0 0.25 0.5 0.75 1 1.25 1.5 1.75 2+ Esper 64% 0.36 [0.15-0.87] hosp. 8/412 12/224 Improvement, RR [CI] Treatment Control Ashraf 68% 0.32 [0.10-1.10] death 10/77 2/5 Huang (ES) 59% 0.41 [0.26-0.64] viral time 32 (n) 37 (n) Guérin 61% 0.39 [0.02-9.06] death 0/20 1/34 Derwand 79% 0.21 [0.03-1.47] death 1/141 13/377 Smith (RCT) 64% 0.36 [0.02-7.70] hosp. 0/7 1/9 Mitjà (RCT) 16% 0.84 [0.35-2.03] hosp. 8/136 11/157 Skipper (RCT) 37% 0.63 [0.21-1.91] death/hosp. 5/231 8/234 Hong 65% 0.35 [0.13-0.72] viral+ 42 (n) 48 (n) Bernabeu-Wittel 94% 0.06 [0.01-0.31] death 24/139 37/83 Yu (ES) 85% 0.15 [0.03-0.74] death 1/73 238/2,604 Ly 56% 0.44 [0.26-0.75] death 18/116 29/110 Ip 55% 0.45 [0.11-1.85] death 2/97 44/970 Heras 96% 0.04 [0.02-0.09] death 8/70 16/30 Kirenga 26% 0.74 [0.47-1.17] recov. time 29 (n) 27 (n) Sulaiman 64% 0.36 [0.16-0.80] death 7/1,817 54/3,724 Guisado-Vasco (ES) 67% 0.33 [0.05-1.55] death 2/65 139/542 Szente Fonseca 64% 0.36 [0.20-0.67] hosp. 25/175 89/542 Cadegiani 81% 0.19 [0.01-3.88] death 0/159 2/137 Simova 94% 0.06 [0.01-0.57] hosp. 0/33 2/5 Omrani (RCT) 12% 0.88 [0.26-2.94] hosp. 7/304 4/152 Agusti 68% 0.32 [0.06-1.67] progression 2/87 4/55 Su 85% 0.15 [0.04-0.57] progression n/a n/a Amaravadi (RCT) 60% 0.40 [0.13-1.28] no recov. 3/15 6/12 Mokhtari 70% 0.30 [0.20-0.45] death 27/7,295 287/21,464 Corradini (ES) 67% 0.33 [0.14-0.78] death 641 (n) 102 (n) Million 83% 0.17 [0.06-0.48] death 5/8,315 11/2,114 Sobngwi (RCT) 52% 0.48 [0.09-2.58] no recov. 2/95 4/92 Rodrigues (RCT) -200% 3.00 [0.13-71.6] hosp. 1/42 0/42 Sawanpanyalert 42% 0.58 [0.18-1.91] progression n/a n/a Atipornwan.. (RCT) -150% 2.50 [0.10-59.6] progression 1/60 0/30 Rouamba (ES) 73% 0.27 [0.09-1.02] progression 23/399 4/33 Avezum (RCT) 1% 0.99 [0.29-3.41] death 5/687 5/682 Roy-García (RCT) -100% 2.00 [0.19-20.9] progression 2/31 1/31 Rathod 73% 0.27 [0.09-0.83] death 513 (n) 52 (n) Tau​2​ = 0.48, I​2​ = 72.3%, p < 0.0001 Early treatment 66% 0.34 [0.25-0.46] 197/22,355 1,024/34,760 66% lower risk Chen (RCT) 29% 0.71 [0.29-1.74] progression 5/15 7/15 Improvement, RR [CI] Treatment Control Zhong Nanshan (钟.. 80% 0.20 [0.08-0.52] viral+ 5/115 17/82 Chen (RCT) 57% 0.43 [0.19-0.97] pneumonia 6/31 14/31 Tang (RCT) 21% 0.79 [0.38-1.62] viral+ 11/75 14/75 Magagnoli 11% 0.89 [0.45-1.77] death 39/148 18/163 Auld -3% 1.03 [0.67-1.57] death 