortality OR 1.03, p = 0.99. | ||
Jun 16 2020 |
et al., Korean J Intern Med, doi:10.3904/kjim.2020.224 | Lopinavir-ritonavir versus hydroxychloroquine for viral clearance and clinical improvement in patients with mild to moderate coronavirus disease 2019 |
Small retrospective study of hospitalized patients with 31 lopinavir-ritonavir and 34 HCQ patients, HCQ 400mg once per day, finding no significant difference in clinical response, but more rapid viral clearance with lopinavir-ritonavir. | ||
Jun 16 2020 |
et al., Annals of the Rheumatic Diseases 2020:79, 1163-1169, doi:10.1136/annrheumdis-2020-217425 | Clinical characteristics of 17 patients with COVID-19 and systemic autoimmune diseases: a retrospective study |
80% lower hospitalization [p=0.001]. Analysis of 1255 COVID-19 patients in Wuhan Tongji Hospital finding 0.61% with systemic autoimmune diseases, much lower than authors expected (3%-10%). Authors hypothesise that protective factors, such as CQ/HCQ use, reduce hospitalization. | ||
Jun 12 2020 |
, AAPS J 22, 86 (2020), doi:10.1208/s12248-020-00465-w (Theory) | Intracellular ABCB1 as a Possible Mechanism to Explain the Synergistic Effect of Hydroxychloroquine-Azithromycin Combination in COVID-19 Therapy |
Proposes a new mechanism supporting the synergistic interaction between HCQ+AZ. | ||
Jun 12 2020 |
et al., Journal of Medical Virology, doi:10.1002/jmv.26407 (date from earlier preprint) | Early administration of lopinavir/ritonavir plus hydroxychloroquine does not alter the clinical course of SARS-CoV-2 infection: a retrospective cohort study |
Late stage study of hospitalized patients comparing treatment starting within 5 days versus later. Note that "early" here is only relative - all patients are hospitalized so this is "late" and "very late". Th.. | ||
Jun 10 2020 |
et al., medRxiv, doi:10.1101/2020.06.11.20128926 (Preprint) | Comorbidity and Sociodemographic determinants in COVID-19 Mortality in an US Urban Healthcare System |
6% lower mortality [p=0.63]. Database analysis of 7,592 patients in NYC, showing adjusted HCQ mortality odds ratio OR 0.96, p = 0.82, and HCQ+AZ OR 0.94, p = 0.63 | ||
Jun 10 2020 |
et al., medRxiv, doi:10.1101/2020.06.10.20101105 (Preprint) | A short therapeutic regimen based on hydroxychloroquine plus azithromycin for the treatment of COVID-19 in patients with non-severe disease. A strategy associated with a reduction in hospital admissions and complications. |
80 moderate cases, HCQ+AZ appears to reduce serious complications and death. Moderate treated cases resulted in hospitalization at the same rate as mild untreated cases suggesting efficacy. | ||
Jun 9 2020 |
et al., Hosp. Pharm. and Clinician, doi:10.1016/j.phclin.2020.06.001 | Beneficial effect of Hydroxychloroquine-Azithromycin combination in the treatment of elderly patients with Covid-19: results of an observational study |
68 very high risk nursing home residents, median age 86, HCQ+AZ early treatment within 2.5 days onset, 2 stopped due to QTc. Only 7 died, significantly less than other nursing homes in France and the same as the median death for the same .. | ||
Jun 9 2020 |
et al., medRxix, doi:10.1101/2020.06.09.20116806 (Preprint) | Pre exposure Hydroxychloroquine use is associated with reduced COVID19 risk in healthcare workers |
81% fewer cases [p=0.001]. HCQ reduced cases from 38% to 7%. 106 people. No serious adverse effects. | ||
Jun 6 2020 |
et al., New Microbes and New Infections, Volume 38, doi:10.1016/j.nmni.2020.100710 (Review) | Influence of conflicts of interest on public positions in the COVID-19 era, the case of Gilead Sciences |
Shows a correlation (Spearman test, p = 0.017) between the amount received from Gilead Sciences and public opposition to the use of HCQ in France. | ||
Jun 6 2020 |
et al., New Microbes and New Infections, doi:10.1016/j.nmni.2020.100709 (meta analysis) | Clinical Efficacy of Chloroquine derivatives in COVID-19 Infection: Comparative metaanalysis between the Big data and the real world |
[H]CQ effective and reduces mortality by a factor 3. Meta analysis of 20 studies. | ||
Jun 5 2020 |
Collaborative Group, NEJM, doi:10.1056/NEJMoa2022926 (press release 6/5) (Preprint) | Effect of Hydroxychloroquine in Hospitalized Patients with COVID-19: Preliminary results from a multi-centre, randomized, controlled trial |
9% higher mortality [p=0.15] and 15% higher ventilation [p=0.19]. RECOVERY trial finds no significant benefit for very late stage (9 days after symptom onset) very sick patients. Results may be due to the unusually high dosage used (9.2g total over 10 days) [twitter.com, twitter.com]. The overall dosage.. | ||
Jun 3 2020 |
et al., NEJM, June 3 2020, doi:10.1056/NEJMoa2016638 | A Randomized Trial of Hydroxychloroquine as Postexposure Prophylaxis for Covid-19 |
17% fewer cases [p=0.35]. Remote post-exposure prophylaxis RCT reporting "[HCQ] did not prevent illness compatible with Covid-19 or confirmed infection when used as postexposure prophylaxis within 4 days after exposure". However, this statement is incorr.. | ||
Jun 1 2020 |
et al., Clin. Pharmacol. Ther., Jun 1, 2020, doi:10.1002/cpt.1874 | Finding the Dose for Hydroxychloroquine Prophylaxis for COVID-19: The Desperate Search for Effectiveness |
Analysis of HCQ dosing regimens, recommending: PrEP: 800mg loading dose followed by 400mg 2 or 3 times weekly to maintain weekly troughs above EC50 in >50% of patients at steady-state. PEP: 800mg loading dose followed in 6 hours by 600mg,.. | ||
May 31 2020 |
