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0 0.5 1 1.5 2+ Δt7-12 ΔCt improvement 81% Improvement Relative Risk Δt<7 ΔCt improvement 24% Δt>12 ΔCt improvement -15% Faíco-Filho et al. HCQ for COVID-19 LATE TREATMENT Is late treatment with HCQ beneficial for COVID-19? Prospective study of 66 patients in Brazil Improved viral reduction rate with HCQ (not stat. sig., p=0.4) Faíco-Filho et al., Braz J Microbiol, doi:10.1007/s42770-020-00395-x Favors HCQ Favors control
No benefit of hydroxychloroquine on SARS-CoV-2 viral load reduction in non-critical hospitalized patients with COVID-19
Faíco-Filho et al., Braz J Microbiol, doi:10.1007/s42770-020-00395-x (date from earlier preprint)
Faíco-Filho et al., No benefit of hydroxychloroquine on SARS-CoV-2 viral load reduction in non-critical hospitalized patients with.., Braz J Microbiol, doi:10.1007/s42770-020-00395-x (date from earlier preprint)
Jun 2020   Source   PDF  
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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 HCQ. The greatest benefit is seen mid-recovery as expected for an effective treatment:
Δt7-12: 81% improvement with HCQ
Δt<7: 24% improvement with HCQ
For Δt>12, everyone has recovered so there is no room for improvement. Since the HCQ group started slightly higher the improvement is slightly less. Most participants have also dropped out by this test, with only 6 HCQ and 9 control remaining (also suggesting HCQ patients recovered faster).
Δt7-12 ΔCt improvement, 80.8% lower, relative rate 0.19, p = 0.40, treatment 34, control 32.
Δt<7 ΔCt improvement, 24.0% lower, relative rate 0.76, p = 0.36, treatment 34, control 32.
Δt>12 ΔCt improvement, 15.0% higher, relative rate 1.15, p = 0.52, treatment 34, control 32.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Faíco-Filho et al., 21 Jun 2020, prospective, Brazil, peer-reviewed, median age 58.0, 6 authors.
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Abstract: Brazilian Journal of Microbiology (2020) 51:1765–1769 CLINICAL MICROBIOLOGY - RESEARCH PAPER No benefit of hydroxychloroquine on SARS-CoV-2 viral load reduction in non-critical hospitalized patients with COVID-19 Klinger Soares Faíco-Filho 1 & Danielle Dias Conte 1 & Luciano Kleber de Souza Luna 1 & Joseane Mayara Almeida Carvalho 1 & Ana Helena Sitta Perosa 2 & Nancy Bellei 1 Received: 4 August 2020 / Accepted: 21 October 2020 / Published online: 27 October 2020 # Sociedade Brasileira de Microbiologia 2020 Abstract Background Some studies have shown that hydroxychloroquine (HCQ) is an effective drug in reducing the in vitro replication of SARS-CoV-2. However, the in vivo effect of HCQ still unclear. Objectives This study aims to evaluate viral load clearance in patients with COVID-19 who underwent HCQ treatment in comparison with a control group that did not receive the drug. Study design This prospective study comprised consecutive viral load measurements in patients with COVID-19 hospitalized with a moderate illness. Patients received 400 mg of HCQ every 12 h for 10 days according to the medical decision. Nasal swab samples were collected from patients during early, intermediary, and final clinical stage of COVID-19. Results A total of 155 samples were collected from 66 patients with COVID-19 (60% female), with a median age of 58 years. The viral load between studied groups, assumed as a semiquantitative measure of cycle threshold (Ct) values, presented no significant difference within the three consecutive measures (ΔCt) (p > 0.05). We also analyzed the ΔCt viral load at different intervals of sample collection (Δt < 7; 7–12; and > 12 days) without significant differences at any ΔCt (p > 0.05). Conclusion In this study, we did not observe any change in viral load reduction in vivo with the use of HCQ. Keywords Viral load . SARS-CoV-2 . Hydroxychloroquine . COVID-19 Background On March 11, 2020, the World Health Organization (WHO) declared the novel severe acute respiratory syndrome coronavirus (SARS-CoV-2), responsible for the coronavirus disease of 2019 (COVID-19), a pandemic, when the virus reached five continents [1]. Since then, several medications have been tested in the treatment of this disease such as hydroxychloroquine (HCQ) [2], tocilizumab [3, 4], remdesivir [5], and heparin [6]. Responsible Editor: Mauricio Nogueira. * Klinger Soares Faíco-Filho 1 Department of Medicine, Discipline of Infectious Diseases, Laboratório de Virologia Clínica, Universidade Federal de São Paulo, Rua Pedro de Toledo, 781 - Vila Clementino, São Paulo, SP 04039-032, Brazil 2 Hospital São Paulo, Universidade Federal de São Paulo, São Paulo, Brazil Some studies have already demonstrated the broadspectrum antiviral potential of HCQ, a drug widely used as an antimalarial or in the treatment of autoimmune disease [7, 8]. Some studies have demonstrated the in vitro effectiveness of HCQ and chloroquine in controlling the replication of SARS-CoV-2 [9, 10]. Other observational study concluded hydroxychloroquine administration was not associated with either a greatly lowered or an increased risk of the composite end point of intubation or death. [11]. The UK RECOVERY trial also concluded that HCQ does not reduce the risk of dying in hospitalized patients [12]. Therefore, more studies need to be carried out to understand the real benefit of HCQ in the treatment of the..
Late treatment
is less effective
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