No benefit of hydroxychloroquine on SARS-CoV-2 viral load reduction in non-critical hospitalized patients with COVID-19
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)
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.
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Δt<7 ΔCt improvement, 24.0% lower, relative rate 0.76, p = 0.36, treatment 34, control 32.
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Δt>12 ΔCt improvement, 15.0% higher, relative rate 1.15, p = 0.52, treatment 34, control 32.
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Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
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Faíco-Filho et al., 21 Jun 2020, prospective, Brazil, peer-reviewed, median age 58.0, 6 authors.
Abstract: Brazilian Journal of Microbiology (2020) 51:1765–1769
https://doi.org/10.1007/s42770-020-00395-x
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
klingerfaiko@hotmail.com
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..
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