Negative Nasopharyngeal SARS-CoV-2 PCR Conversion in Response to Different Therapeutic Interventions
Alwafi et al.,
Negative Nasopharyngeal SARS-CoV-2 PCR Conversion in Response to Different Therapeutic Interventions,
Cureus, doi:10.7759/cureus.21442
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%).
Although the viral clearance result is not statistically significant, it is consistent with the significant 20% improved viral clearance
[10‑29%] from meta analysis of the
42 viral clearance results to date.
This study is excluded in the after exclusion results of meta
analysis:
excessive unadjusted differences between groups.
risk of no viral clearance, 14.7% lower, RR 0.85, p = 0.65, treatment 12 of 45 (26.7%), control 15 of 48 (31.2%), NNT 22, day 5, primary outcome.
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risk of no viral clearance, 25.3% lower, RR 0.75, p = 0.60, treatment 7 of 45 (15.6%), control 10 of 48 (20.8%), NNT 19, day 12.
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Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
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Alwafi et al., 20 Jan 2022, retrospective, Saudi Arabia, peer-reviewed, 6 authors, study period 7 March, 2020 - 15 April, 2020.
Abstract: Open Access Original
Article
DOI: 10.7759/cureus.21442
Negative Nasopharyngeal SARS-CoV-2 PCR
Conversion in Response to Different Therapeutic
Interventions
Review began 01/11/2022
Review ended 01/17/2022
Hassan Alwafi 1 , Mohammed H. Shabrawishi 2 , Abdallah Y. Naser 3 , Ahmad M. Aldobyany 4 , Sultan A.
Qanash 5, 6 , Abdelfattah A. Touman 4
Published 01/20/2022
© Copyright 2022
Alwafi et al. This is an open access article
distributed under the terms of the Creative
Commons Attribution License CC-BY 4.0.,
which permits unrestricted use, distribution,
and reproduction in any medium, provided
the original author and source are credited.
1. Pharmacology and Therapeutics, Umm Al-Qura University, Mecca, SAU 2. Pulmonology Department, Al Noor
Specialist Hospital, Mecca, SAU 3. Faculty of Pharmacy, Isra University, Amman, JOR 4. Pulmonology Department,
King Abdullah Medical City, Mecca, SAU 5. Department of Internal Medicine, King Saud bin Abdulaziz University for
Health Sciences, Jeddah, SAU 6. King Abdullah International Medical Research Center, King Abdulaziz Medical City,
Jeddah, SAU
Corresponding author: Abdelfattah A. Touman, abdotouman@gmail.com
Abstract
Background
The current management practices for patients with COVID-19 consist of infection prevention and
supportive care. We aimed to explore the association between negative nasopharyngeal SARS-CoV-2
polymerase chain reaction (PCR) clearance and different therapeutic interventions.
Methods
This study is a retrospective cohort study of 93 patients who were admitted to a tertiary hospital in Saudi
Arabia with a PCR confirmed diagnosis of COVID-19. There were three intervention subgroups (group A) (n
= 45), which included those who received chloroquine or hydroxychloroquine (HCQ) only (A1), those who
received chloroquine or HCQ in combination with azithromycin (A2), and those who received chloroquine or
HCQ in combination with antiviral drugs with or without azithromycin (A3), as well as one supportive care
group (group B) (n = 48). The primary and secondary endpoints were achieving negative SARS-CoV-2
nasopharyngeal PCR samples within five and 12 days from the start of the intervention, respectively.
Results
A median time of three days (interquartile range (IQR): 2.00-6.50) is needed from the time of starting the
intervention/supportive care to the first negative PCR sample. There was no statistically significant
difference neither between the percentage of patients in the intervention group and the supportive care
group who achieved the primary or secondary endpoint nor in the median time needed to achieve the first
negative PCR sample (p > 0.05).
Conclusion
Prescribing antimalarial medications was not shown to shorten the disease course nor to accelerate the
negative PCR conversion rate.
Categories: Infectious Disease, Therapeutics
Keywords: novel coronavirus, infectious disease, sars-cov-2, hydroxychloroquine, covid-19
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