Treating COVID-19 with Chloroquine
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
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.
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
journals.permissions@oup.com
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..
Please send us corrections, updates, or comments. Vaccines and
treatments are complementary. All practical, effective, and safe means should
be used based on risk/benefit analysis. No treatment, vaccine, or intervention
is 100% available and effective for all current and future variants. We do not
provide medical advice. Before taking any medication, consult a qualified
physician who can provide personalized advice and details of risks and
benefits based on your medical history and situation.
FLCCC and
WCH
provide treatment protocols.
Submit