et al., Asian J. Medicine and Health, July 15, 2020, doi:10.9734/ajmah/2020/v18i730224 (date from earlier preprint) | Azithromycin and Hydroxychloroquine Accelerate Recovery of Outpatients with Mild/Moderate COVID-19 |
65% faster recovery [p=0.0001]. Mean clinical recovery time reduced from 26 days (SOC) to 9 days, p<0.0001 (HCQ+AZ) or 13 days, p<0.0001 (AZ). No cardiac toxicity. Small retrospective study of 88 patients with case control analysis with matched patients. | ||
May 29 2020 |
et al., Lung Cancer, doi:10.1016/j.lungcan.2020.05.034 | Covid-19 and lung cancer: A greater fatality rate? |
92% lower mortality [p=0.02]. Retrospective 17 hospitalized lung cancer patients showing lower mortality with HCQ+AZ treatment. | ||
May 28 2020 |
et al., medRxiv 2020.05.28.20114835, doi:10.1101/2020.05.28.20114835 (Preprint) | Viral Dynamics Matter in COVID-19 Pneumonia: the success of early treatment with hydroxychloroquine and azithromycin in Lebanon |
HCQ+AZ potentially explains 94.7% success in treating a fairly complex cohort. | ||
May 28 2020 |
et al., Indian J. Med. Res., June 20, 2020, doi:10.4103/ijmr.IJMR_2234_20 | Healthcare workers & SARS-CoV-2 infection in India: A case-control investigation in the time of COVID-19 |
67% fewer cases [p=0.001]. 4+ doses of HCQ associated with a significant decline in the odds of getting infected, dose-response relationship exists. | ||
May 28 2020 |
et al., National Science Review, nwaa113, doi:10.1093/nsr/nwaa113 | Preliminary evidence from a multicenter prospective observational study of the safety and efficacy of chloroquine for the treatment of COVID-19 |
67% faster viral clearance [p=0.0001]. 197 CQ patients, 176 control. Mean time to undetectable viral RNA and duration of fever significantly reduced. No serious adverse events. | ||
May 27 2020 |
et al., NEJM, doi:10.1056/NEJMoa2015301 | Remdesivir for 5 or 10 Days in Patients with Severe Covid-19 |
22% lower mortality [p=0.46]. Study focused on remdesivir but with results for HCQ in the supplementary appendix, showing 9% death with HCQ versus 12% control, unadjusted relative risk uRR 0.78, p = 0.46. | ||
May 28 2020 |
et al., Lancet, June 20, 2020, doi:10.1016/S0140-6736(20)31187-9 (date from earlier preprint) | Clinical impact of COVID-19 on patients with cancer (CCC19): a cohort study |
134% higher mortality [p<0.0001]. Retrospective 928 cancer patients, showing HCQ OR 1.06 [0.51-2.20]. HCQ+AZ OR 2.93 [1.79-4.79]. The relative risks of different therapies suggest that the results are overly affected by confounding by indication. Authors note: HCQ+AZ migh.. | ||
May 28 2020 |
et al., Annals of the Rheumatic Diseases, 79:7, 859-866, doi:10.1136/annrheumdis-2020-217871 | Characteristics associated with hospitalisation for COVID-19 in people with rheumatic disease: data from the COVID-19 Global Rheumatology Alliance physician-reported registry |
3% lower hospitalization [p=0.82]. Analysis of rheumatic disease patients showing no significant association between antimalarial therapy and hospitalisation, OR=0.94 [0.57-1.57], p=0.82 after adjustments. | ||
May 27 2020 |
, American Journal of Epidemiology, kwaa093, 27 May 2020, doi:10.1093/aje/kwaa093 (meta analysis) | Early Outpatient Treatment of Symptomatic, High-Risk Covid-19 Patients that Should be Ramped-Up Immediately as Key to the Pandemic Crisis |
Five studies, including two controlled clinical trials, have demonstrated significant outpatient treatment efficacy. | ||
May 25 2020 |
et al., PLoS ONE, doi:10.1371/journal.pone.0237693 | Hydroxychloroquine and Tocilizumab Therapy in COVID-19 Patients - An Observational Study |
1% lower mortality [p=0.93]. Retrospective study of late stage use on 2,512 hospitalized patients showing no significant differences in associated mortality for patients receiving any HCQ during the hospitalization (HR, 0.99 [95% CI, 0.80-1.22]), HCQ alone (HR, 1.02 .. | ||
May 24 2020 |
et al., Ann. Intensive Care, doi:10.1186/s13613-020-00678-4 | Lack of viral clearance by the combination of hydroxychloroquine and azithromycin or lopinavir and ritonavir in SARS-CoV-2-related acute respiratory distress syndrome |
65% lower mortality [p=0.21] and 3% worse viral clearance [p=1]. Retrospective 45 ICU patients, 17 treated with HCQ+AZ, showing no significant difference in viral clearance after 6 days, or mortality 6 days from ARDS. | ||
May 22 2020 |
, Indian Council of Medical Research (News) | Revised advisory on the use of Hydroxychloroquine (HCQ) as prophylaxis for SARS-CoV-2 infection |
Healthcare workers on HCQ prophylaxis less likely to get COVID. Significant dose-response relationship. Extends recommended HCQ prophylaxis to asymptomatic household contacts of cases and frontline workers. Degree of benefit not quantified. | ||
May 22 2020 |
et al., The Lancet, May 22, 2020, doi: 10.1016/S0140-6736(20)31180-6 | Hydroxychloroquine or chloroquine with or without a macrolide for treatment of COVID-19: a multinational registry analysis |
Incorrect at first read (implausible death, ventilation, and population numbers). This paper was retracted. | ||
May 21 2020 |
et al., The American Journal of Tropical Medicine and Hygiene, doi:10.4269/ajtmh.20-0375 | Metformin Treatment Was Associated with Decreased Mortality in COVID-19 Patients with Diabetes in a Retrospective Analysis |
32% lower mortality [p=0.72]. Retrospective 283 COVID-19+ diabetes patients in China, showing non-statistically significant lower mortality with HCQ/CQ treatment. | ||
May 19 2020 |
et al., medRxiv, doi:10.1101/2020.05.12.20099028 (Preprint) | Outcomes of Hydroxychloroquine Treatment Among Hospitalized COVID-19 Patients in the United States- Real-World Evidence From a Federated Electronic Medical Record Network |