33/114 29/103 Sánchez-Álvarez 46% 0.54 [0.34-0.84] death 322 (n) 53 (n) Mallat -203% 3.03 [1.11-7.69] viral time 23 (n) 11 (n) Membrillo de No.. 55% 0.45 [0.29-0.71] death 27/123 21/43 Alberici 43% 0.57 [0.24-1.13] death 17/72 9/22 Rosenberg -35% 1.35 [0.76-2.40] death 189/735 28/221 Shabrawishi 15% 0.85 [0.45-1.62] viral+ 12/45 15/48 Mahévas -20% 1.20 [0.40-3.30] death 9/84 8/89 Yu 60% 0.40 [0.22-0.72] death 9/48 238/502 Kim 51% 0.49 [0.28-0.87] hosp. time 22 (n) 40 (n) Luo 32% 0.68 [0.08-5.88] death 19 (n) 264 (n) Ip 1% 0.99 [0.80-1.22] death 432/1,914 115/598 Huang 67% 0.33 [0.19-0.57] viral time 197 (n) 176 (n) Rogado 92% 0.08 [0.00-0.87] death 1/8 7/9 Paccoud 11% 0.89 [0.23-3.47] death 21/38 26/46 Faíco-Filho 81% 0.19 [0.00-8.66] viral rate 34 (n) 32 (n) Chen (RCT) 20% 0.80 [0.42-1.52] recov. time 18 (n) 12 (n) Fontana 50% 0.50 [0.16-1.55] death 4/12 2/3 Bousquet 43% 0.57 [0.24-1.36] death 5/27 23/81 Lagier 59% 0.41 [0.27-0.62] death 35/3,119 58/618 Komissarov -25% 1.25 [0.71-2.21] viral load 26 (n) 10 (n) Mikami 47% 0.53 [0.41-0.68] death 575/2,077 231/743 Arshad 51% 0.49 [0.39-0.60] death 162/1,202 108/409 An 3% 0.97 [0.57-1.67] viral+ 31 (n) 195 (n) Rivera-Izquierdo 19% 0.81 [0.24-2.76] death 215 (n) 23 (n) Chen -29% 1.29 [0.58-2.86] viral+ 16/28 4/9 Chen (RCT) 24% 0.76 [0.20-2.84] viral+ 4/21 3/12 Trullàs 36% 0.64 [0.39-1.07] death 20/66 16/34 Lyngbakken (RCT) 4% 0.96 [0.06-14.6] death 1/27 1/26 Bernaola 17% 0.83 [0.77-0.89] death 236/1,498 28/147 Rivera -2% 1.02 [0.67-1.53] death 44/179 59/327 Cavalcanti (RCT) 16% 0.84 [0.28-2.53] death 8/331 5/173 Novartis (RCT) 71% 0.29 [0.01-6.03] no disch. 0/7 1/5 D'Arminio Monfo.. 34% 0.66 [0.39-1.11] death 53/197 47/92 Davido 55% 0.45 [0.23-0.89] int./hosp. 12/80 13/40 Yu 83% 0.17 [0.03-0.99] progression 1/231 32/1,291 Berenguer 18% 0.82 [0.74-0.90] death 681/2,618 438/1,377 Kalligeros -67% 1.67 [0.29-9.36] death 36 (n) 72 (n) Pablos -126% 2.26 [1.35-3.79] severe case 172 (n) 56 (n) Pinato 59% 0.41 [0.29-0.58] death 30/182 181/446 Dubernet 88% 0.12 [0.02-0.88] ICU 1/17 9/19 Gonzalez 27% 0.73 [0.53-1.01] death 1,246/8,476 341/1,168 Catteau 32% 0.68 [0.62-0.76] death 804/4,542 957/3,533 Di Castelnuovo 30% 0.70 [0.59-0.84] death 386/2,634 90/817 Synolaki 24% 0.76 [0.49-1.18] death 21/98 60/214 Heberto 54% 0.46 [0.19-0.97] death 139 (n) 115 (n) Lauriola 