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All Studies   Meta Analysis    Recent:   

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)

Chen et al., PLoS ONE, doi:10.1371/journal.pone.0242763
Jul 2020  
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Viral clearance -29% Improvement Relative Risk HCQ for COVID-19  Chen et al.  LATE TREATMENT Is late treatment with HCQ beneficial for COVID-19? Retrospective 37 patients in Taiwan No significant difference in viral clearance c19hcq.org Chen et al., PLoS ONE, July 2020 FavorsHCQ Favorscontrol 0 0.5 1 1.5 2+
HCQ for COVID-19
1st treatment shown to reduce risk in March 2020
 
*, now with p < 0.00000000001 from 411 studies, recognized in 46 countries.
No treatment is 100% effective. Protocols combine treatments. * >10% efficacy, ≥3 studies.
4,300+ studies for 75 treatments. c19hcq.org
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, p = 0.71.
Small retrospective study with 12 of 28 HCQ patients and 5 of 9 in the control group being PCR- at day 14, RR 1.29, p = 0.7.
The RCT and retrospective study are listed separately1,2.
Viral load measured by PCR may not accurately reflect infectious virus measured by viral culture. Porter et al. show that viral load early in infection was correlated with infectious virus, but viral load late in infection could be high even with low or undetectable infectious virus. Assessing viral load later in infection may underestimate reductions in infectious virus with treatment.
risk of no viral clearance, 29.0% higher, RR 1.29, p = 0.70, treatment 16 of 28 (57.1%), control 4 of 9 (44.4%), day 14.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Chen et al., 10 Jul 2020, retrospective, Taiwan, peer-reviewed, 19 authors.
This PaperHCQAll
{ 'indexed': {'date-parts': [[2024, 3, 3]], 'date-time': '2024-03-03T01:54:12Z', 'timestamp': 1709430852425}, 'reference-count': 35, 'publisher': 'Public Library of Science (PLoS)', 'issue': '12', 'license': [ { 'start': { 'date-parts': [[2020, 12, 2]], 'date-time': '2020-12-02T00:00:00Z', 'timestamp': 1606867200000}, 'content-version': 'vor', 'delay-in-days': 0, 'URL': 'http://creativecommons.org/licenses/by/4.0/'}], 'funder': [ { 'DOI': '10.13039/100008903', 'name': 'Ministry of Health and Welfare', 'doi-asserted-by': 'publisher'}], 'content-domain': {'domain': ['www.plosone.org'], 'crossmark-restriction': False}, 'abstract': '<jats:sec id="sec001">\n' '<jats:title>Objective</jats:title>\n' '<jats:p>In this study, we evaluated the efficacy of hydroxychloroquine (HCQ) against ' 'coronavirus disease 2019 (COVID-19) via a randomized controlled trial (RCT) and a ' 'retrospective study.</jats:p>\n' '</jats:sec>\n' '<jats:sec id="sec002">\n' '<jats:title>Methods</jats:title>\n' '<jats:p>Subjects admitted to 11 designated public hospitals in Taiwan between April 1 and May ' '31, 2020, with COVID-19 diagnosis confirmed by pharyngeal real-time RT-PCR for SARS-CoV-2, ' 'were randomized at a 2:1 ratio and stratified by mild or moderate illness. HCQ (400 mg twice ' 'for 1 d or HCQ 200 mg twice daily for 6 days) was administered. Both the study and control ' 'group received standard of care (SOC). Pharyngeal swabs and sputum were collected every other ' 'day. The proportion and time to negative viral PCR were assessed on day 14. In the ' 'retrospective study, medical records were reviewed for patients admitted before March 31, ' '2020.