5% lower mortality [p=0.72] and 19% lower ventilation [p=0.26]. EHR analysis of 3,372 hospitalized COVID-19 patients not showing a significant difference for mortality or the risk of mechanical ventilation. Subject to the limitations of EHR analysis. Misclassification is possible. Confounding by indic.. | ||
May 18 2020 |
et al., medRxiv, doi:10.1101/2020.05.13.20094193 (Preprint) | Treatment Response to Hydroxychloroquine, Lopinavir/Ritonavir, and Antibiotics for Moderate COVID 19: A First Report on the Pharmacological Outcomes from South Korea |
51% shorter hospitalization [p=0.01] and 56% faster viral clearance [p=0.005]. Retrospective of 97 moderate cases. Time to viral clearance significantly shorter for HCQ+antibiotic. Preprint withdrawn pending peer review. | ||
May 18 2020 |
et al., doi:10.1101/2020.05.18.20066902 (Preprint) | Doxycycline and Hydroxychloroquine as Treatment for High-Risk COVID-19 Patients: Experience from Case Series of 54 Patients in Long-Term Care Facilities |
54 patients in long term care facilities. 6% death with HCQ+AZ compared to 22% using a naive indirect comparison. | ||
May 16 2020 |
et al., medRxiv, 10.1101/2020.05.16.20104141 (Preprint) | Similar incidence of Coronavirus Disease 2019 (COVID-19) in patients with rheumatic diseases with and without hydroxychloroquine therapy |
26% lower hospitalization [p=1] and 49% more cases [p=0.53]. Very small retrospective study of rheumatic disease patients, sample size is too small for statistical significance (HCQ 0.5-4.0%, no-HCQ 0.4-2.7%). Confirmed cases were 1 HCQ and 2 no-HCQ, confirmed+likely cases were 1 HCQ and 3 no-HCQ. .. | ||
May 15 2020 |
et al., Science China Life Sciences, 2020 May 15, 1-7, doi:10.1007/s11427-020-1732-2 | Low Dose of Hydroxychloroquine Reduces Fatality of Critically Ill Patients With COVID-19 |
60% lower mortality [p=0.002]. Retrospective, 550 critically ill patients. 19% fatality for HCQ versus 47% for non-HCQ, RR 0.395, p=0.002. The levels of inflammatory cytokine IL-6 were significantly reduced from 22.2 pg/mL to 5.2 pg/mL (p<0.05) at the end of the treatm.. | ||
May 14 2020 |
et al., BMJ 2020, 369, doi: https://doi.org/10.1136/bmj.m1844 | Clinical efficacy of hydroxychloroquine in patients with covid-19 pneumonia who require oxygen: observational comparative study using routine care data |
20% higher mortality [p=0.75]. Observational study of 181 patients with advanced disease requiring oxygen showing no benefit for HCQ. Power of study appears too low to support conclusions [bmj.com]. None of the 15 patients receiving HCQ+AZ were transferred to intensive.. | ||
May 13 2020 |
et al., Journal of Pharmacokinetics and Pharmacodynamics, May 13, 2020, doi:10.1007/s10928-020-09689-x | Hydroxychloroquine and azithromycin as potential treatments for COVID-19; clinical status impacts the outcome |
Odds of PCR-positive decrease by 53% for each unit increase in HCQ log-concentration. Similarly, the odds decrease by 61%, and by 12% for each day increase, and for azithromycin co-treatment, respectively. Computes the minimum HCQ concent.. | ||
May 12 2020 |
et al., Annals of the Rheumatic Diseases, doi:10.1136/annrheumdis-2020-217717 | COVID-19 infection in a northern-Italian cohort of systemic lupus erythematosus assessed by telemedicine |
50% more cases [p=0.59]. Survey of 165 SLE patients, 127 on HCQ. 8 patients with suspected COVID-19 and 4 confirmed cases. No mortality, one ICU case. 7 patients had no symptoms despite contact with a COVID-19 patient. No adjustment for concomitant medications or.. | ||
May 11 2020 |
et al., medRxix, doi:10.1101/2020.05.08.20095679 (Preprint) | Negative nasopharyngeal SARS-CoV-2 PCR conversion in response to different therapeutic interventions |
15% improved viral clearance [p=0.66]. Retrospective 93 hospitalized patients in Saudi Arabia showing a non-statistically significant 15% reduction in PCR positive results at day 5, RR 0.85, p = 0.65. The treatment group had significantly more severe illness and significantly .. | ||
May 11 2020 |
et al., JAMA, May 11, 2020, doi:10.1001/jama.2020.8630 | Association of Treatment With Hydroxychloroquine or Azithromycin With In-Hospital Mortality in Patients With COVID-19 in New York State |
35% higher mortality [p=0.31]. Restrospective observational late stage study showing no significant differences but calling for clinical trials. Zervos et al. [ijidonline.com] point out serious limitations that they say should be corrected on the record: patients recei.. | ||
May 10 2020 |
et al., Kidney Int., 98:1, 20-26, July 1, 2020, doi:10.1016/j.kint.2020.04.030 (date from earlier preprint) | A report from the Brescia Renal COVID Task Force on the clinical characteristics and short-term outcome of hemodialysis patients with SARS-CoV-2 infection |
43% lower mortality [p=0.12]. Analysis of 94 hemodialysis COVID-19 positive patients, showing lower mortality with HCQ treatment, not reaching statistical significance. | ||
May 8 2020 |
et al., Clinical Infectious Diseases, doi:10.1093/cid/ciaa546 (Ex Vivo) | Chloroquine Inhibits the Release of Inflammatory Cytokines by Human Lung Explants |
On human lung parenchymal explants, CQ concentration clinically achievable in the lung (100µM) inhibited the lipopolysaccharide-induced release of TNF-ɑ (by 76%), IL-6 (by 68%), CCL2 (by 72%), and CCL3 (by 67%). In addition to antiviral a.. | ||
May 8 2020 |
