Preliminary evidence from a multicenter prospective observational study of the safety and efficacy of chloroquine for the treatment of COVID-19

DOI record: { "DOI": "10.1093/nsr/nwaa113", "ISSN": [ "2095-5138", "2053-714X" ], "URL": "http://dx.doi.org/10.1093/nsr/nwaa113", "abstract": "<jats:title>Abstract</jats:title><jats:p>Effective therapies are urgently needed for the SARS-CoV-2 pandemic. Chloroquine has been proved to have antiviral effect against coronavirus in vitro. In this study, we aimed to assess the efficacy and safety of chloroquine with different doses in COVID-19. In this multicenter prospective observational study, we enrolled patients older than 18 years old with confirmed SARS-CoV-2 infection excluding critical cases from 12 hospitals in Guangdong and Hubei Provinces. Eligible patients received chloroquine phosphate 500 mg, orally, once (half dose) or twice (full dose) daily. Patients treated with non-chloroquine therapy were included as historical controls. The primary endpoint is the time to undetectable viral RNA. Secondary outcomes include the proportion of patients with undetectable viral RNA by day 10 and 14, hospitalization time, duration of fever, and adverse events. A total of 197 patients completed chloroquine treatment, and 176 patients were included as historical controls. The median time to achieve an undetectable viral RNA was shorter in chloroquine than in non-chloroquine (absolute difference in medians −6.0 days; 95% CI −6.0 to −4.0). The duration of fever is shorter in chloroquine (geometric mean ratio 0.6; 95% CI 0.5 to 0.8). No serious adverse events were observed in the chloroquine group. Patients treated with half dose experienced lower rate of adverse events than with full dose. Although randomized trials are needed for further evaluation, this study provides evidence for safety and efficacy of chloroquine in COVID-19 and suggests that chloroquine can be a cost-effective therapy for combating the COVID-19 pandemic.</jats:p>", "author": [ { "affiliation": [ { "name": "Department of Infectious Diseases, The Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai 519000, China" } ], "family": "Huang", "given": "Mingxing", "sequence": "first" }, { "affiliation": [ { "name": "Guangdong Provincial Key Laboratory of Biomedical Imaging and Guangdong Provincial Engineering Research Center of Molecular Imaging, The Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai 519000, China" }, { "name": "Center for Interventional Medicine, The Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai 519000, China" } ], "family": "Li", "given": "Man", "sequence": "additional" }, { "affiliation": [ { "name": "Department of Infectious Diseases, The Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai 519000, China" }, { "name": "Guangdong Provincial Key Laboratory of Biomedical Imaging and Guangdong Provincial Engineering Research Center of Molecular Imaging, The Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai 519000, China" } ], "family": "Xiao", "given": "Fei", "sequence": "additional" }, { "affiliation": [ { "name": "Guangdong Provincial Key Laboratory of Biomedical Imaging and Guangdong Provincial Engineering Research Center of Molecular Imaging, The Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai 519000, China" }, { "name": "Center for Interventional Medicine, The Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai 519000, China" } ], "family": "Pang", "given": "Pengfei", "sequence": "additional" }, { "affiliation": [ { "name": "Department of Pharmacy, The Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai 519000, China" } ], "family": "Liang", "given": "Jiabi", "sequence": "additional" }, { "affiliation": [ { "name": "Department of Respiratory and Critical Care Medicine, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, China" } ], "family": "Tang", "given": "Tiantian", "sequence": "additional" }, { "affiliation": [ { "name": "Clinical Research Center Office, The Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai 519000, China" } ], "family": "Liu", "given": "Shaoxuan", "sequence": "additional" }, { "affiliation": [ { "name": "Department of Radiology, The Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai 519000, China" } ], "family": "Chen", "given": "Binghui", "sequence": "additional" }, { "affiliation": [ { "name": "Department of Pharmacy, The Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai 519000, China" } ], "family": "Shu", "given": "Jingxian", "sequence": "additional" }, { "affiliation": [ { "name": "Department of Stomatology, The Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai 519000, China" } ], "family": "You", "given": "Yingying", "sequence": "additional" }, { "affiliation": [ { "name": "Guangdong Provincial Key Laboratory of Biomedical Imaging and Guangdong Provincial Engineering Research Center of Molecular Imaging, The Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai 519000, China" }, { "name": "Center for Interventional Medicine, The Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai 519000, China" } ], "family": "Li", "given": "Yang", "sequence": "additional" }, { "affiliation": [ { "name": "Department of Hematology, The Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai 519000, China" } ], "family": "Tang", "given": "Meiwen", "sequence": "additional" }, { "affiliation": [ { "name": "Department of Clinical Laboratory, The Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai 519000, China" } ], "family": "Zhou", "given": "Jianhui", "sequence": "additional" }, { "affiliation": [ { "name": "Department of Clinical Laboratory, The Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai 519000, China" } ], "family": "Jiang", "given": "Guanmin", "sequence": "additional" }, { "affiliation": [ { "name": "Department of Emergency, Wuhan East West Lake Mobile Cabin Hospitals, Wuhan 430040, China" } ], "family": "Xiang", "given": "Jingfen", "sequence": "additional" }, { "affiliation": [ { "name": "Department of Infectious Diseases, Guangzhou Eighth People's Hospital, Guangzhou 510060, China" } ], "family": "Hong", "given": "Wenxin", "sequence": "additional" }, { "affiliation": [ { "name": "Department of Infectious Diseases, Dongguan Ninth People's Hospital, Dongguan 532016, China" } ], "family": "He", "given": "Songmei", "sequence": "additional" }, { "affiliation": [ { "name": "Department of Infectious Diseases, Shenzhen Third People's Hospital, Shenzhen 518100, China" } ], "family": "Wang", "given": "Zhaoqin", "sequence": "additional" }, { "affiliation": [ { "name": "Department of Infectious Diseases, Zhongshan Second People's Hospital, Zhongshan 528447, China" } ], "family": "Feng", "given": "Jianhua", "sequence": "additional" }, { "affiliation": [ { "name": "Department of Respiratory and Critical Care Medicine, Huizhou Central People's Hospital, Huizhou 516001, China" } ], "family": "Lin", "given": "Changqing", "sequence": "additional" }, { "affiliation": [ { "name": "Department of Infectious Diseases, Foshan First people's Hospital, Foshan 528000, China" } ], "family": "Ye", "given": "Yinong", "sequence": "additional" }, { "affiliation": [ { "name": "Department of Respiratory and Critical Care Medicine, The Fourth People's Hospital of Foshan City, Foshan 528000, China" } ], "family": "Wu", "given": "Zhilong", "sequence": "additional" }, { "affiliation": [ { "name": "Department of Infectious Diseases, Maoming People's Hospital, Maoming 525000, China" } ], "family": "Li", "given": "Yaocai", "sequence": "additional" }, { "affiliation": [ { "name": "Department of Infectious Diseases, The Sixth Affiliated Hospital of 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