</jats:p>\n' '</jats:sec>\n' '<jats:sec id="sec003">\n' '<jats:title>Results</jats:title>\n' '<jats:p>There were 33 and 37 cases in the RCT and retrospective study, respectively. In the ' 'RCT, the median times to negative rRT-PCR from randomization to hospital day 14 were 5 days ' '(95% CI; 1, 9 days) and 10 days (95% CI; 2, 12 days) for the HCQ and SOC groups, respectively ' '(<jats:italic>p</jats:italic> = 0.40). On day 14, 81.0% (17/21) and 75.0% (9/12) of the ' 'subjects in the HCQ and SOC groups, respectively, had undetected virus ' '(<jats:italic>p</jats:italic> = 0.36). In the retrospective study, 12 (42.9%) in the HCQ ' 'group and 5 (55.6%) in the control group had negative rRT-PCR results on hospital day 14 ' '(<jats:italic>p</jats:italic> = 0.70).</jats:p>\n' '</jats:sec>\n' '<jats:sec id="sec004">\n' '<jats:title>Conclusions</jats:title>\n' '<jats:p>Neither study demonstrated that HCQ shortened viral shedding in mild to moderate ' 'COVID-19 subjects.</jats:p>\n' '</jats:sec>', 'DOI': '10.1371/journal.pone.0242763', 'type': 'journal-article', 'created': {'date-parts': [[2020, 12, 2]], 'date-time': '2020-12-02T19:19:35Z', 'timestamp': 1606936775000}, 'page': 'e0242763', 'update-policy': 'http://dx.doi.org/10.1371/journal.pone.corrections_policy', 'source': 'Crossref', 'is-referenced-by-count': 35, 'title': '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)', 'prefix': '10.1371', 'volume': '15', 'author': [ {'given': 'Cheng-Pin', 'family': 'Chen', 'sequence': 'first', 'affiliation': []}, {'given': 'Yi-Chun', 'family': 'Lin', 'sequence': 'additional', 'affiliation': []}, {'given': 'Tsung-Chia', 'family': 'Chen', 'sequence': 'additional', 'affiliation': []}, {'given': 'Ting-Yu', 'family': 'Tseng', 'sequence': 'additional', 'affiliation': []}, {'given': 'Hon-Lai', 'family': 'Wong', 'sequence': 'additional', 'affiliation': []}, {'given': 'Cheng-Yu', 'family': 'Kuo', 'sequence': 'additional', 'affiliation': []}, {'given': 'Wu-Pu', 'family': 'Lin', 'sequence': 'additional', 'affiliation': []}, {'given': 'Sz-Rung', 'family': 'Huang', 'sequence': 'additional', 'affiliation': []}, {'given': 'Wei-Yao', 'family': 'Wang', 'sequence': 'additional', 'affiliation': []}, {'given': 'Jia-Hung', 'family': 'Liao', 'sequence': 'additional', 'affiliation': []}, {'given': 'Chung-Shin', 'family': 'Liao', 'sequence': 'additional', 'affiliation': []}, {'given': 'Yuan-Pin', 'family': 'Hung', 'sequence': 'additional', 'affiliation': []}, {'given': 'Tse-Hung', 'family': 'Lin', 'sequence': 'additional', 'affiliation': []}, {'given': 'Tz-Yan', 'family': 'Chang', 'sequence': 'additional', 'affiliation': []}, {'given': 'Chin-Fu', 'family': 'Hsiao', 'sequence': 'additional', 'affiliation': []}, { 'ORCID': 'http://orcid.org/0000-0001-6097-3910', 'authenticated-orcid': True, 'given': 'Yi-Wen', 'family': 'Huang', 'sequence': 'additional', 'affiliation': []}, {'given': 'Wei-Sheng', 'family': 'Chung', 'sequence': 'additional', 'affiliation': []}, {'given': 'Chien-Yu', 'family': 'Cheng', 'sequence': 'additional', 'affiliation': []}, { 'ORCID': 'http://orcid.org/0000-0002-6256-0527', 'authenticated-orcid': True, 'given': 'Shu-Hsing', 'family': 'Cheng', 'sequence': 'additional', 'affiliation': []}, { 'name': 'on behalf of the Taiwan HCQ Study Group', 'sequence': 'additional', 'affiliation': []}], 'member': '340', 'published-online': {'date-parts': [[2020, 12, 2]]}, 'reference': [ { 'key': 'pone.0242763.ref001', 'unstructured': 'World Health Organization. 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Interim guidelines for clinical management of SARS-CoV-2 ' 'infection (5th ed.) [cited 2020 June 6]. 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Late treatment
is less effective
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