et al., J. Med. Microbiol., Sep 15, 2020, doi: 10.1099/jmm.0.001250 (date from earlier preprint) | Zinc sulfate in combination with a zinc ionophore may improve outcomes in hospitalized COVID-19 patients |
Retrospective 932 patients showing that the addition of zinc to HCQ+AZ reduced mortality / transfer to hospice, ICU admission, and the need for ventilation. | ||
May 7 2020 |
et al., Annals of the Rheumatic Diseases, doi:10.1136/annrheumdis-2020-217690 | Baseline use of hydroxychloroquine in systemic lupus erythematosus does not preclude SARS-CoV-2 infection and severe COVID-19 |
3% lower hospitalization [p=0.88]. Analysis of 80 SLE patients diagnosed with COVID-19, showing the frequency of hospitalisation did not differ between individuals using an antimalarial versus non-users (55% (16/29) vs 57% (29/51), p=ns. Authors suggest that the dosage use.. | ||
May 7 2020 |
, H., Int. J. Antimicrobial Agents, 7 May 2020, doi:10.1016/j.ijantimicag.2020.106007 (Theory) | Excessive lysosomal ion-trapping of hydroxychloroquine and azithromycin |
Discusses pharmacokinetic properties of HCQ+AZ as a potential underlying mechanism of the observed antiviral effects. | ||
May 7 2020 |
et al., NEJM, May 7, 2020, doi:10.1056/NEJMoa2012410 | Observational Study of Hydroxychloroquine in Hospitalized Patients with Covid-19 |
4% higher combined mortality/intubation [p=0.76]. Before propensity matching, 38 control patients had hypertension. After propensity matching, 146 patients had hypertension (Table 1). Even if all propensity matched control patients had hypertension, the control prevalence would only be 1.. | ||
May 7 2020 |
(News) | Sermo reports: COVID-19 treatment trends over 6 weeks and 33,700 interviews: Usage, efficacy and safety perceptions of most-used therapies |
HCQ used by 55% of physicians worldwide for COVID. Survey of 6,150 physicians. | ||
May 6 2020 |
et al., Nature, 2020, doi:10.1038/s41586-020-2558-4 (date from earlier preprint) | Hydroxychloroquine use against SARS-CoV-2 infection in non-human primates |
Monkey study which reports no effect of HCQ or HCQ+AZ. However, there are several signs of effectiveness despite the very small sample sizes and 100% recovery of all treated and control monkeys. 58% reduction in lung lesions: the final da.. | ||
May 5 2020 |
et al., Preprints 2020, 2020050057, doi:10.20944/preprints202005.0057.v1 (Preprint) | Early Hydroxychloroquine Is Associated with an Increase of Survival in COVID-19 Patients: An Observational Study |
55% lower mortality [p=0.002]. 166 patients hospitalised with COVID-19, HCQ increased survival 1.4 - 1.8 times when patients admitted in early stages. Early is relative to hospital admission here - all patients were in relatively serious condition. | ||
May 5 2020 |
et al., Travel Med Infect Dis., 2020 May 5, doi:10.1016/j.tmaid.2020.101738 | Early Treatment of COVID-19 Patients With Hydroxychloroquine and Azithromycin: A Retrospective Analysis of 1061 Cases in Marseille, France |
Retrospective 1061 patients. HCQ+AZ safe and results in a low fatality rate. | ||
May 5 2020 |
et al., Autoimmunity Reviews, 19:7, July 2020, doi:10.1016/j.autrev.2020.102566 | Continuous Hydroxychloroquine or Colchicine Therapy Does Not Prevent Infection With SARS-CoV-2: Insights From a Large Healthcare Database Analysis |
8% fewer cases [p=0.88]. Very small study of rheumatic disease/autoimmune disorder patients showing no significant difference but with only 3 chronic HCQ patient cases. Only considers people tested at a time when primarily symptomatic cases were tested. Other res.. | ||
May 5 2020 |
et al., SSRN, doi:10.2139/ssrn.3586954 (Preprint) | Markedly Lower Rates of Coronavirus Infection and Fatality in Malaria-Endemic Regions – A Clue As to Treatment? |
99% lower mortality [p=0.0001]. Analysis of COVID-19 amongst 2.4B people shows a wide counterintuitive disparity between well-developed and less-developed countries, with more affluent countries about one hundred times more likely to be infected and die due to COVID-19... | ||
May 2 2020 |
et al., Medicine (Baltimore), doi:10.1097/MD.0000000000023720 (date from earlier preprint) | Hydroxychloroquine is associated with slower viral clearance in clinical COVID-19 patients with mild to moderate disease: A retrospective study |
203% slower viral clearance [p=0.02]. Very small retrospective analysis of 34 patients finding slower binary PCR viral clearance with HCQ. No information on severity for treatment versus control is provided. No deaths, ICU admission, or mechanical ventilation. Binary PCR does.. | ||
May 1 2020 |
et al., JAMA Cardiol., May 1, 2020, doi:10.1001/jamacardio.2020.1834 | Risk of QT Interval Prolongation Associated With Use of Hydroxychloroquine With or Without Concomitant Azithromycin Among Hospitalized Patients Testing Positive for Coronavirus Disease 2019 (COVID-19) |
Study of 90 hospitalized patients given HCQ, 53 also receiving AZ, 53% hypertension, 29% diabetes mellitus, baseline median QTc 473ms for HCQ, and 442ms for HCQ+AZ. Median change for HCQ+AZ ΔQTc of 23ms vs. 5.5ms for HCQ. Other factors su.. | ||
May 1 2020 |
et al., JAMA Cardiol., May 1, 2020, doi:10.1001/jamacardio.2020.1787 | Assessment of QT Intervals in a Case Series of Patients With Coronavirus Disease 2019 (COVID-19) Infection Treated With Hydroxychloroquine Alone or in Combination With Azithromycin in an Intensive Care Unit |
Study of 40 very serious condition ICU patients, 75% required invasive mechanical ventilation, 63% received vasoactive drugs, 50% received other treatments favoring QT prolongation. HCQ with or w/o AZ was given to 45% and 55% respectively.. | ||