74% 0.27 [0.17-0.41] death 102/297 35/63 Ashinyo 33% 0.67 [0.47-0.96] hosp. time 61 (n) 61 (n) Serrano 43% 0.57 [0.28-1.18] death 6/14 6/8 Lammers 32% 0.68 [0.47-0.99] death/ICU 30/189 101/498 Ayerbe 52% 0.48 [0.37-0.62] death 237/1,857 49/162 Almazrou 65% 0.35 [0.09-1.35] ventilation 3/95 6/66 Nachega 28% 0.72 [0.49-1.06] death 69/630 28/96 Guisado-Vasco 20% 0.80 [0.47-1.26] death 127/558 14/49 Ñamendys-S.. (ICU) 32% 0.68 [0.38-1.20] death 24/54 42/64 Dubee (RCT) 46% 0.54 [0.21-1.42] death 6/124 11/123 Lano 33% 0.67 [0.28-1.31] death 56 (n) 66 (n) Frontera (PSM) 37% 0.63 [0.44-0.91] death 121/1,006 424/2,467 López 64% 0.36 [0.14-0.89] progression 5/36 14/36 Núñez-Gil 8% 0.92 [0.87-0.94] death 200/686 100/268 ORCHID Self (RCT) -6% 1.06 [0.57-1.87] death 25/241 25/236 Águila-Gordo 67% 0.33 [0.09-1.24] death 151/346 47/70 Sheshah 80% 0.20 [0.09-0.45] death 267 (n) 33 (n) Falcone (PSM) 65% 0.35 [0.07-1.73] death 40/238 30/77 Burdick -59% 1.59 [0.89-2.83] death 142 (n) 148 (n) van Halem 32% 0.68 [0.47-1.00] death 34/164 47/155 Rodriguez-Gonzalez 23% 0.77 [0.51-1.17] death 251/1,148 17/60 Lambermont 32% 0.68 [0.25-1.87] death 97/225 14/22 Abdulrahman (PSM) 17% 0.83 [0.26-2.69] death 5/223 6/223 Capsoni 40% 0.60 [0.29-1.25] ventilation 12/40 6/12 Peng 11% 0.89 [0.62-1.29] progression 29/453 256/3,567 Modrák 59% 0.41 [0.18-0.95] death 108 (n) 105 (n) Ozturk 44% 0.56 [0.28-1.13] death 165/1,127 6/23 Guglielmetti 35% 0.65 [0.33-1.30] death 181 (n) 37 (n) Johnston (RCT) 30% 0.70 [0.19-2.54] hosp. 5/148 4/83 Alqassieh 18% 0.82 [0.64-1.05] hosp. time 63 (n) 68 (n) Tan 35% 0.65 [0.43-0.98] hosp. time 8 (n) 277 (n) Naseem 33% 0.67 [0.30-1.53] death 77 (n) 1,137 (n) Orioli 13% 0.87 [0.26-2.94] death 8/55 3/18 Signes-Costa 47% 0.53 [0.37-0.75] death 4,854 (n) 993 (n) Matangila 55% 0.45 [0.07-1.27] death 25/147 8/13 Cangiano 73% 0.27 [0.12-0.61] death 5/33 37/65 Taccone (ICU) 25% 0.75 [0.58-0.95] death 449/1,308 183/439 Güner 77% 0.23 [0.03-1.76] ICU 604 (n) 100 (n) Li -40% 1.40 [0.99-1.98] viral time 18 (n) 19 (n) Li 50% 0.50 [0.23-1.10] no disch. 