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0 0.5 1 1.5 2+ Recovery at day 14 92% Improvement Relative Risk Improvement in pneumon.. 83% Huang et al. HCQ for COVID-19 RCT EARLY TREATMENT Is early treatment with HCQ beneficial for COVID-19? RCT 22 patients in China Trial compares with lopinavir/ritonavir, results vs. placebo may differ Improved recovery with HCQ (p=0.015) Huang et al., J. Molecular Cell Biology, Volume .., doi:10.1093/jmcb/mjaa014 Favors HCQ Favors lopinavir/ri..
Treating COVID-19 with Chloroquine
Huang et al., Journal of Molecular Cell Biology, Volume 12, Issue 4, April 2020, 322–325, doi:10.1093/jmcb/mjaa014
Huang et al., Treating COVID-19 with Chloroquine, Journal of Molecular Cell Biology, Volume 12, Issue 4, April 2020, 322–325, doi:10.1093/jmcb/mjaa014
Apr 2020   Source   PDF  
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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. This study is excluded in meta analysis: excessive unadjusted differences between groups.
risk of no recovery at day 14, 91.7% lower, RR 0.08, p = 0.02, treatment 0 of 10 (0.0%), control 6 of 12 (50.0%), NNT 2.0, relative risk is not 0 because of continuity correction due to zero events (with reciprocal of the contrasting arm).
risk of no improvement in pneumonia at day 14, 83.0% lower, RR 0.17, p = 0.22, treatment 10, control 12.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Huang et al., 1 Apr 2020, Randomized Controlled Trial, China, peer-reviewed, 18 authors, average treatment delay 2.5 days, dosage chloroquine 500mg bid days 1-10, this trial compares with another treatment - results may be better when compared to placebo.
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Abstract: 322 | Journal of Molecular Cell Biology (2020), 12(4), 322–325 doi:10.1093/jmcb/mjaa014 Published online April 1, 2020 Application Note Treating COVID-19 with Chloroquine This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons. org/licenses/by-nc/4.0/), which permits noncommercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact 2008), and the newly discovered SARSCoV-2 (previously known as 2019-nCoV) (Wang et al., 2020). Therefore, Chloroquine may be repurposed for COVID-19 as an emergency therapy. From January 27, 2020 to February 15, 2020, we initiated a clinical study to evaluate the efficacy and safety of Chloroquine in hospitalized patients with COVID-19. At that time, Lopinavir/Ritonavir, a protease inhibitor treatment combination for HIV infection, had been recommended for treating COVID-19 according to the diagnosis and treatment guidelines of novel coronavirus pneumonia (NCP) (World Health Organization, 2020) by the National Health Commission of the People’s Republic of China. Therefore, we included Lopinavir/Ritonavir treatment as a control group. In our study, efficacy was evaluated by (i) real-time polymerase chain reaction (RT-PCR) for measuring COVID-19 viral RNAs, (ii) lung computerized tomography (CT) for assessing the improvement of NCP, and (iii) length of hospitalization for assessing patient recovery. Safety was evaluated by adverse event monitoring. Here, we report our initial results on Chloroquine therapy of COVID-19 patients. Firstly, among the 82 patients screened, 22 met the enrollment criteria (Figure 1A; Supplementary material). All the 22 patients were tested positive for SARS-CoV-2 by RT-PCR assay before enrollment. Their main symptoms were dry cough, fatigue, and fever, and severe cases were characterized by dyspnea, hypoxemia, or acute respiratory dysfunction. Patients were then randomized into two groups: 10 patients, including 3 severe and 7 moderate cases, were treated with Chloroquine 500 mg orally twice daily for 10 days; 12 patients, including 5 severe and 7 moderate cases, were treated with Lopinavir/Ritonavir 400/100 mg orally twice daily for 10 days. Primary baseline demographic and clinical features of the patients are listed in Table 1, with fairly even matched characteristics between two groups. Secondary baseline information is listed in Supplementary Table S1. We initially relied on RT-PCR to measure virological outcomes and showed that one patient in the Chloroquine group became SARS-CoV-2 negative after treatment for only 2 days (Figure 1B, left panel). There were then steady increases in the number of patients turning negative, cumulating at Day 13 when all of the Chloroquine-treated patients became negative (Figure 1B, left panel; Supplementary Table S2). In comparison, patients in the Lopinavir/Ritonavir group only became SARS-CoV-2 negative after 3 days of dosing, and 11 out of 12 turned negative at Day 14. Comparing to the Lopinavir/Ritonavir group, the percentages of patients who became SARS-CoV-2 negative in the Chloroquine group were slightly higher at Day 7, Day 10, and Day 14 (Supplementary Table S2). These results suggest that Chloroquine has slight advantage over Lopinavir/Ritonavir based on RNA tests. Besides, lung CT is another effective indicator to clinically evaluate..
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