May 2 2020 |
(News) | Coronavirus: a study in Senegal confirms the effectiveness of hydroxychloroquine |
Preliminary results of Senegal trial with 181 patients showing faster recovery with HCQ, and even faster recovery with HCQ+AZ. | ||
Apr 30 2020 |
et al., Eur. Rev. Med. Pharmacol. Sci. 2020, 24 (8), 4539-4547, doi:10.26355/eurrev_202004_21038 | Efficacy of chloroquine and hydroxychloroquine in the treatment of COVID-19 |
Analysis of COVID-19 and malaria, finding that COVID-19 is highly pandemic in countries where malaria is least pandemic, and vice versa, suggesting that CQ/HCQ (widely used for malaria) are protective for COVID-19. This paper also include.. | ||
Apr 27 2020 |
et al., Nefrología, doi:10.1016/j.nefroe.2020.04.002 | Status of SARS-CoV-2 infection in patients on renal replacement therapy. Report of the COVID-19 Registry of the Spanish Society of Nephrology (SEN) |
46% lower mortality [p=0.005]. Analysis of 868 patients on renal replacement therapy. Statistically significant reduction in mortality with HCQ for patients on dialysis (OR 0.47, p=0.005). No statistically significant change was found for transplant patients (the resul.. | ||
Apr 29 2020 |
et al., Circulation: Arrhythmia and Electrophysiology, doi:10.1161/CIRCEP.120.008662 | The Effect of Chloroquine, Hydroxychloroquine and Azithromycin on the Corrected QT Interval in Patients with SARS-CoV-2 Infection |
201 hospitalized patients. No serious side effects of HCQ. No instances of Torsade de pointes, or arrhythmogenic death were reported. They report that although use of these medications resulted in QT prolongation, clinicians seldom need t.. | ||
Apr 27 2020 |
et al., Med. Hypotheses, doi:10.1016/j.mehy.2020.109783 | Hydroxychloroquine as an aerosol might markedly reduce and even prevent severe clinical symptoms after SARS-CoV-2 infection |
Proposal to use HCQ as an aerosol in order to reach sufficient therapeutic levels at the alveolar epithelial cells. Authors suggest this will reduce adverse drug reactions compared with oral application, and the increase in tolerability e.. | ||
Apr 26 2020 |
et al., Critical Care Medicine, doi:10.1097/ccm.0000000000004457 | ICU and ventilator mortality among critically ill adults with COVID-19 |
3% higher mortality [p=1]. Retrospective 217 critically ill patients, 114 receiving HCQ, showing no significant difference in mortality. | ||
Apr 25 2020 |
et al., Microbial Pathogenesis, doi:/10.1016/j.micpath.2020.104228 (In Vitro) | In vitro testing of combined hydroxychloroquine and azithromycin on SARS-CoV-2 shows synergistic effect |
In Vitro study showing that HCQ and AZ have a synergistic effect on SARS-CoV-2 at concentrations compatible with that obtained in human lung. | ||
Apr 24 2020 |
et al., medRxiv doi:10.1101/2020.04.20.20072421.t (Preprint) | COVID-19 in Iran, a comprehensive investigation from exposure to treatment outcomes |
68% lower mortality [p=0.15]. Small limited trial with 100 patients concluding that HCQ improved clinical outcome, OR 0.016 [0.002-0.11] in regression analysis. | ||
Apr 21 2020 |
M., SSRN, doi:10.2139/ssrn.3575899 (Preprint) | Countries which Primarily Use Antimalarial Drugs As COVID-19 Treatment See Slower Dynamic of Daily Deaths |
85% lower mortality [p=0.001]. Compares the dynamics of daily deaths in the 10 days following the 3rd death in countries using and not using [H]CQ, showing dramatically lower death in [H]CQ countries. This paper does not attempt to account for population age and other .. | ||
Apr 21 2020 |
et al., Med (2020), doi:10.1016/j.medj.2020.06.001 (date from earlier preprint) | Outcomes of hydroxychloroquine usage in United States veterans hospitalized with Covid-19 |
11% lower mortality [p=0.74]. Retrospective 807 hospitalized patients, no statistically significant reduction in mortality or the need for mechanical ventilation with HCQ or HCQ+AZ, or for death with HCQ+AZ, HR 1.83, p=0.009 for HCQ mortality. The preprint notes that .. | ||
Apr 17 2020 |
at al., Int. J. Antimicrob. Agents, 2020, Apr 17, doi:10.1016/j.ijantimicag.2020.105988 | Can Post-Exposure Prophylaxis for COVID-19 Be Considered as an Outbreak Response Strategy in Long-Term Care Hospitals? |
Post exposure prophylaxis of 211 high-risk people after major exposure event in a long term care hospital, showing no positive cases after 14 days. | ||
Apr 16 2020 |
et al., JAMA Network Open, doi:10.1001/jamanetworkopen.2020.8857 | Chloroquine diphosphate in two different dosages as adjunctive therapy of hospitalized patients with severe respiratory syndrome in the context of coronavirus (SARS-CoV-2) infection: Preliminary safety results of a randomized, double-blinded, phase IIb clinical trial (CloroCovid-19 Study) |
Comparison of typical CQ dosage with high dosage CQ (600mg CQ twice daily for 10 days), showing higher mortality with high dosage, OR 2.8 [0.9 - 8.5] when controlled by age in multivariate analysis. Increased incidence of prolonged QT and.. | ||
Apr 15 2020 |
et al., Prevent Senior Institute, São Paulo, Brazil (Preprint) | Empirical treatment with hydroxychloroquine and azithromycin for suspected cases of COVID-19 followed-up by telemedicine |
64% lower hospitalization [p=0.02]. 636 patients. HCQ+AZ reduced hospitalization 79% when used within 7 days (65% overall). Non-randomized. | ||
Apr 15 2020 |
, A., J. Medical Virology, doi:10.1002/jmv.25887 (Theory) | Hyperglycemia, hydroxychloroquine, and the COVID-19 pandemic |
Theory on the effectiveness of HCQ. HCQ has been shown to block the polarization of macrophages to an M1 inflammatory subtype and is predicted to interfere with glycosylation of a number of proteins involved in the humoral immune response.. | ||
Apr 14 2020 |
et al., BMJ 2020, 369, doi:10.1136/bmj.m1849 | Hydroxychloroquine in patients with mainly mild to moderate coronavirus disease 2019: open label, randomised controlled trial |
21% improved viral clearance [p=0.51]. 150 patients very late stage RCT showing no significant difference. Treatment very late, average 16.6 days after symptom onset. Data favorable to HCQ was deleted in the second version, see analysis [mediterranee-infection.com]. "[HC.. | ||
Apr 13 2020 |
et al., Biosci Trends, May 21, 2020, 14:2, 156-158, doi:10.5582/bst.2020.03072, Epub Apr 13, 2020 (Review) | Update on Use of Chloroquine/Hydroxychloroquine to Treat Coronavirus Disease 2019 (COVID-19) |
Increasing evidence from completed clinical studies shows CQ and HCQ effective (HCQ more effective). | ||
Apr 12 2020 |
et al., Preprint (Preprint) | Clinical outcomes of hydroxychloroquine in hospitalized patients with COVID-19: a quasi-randomized comparative study |
147% higher mortality [p=0.58]. Small retrospective study with 63 patients (32 treated with HCQ), showing no effectiveness, however the baseline state of each arm significantly differs. This preprint was submitted to NEJM but has not been published several months later. | ||
Apr 11 2020 |
et al., Travel Medicine and Infectious Disease, doi:10.1016/j.tmaid.2020.101663 | Clinical and microbiological effect of a combination of hydroxychloroquine and azithromycin in 80 COVID-19 patients with at least a six-day follow up: A pilot observational study |
Pilot study suggesting improvement with HCQ+AZ and recommending further study. 80 patients with relatively mild cases, no control group, and no attempt to analyze confounding factors. | ||
Apr 10 2020 |
, medRxiv, doi:10.1101/2020.03.22.20040949 (Preprint) (meta analysis) | Quantifying treatment effects of hydroxychloroquine and azithromycin for COVID-19: a secondary analysis of an open label non-randomized clinical trial (Gautret et al, 2020) |
Secondary analysis of Gautret et al. showing "modest to no impact of HCQ treatment, with more significant effects from [HCQ+AZ]". | ||
Apr 6 2020 |
et al., Medical Hypotheses, doi:10.1016/j.mehy.2020.109815 (date from earlier preprint) (Review) | Does zinc supplementation enhance the clinical efficacy of chloroquine/hydroxychloroquine to win today's battle against COVID-19? |
Hypothesis that HCQ/CQ + zinc will be more effective than HCQ/CQ alone for COVID-19. | ||
Apr 3 2020 |
et al., Int J Antimicrob Agents, 55:5, doi:10.1016/j.ijantimicag.2020.105960 (Theory) | Structural and molecular modelling studies reveal a new mechanism of action of chloroquine and hydroxychloroquine against SARS-CoV-2 infection |
In Silico analysis confirming the antiviral properties of CQ, showing a new mechanism of action of CQ, and showing that HCQ is more potent than CQ. | ||
Apr 1 2020 |
et al., Journal of Molecular Cell Biology, Volume 12, Issue 4, April 2020, 322–325, doi:10.1093/jmcb/mjaa014 | Treating COVID-19 with Chloroquine |
92% improved recovery [p=0.02] and 83% lower pneumonia [p=0.22]. 22 patients. All CQ patients discharged by day 14 versus 50% of lopinavir/ritonavir patients. Symptom onset was very different - 2.5 days for CQ vs. 6.5 days for lopinavir/ritonavir. | ||
Mar 31 2020 |
et al., medRxiv doi:10.1101/2020.03.22.20040758 (Preprint) | Efficacy of hydroxychloroquine in patients with COVID-19: results of a randomized clinical trial |
57% lower pneumonia [p=0.04]. 62 patients. RCT showing significantly faster recovery with HCQ. 13% progressed to severe cases in the control group, versus 0% for the treatment group. Significant improvement seen in pneumonia on chest CT for 61% of treated patients and.. | ||
Mar 31 2020 |
et al., Front. Microbiol., 10 July 2020, doi:10.3389/fmicb.2020.01704 (date from earlier preprint) (In Vitro) | Combined Prophylactic and Therapeutic Use Maximizes Hydroxychloroquine Anti-SARS-CoV-2 Effects in vitro |
In Vitro study showing greater inhibition for combined pre and post-exposure treatment for Vero E6 and Caco-2 cells. | ||
Mar 28 2020 |
et al., Médecine et Maladies Infectieuses, 50:4, June 2020, 10.1016/j.medmal.2020.03.006 (date from earlier preprint) | No evidence of rapid antiviral clearance or clinical benefit with the combination of hydroxychloroquine and azithromycin in patients with severe COVID-19 infection |
Report on 11 patients treated with HCQ with no control group. Authors suggest there is no evidence of benefit for HCQ based on PCR+ results for 8/10 patients at day 5-6. Binary PCR evaluation with an unknown Ct. Binary PCR does not distin.. | ||
Mar 26 2020 |
Nanshan (钟南山) (Preprint) | Efficacy and safety of chloroquine for treatment of COVID-19. An open-label, multi-center, non-randomized trial |
80% improved viral clearance [p=0.0001]. 197 patients. CQ effective. Day 10 viral RNA negative 91.4% HCQ versus 57.4% control. Median time to negative test 3 days versus 9 days for control. | ||
Mar 24 2020 |
et al., Clin. Infect. Dis., 2020 Mar 24, doi:10.1093/cid/ciaa320 (Theory) | Is Hydroxychloroquine a Possible Post-Exposure Prophylaxis Drug to Limit the Transmission to Health Care Workers Exposed to COVID19? |
CQ and HCQ inhibit replication at early stages of infection, no similar effect reported for other drugs which are only able to interfere after cell infection. Large volume of existing data on safety. (8/23: we corrected the classification.. | ||
Mar 23 2020 |
et al., Nature Nanotechnology, 15, 247–249, 2020, doi:10.1038/s41565-020-0674-9 (Theory) | Insights from nanomedicine into chloroquine efficacy against COVID-19 |
CQ is known in nanomedicine research for the investigation of nanoparticle uptake in cells, and may have potential for the treatment of COVID-19. | ||
Mar 21 2020 |
, Indian Council of Medical Research (News) | Advisory on the use of hydroxy-chloroquine as prophylaxis for SARS-CoV-2 infection |
Recommends HCQ for prophylaxis in asymptomatic healthcare workers as found effective in-vitro and in-vivo. | ||
Mar 20 2020 |
et al., Shanghai Combined Task Force on COVID-19 (News) | Shanghai Experience of COVID-19 Management |
Clinical studies of HCQ with 184 cases and 21 hospitals show HCQ is effective. | ||
Mar 18 2020 |
et al., Cell Discovery 6, 16 (2020), doi:10.1038/s41421-020-0156-0 (In Vitro) | Hydroxychloroquine, a less toxic derivative of chloroquine, is effective in inhibiting SARS-CoV-2 infection in vitro |
In Vitro study showing that HCQ is effective in vitro and less toxic than CQ. In addition to direct antiviral activity, HCQ is a safe and successful anti-inflammatory agent that has been used extensively in autoimmune diseases and can sig.. | ||
Mar 17 2020 |
et al., Int. J. of Antimicrobial Agents, doi:10.1016/j.ijantimicag.2020.105949 (date from earlier preprint) | Hydroxychloroquine and azithromycin as a treatment of COVID-19: results of an open-label non-randomized clinical trial |
66% improved viral clearance [p=0.001]. HCQ was significantly associated with reduction / elimination of viral load, which was enhanced with AZ. Updated 8/13: responses to this paper have raised methodological issues [sciencedirect.com, sciencedirect.com, sciencedirect.com]. De.. | ||
Mar 17 2020 |
et al., Int. J. Antimicrobial Agents, April 2020, 55:4, doi:10.1016/j.ijantimicag.2020.105945 (Review) | Aminoquinolines against coronavirus disease 2019 (COVID-19): chloroquine or hydroxychloroquine |
Discussion of mechanisms of action, CQ vs. HCQ, early studies, safety. | ||
Mar 13 2020 |
and Rigano (Review) (Preprint) | An Effective Treatment for Coronavirus (COVID-19) |
Discussion of existing research, treatment guidelines, and mechanisms of action for CQ and HCQ, recommending use. | ||
Mar 12 2020 |
et al., International Journal of Antimicrobial Agents, doi:10.1016/j.ijantimicag.2020.105938 (Theory) | New insights on the antiviral effects of chloroquine against coronavirus: what to expect for COVID-19? |
Discusses mechanisms of CQ interference with the SARS-CoV-2 replication cycle. | ||
Mar 10 2020 |
et al., J. Crit. Care, June 2020, 57:279-283, doi:10.1016/j.jcrc.2020.03.005, Epub Mar 10, 2020 (meta analysis) | A Systematic Review on the Efficacy and Safety of Chloroquine for the Treatment of COVID-19 |
Review of six articles and 23 ongoing clinical trials in China recommending research and clinical use adhering to MEURI. | ||
Mar 9 2020 |
et al., Clin. Infect. Dis., 2020 Mar 9, doi:10.1093/cid/ciaa237 (In Vitro) | In Vitro Antiviral Activity and Projection of Optimized Dosing Design of Hydroxychloroquine for the Treatment of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) |
In Vitro study showing that HCQ is more potent than CQ in vitro for inhibiting SARS-CoV-2. Simulates HCQ concentration in lung fluid and provides dosing recommendations. See also [academic.oup.com, sciencedirect.com]. | ||
Mar 6 2020 |
et al., J. Zhejiang University (Med Sci), doi:10.3785/j.issn.1008-9292.2020.03.03 | A pilot study of hydroxychloroquine in treatment of patients with common coronavirus disease-19 (COVID-19) |
29% lower progression [p=0.57] and 100% worse viral clearance [p=1]. 30 moderate hospitalized cases, all recovered. Time to RNA negative comparable. Less frequent radiological progression with HCQ but not statistically significant. One HCQ patient developed to a severe case. Treatment group 4 years older a.. | ||
Mar 4 2020 |
et al., Int J. Antimicrob Agents, doi: 10.1016/j.ijantimicag.2020.105932. Epub 2020 Mar 4. (Review) | Chloroquine and Hydroxychloroquine as Available Weapons to Fight COVID-19 |
Recommending CQ and HCQ for COVID-19 based on 20 clinical studies in China and a strong rationale for use. | ||
Feb 20 2020 |
et al., Chin. J. Tuberc. Respir. Dis., 2020, 43, doi:10.3760/cma.j.issn.1001-0939.2020.0019 | Expert Consensus on Chloroquine Phosphate for the Treatment of Novel Coronavirus Pneumonia |
Early trials in China show CQ results in shorter hospital stays and improved patient outcomes. | ||
Feb 19 2020 |
et al., BioScience Trends, 2020, doi:10.5582/bst.2020.01047 | Breakthrough: Chloroquine phosphate has shown apparent efficacy in treatment of COVID-19 associated pneumonia in clinical studies |
Results from 15 clinical trials in China showing CQ is effective. | ||
Feb 17 2020 |
, Y., deputy head of the China National Center for Biotechnology Development (News) | Antimalarial drug confirmed effective on COVID-19 |
HCQ under clinical trials in >10 hospitals in China and has shown fairly good efficacy. | ||
Feb 11 2020 |
et al., ChiCTR2000029741 (Preprint) | Efficacy of Chloroquine and Lopinavir/ Ritonavir in mild/general novel coronavirus (CoVID-19) infections: a prospective, open-label, multicenter randomized controlled clinical study |
38% improved viral clearance [p=0.17]. Early results from a very small trial, reported within the application for a later trial. Very minimal details are provided, but we include this as the earliest published results. For COVID-19 patients with pneumonia the viral negative co.. | ||
Feb 4 2020 |
et al., Cell Res. 30, 269–271, doi:L10.1038/s41422-020-0282-0 (In Vitro) | Remdesivir and chloroquine effectively inhibit the recently emerged novel coronavirus (2019-nCoV) in vitro |
In Vitro study showing that Remdesivir and CQ potently blocked SARS-CoV-2 infection. | ||
Nov 23 2017 |
et al., Journal of Chromatography B, Analytical Technologies in the Biomedical and Life Sciences, 22 Nov 2017, 1072:320-327 doi:10.1016/j.jchromb.2017.11.026 | Simultaneous quantitation of hydroxychloroquine and its metabolites in mouse blood and tissues using LC-ESI-MS/MS: An application for pharmacokinetic studies |
Presents a method for quantification of HCQ in mouse blood and tissues. They show a lung concentration significantly higher than other organs, and about 30 times the blood concentration. | ||
Apr 4 2014 |
, D., Pharmacology of Chloroquine and Hydroxychloroquine, 2014, 35-63, doi:10.1007/978-1-4939-0597-3_2 | Pharmacology of Chloroquine and Hydroxychloroquine |
Review of the pharmacology of CQ and HCQ. Some notable points: - HCQ and CQ are equipotent but CQ is more toxic, the therapeutic ratio is higher for HCQ. - Concentrations in different tissues can vary >10x, in particular the concentration.. | ||
Jul 15 2014 |
et al., Antimicrobial Agents and Chemotherapy, Jul 2014, 58:8, 4875-4884, doi:10.1128/AAC.03011-14 (In Vitro) | Screening of an FDA-Approved Compound Library Identifies Four Small-Molecule Inhibitors of Middle East Respiratory Syndrome Coronavirus Replication in Cell Culture |
CQ inhibits SARS-CoV, MERS-CoV, and HCoV-229E-GFP replication in the low-micromolar range. | ||
Dec 4 2012 |
et al., Cell Research, 23, 300–302, doi:10.1038/cr.2012.165 | Anti-malaria drug chloroquine is highly effective in treating avian influenza A H5N1 virus infection in an animal model |
CQ, a known autophagy inhibitor that is in clinical use, can efficiently ameliorate acute lung injury and dramatically improve the survival rate in mice infected with live avian influenza A H5N1 virus. | ||
Aug 1 2009 |
et al., Antimicrob. Agents Chemother, August 2009, 53(8), doi:0.1128/AAC.01509-08 | Antiviral Activity of Chloroquine against Human Coronavirus OC43 Infection in Newborn Mice |
CQ inhibits HCoV-OC43 replication in HRT-18 cells. A lethal HCoV-OC43 infection in newborn C57BL/6 mice can be treated with CQ acquired transplacentally or via maternal milk. The highest survival rate (98.6%) was found when mother mice we.. | ||
Dec 4 2007 |
et al., Antiviral Research, 77:2, February 2008, 150-152, 10.1016/j.antiviral.2007.10.011 (In Vitro) | Inhibition of human coronavirus 229E infection in human epithelial lung cells (L132) by chloroquine: Involvement of p38 MAPK and ERK |
CQ significantly decreased viral replication of HCoV-229E at concentrations lower than in clinical usage. CQ affects the activation of p38 mitogen-activated protein kinase (MAPK) and extracellular signal-regulated kinase (ERK). p38 MAPK i.. | ||
Feb 1 2006 |
et al., Lancet Infect. Dis., doi:10.1016/S1473-3099(06)70361-9 (In Vitro) | New insights into the antiviral effects of chloroquine |
Update to 2003 paper. Hypothesis of CQ inhibiting SARS replication has been confirmed in two in-vitro studies. CQ affected an early stage of SARS replication. | ||
Oct 22 2005 |
et al., Virol. J. 2:69, 2005, doi:10.1186/1743-422X-2-69 (In Vitro) | Chloroquine is a potent inhibitor of SARS coronavirus infection and spread |
In Vitro study for SARS-CoV-1. CQ has strong antiviral effects on SARS CoV infection when cells treated either before or after exposure, suggesting prophylactic and treatment use. Describes three mechanisms by which the drug might work an.. | ||
Aug 28 2004 |
et al., Biochem. Biophys. Res. Comm., 323:1, 8 October 2004, doi:10.1016/j.bbrc.2004.08.085 (In Vitro) | In vitro inhibition of severe acute respiratory syndrome coronavirus by chloroquine |
In Vitro study for SARS-CoV-1. IC50 of CQ for antiviral activity (8.8) is significantly lower than cytostatic activity CC50 (261.3), selectivity index of 30. IC50 for inhibition of SARS-CoV in vitro approximates the plasma concentrations .. | ||
Nov 1 2003 |
et al., Lancet Infect. Dis., doi:10.1016/S1473-3099(03)00806-5 (Theory) | Effects of chloroquine on viral infections: an old drug against today's diseases |
Discussion/review noting that CQ exerts antiviral effects, inhibiting the replication of several viruses including members of the flaviviruses, retroviruses, and coronaviruses. Notes that CQ has immunomodulatory effects, suppressing the.. | ||
Dec 21 1918 |
, E., Medical Record, 97:6, 235, Feb 7, 1920 | A confirmatory report upon the abortive action of quinine dihydrochloride |
Quinine was found to be effective for the Spanish Flu in 1918. | ||
Jan 1 1901 |
, B., 1901 | A manual of medical treatment or clinical therapeutics |
Quinine is refered to as "the remedy that is most deserving of confidence in the treatment of influenza". | ||
Nov 3 1894 |
, Lancet, Nov 3, 1894 | Pathogenesis and Treatment of Influenza |
Lancet study showing quinine protected rabbits from influenza and recommending use for prophylaxis and treatment. | ||
Jan 1 1890 |
(News) | Quinine use for the Russian influenze pandemic if 1889-1890 |
Quinine and antipyrine, a bitherapy for defying death during the Russian influenza pandemic of 1889-1890 (around 40,000 deaths in France at the beginning of 1890). | ||
Jan 1 1889 |
(News) | Laxative Bromo Quinine |
Quinine was considered effective for respiratory infections as early as 1889. |
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