14 (n) 14 (n) Di Castelnuovo 40% 0.60 [0.50-0.70] death 3,270 (n) 1,000 (n) Ouedraogo 33% 0.67 [0.28-1.62] death 397 (n) 59 (n) Hernandez-C.. (RCT) 12% 0.88 [0.51-1.53] death 106 (n) 108 (n) Purwati (RCT) 66% 0.34 [0.26-0.44] viral+ 38/121 111/119 Lora-Tamayo 50% 0.50 [0.44-0.56] death 7,192 (n) 1,361 (n) Beltran Gon.. (RCT) 63% 0.37 [0.08-1.73] death 2/33 6/37 Salvador 33% 0.67 [0.40-1.03] death 28/121 58/124 Barry 99% 0.0 [0.00-1e+05] death 0/6 91/599 TOGETHER Reis (RCT) 66% 0.34 [0.01-8.30] death 0/214 1/227 Corradini 70% 0.30 [0.21-0.41] death 1,439 (n) 274 (n) Réa-Neto (RCT) -57% 1.57 [0.79-3.13] death 16/53 10/52 Kokturk -4% 1.04 [0.10-7.64] death 62/1,382 5/118 Aghajani 19% 0.81 [0.62-1.03] death 553 (n) 438 (n) Haji Aghajani 19% 0.81 [0.62-1.03] death 553 (n) 438 (n) De Rosa 35% 0.65 [0.44-0.93] death 118/731 80/280 Sivapalan (RCT) 92% 0.08 [0.00-11.7] death 1/61 2/56 Byakika-Ki.. (RCT) 0% 1.00 [0.56-1.75] recov. time 36 (n) 29 (n) Lagier 32% 0.68 [0.52-0.88] death 93/1,270 146/841 Singh (RCT) 48% 0.53 [0.15-1.82] death 3/20 6/21 Turrini 10% 0.90 [0.75-1.03] death 103/160 33/45 Schwartz (RCT) -133% 2.33 [0.10-56.1] ICU 1/111 0/37 Gerlovin -22% 1.22 [0.91-1.63] death 90/429 141/770 Taieb 39% 0.61 [0.41-0.92] no disch. 674 (n) 252 (n) Barrat-Due (RCT) -120% 2.20 [0.40-10.8] death 4/45 2/48 Alotaibi -134% 2.33 [0.99-5.49] death 193 (n) 244 (n) Uygen 12% 0.88 [0.77-1.00] viral time 15 (n) 25 (n) Panda (RCT) 48% 0.53 [0.15-1.82] death 3/20 6/21 Babalola (RCT) -55% 1.55 [0.88-2.72] no disch. 17/30 11/30 Atipornwan.. (RCT) 56% 0.44 [0.19-1.02] death 7/100 16/100 Guglielmetti 28% 0.72 [0.48-1.08] death 474 (n) 126 (n) Calderón -215% 3.15 [0.40-24.7] death 5/27 1/17 Ferreira -151% 2.51 [1.09-4.43] death 17/111 11/81 AbdelGhaffar 100% 0.00 [0.00-0.02] death 0/238 900/3,474 Lavilla Olleros 36% 0.64 [0.55-0.73] death 2,285/12,772 774/2,149 Omma 28% 0.72 [0.39-1.33] death 17/213 20/180 Beaumont 14% 0.86 [0.39-1.41] death/int. 7/38 88/258 Rouamba 80% 0.20 [0.10-0.44] death 20/336 24/73 Tsanovska (PSM) 58% 0.42 [0.20-0.90] death 8/70 19/70 Uyaroğlu (PSM) -200% 3.00 [0.13-71.6] death 1/42 0/42 Ebongue 43% 0.57 [0.33-0.97] death 93/522 36/58 AlQahtani (RCT) 24% 0.76 [0.18-3.25] ICU 3/51 4/52 Hafez 12% 0.88 [0.53-1.43] viral+ 40 (n) 1,446 (n) Bassets-Bosch 29% 0.71 [0.30-1.69] viral time 5 (n) 5 (n) Hong (PSM) 25% 0.75 [0.36-1.58] no recov. 15 (n) 15 (n) Silva -46% 1.46 [0.77-2.21] death 21 (n) 374 (n) Osawa 29% 0.71 [0.50-1.02] death 25/71 71/144 Bowen 20% 0.80 [0.68-0.94] death 1,317 (n) 3,314 (n) Babayigit -112% 2.12 [0.65-5.71] ventilation 63/1,378 6/94 Núñez-Gil (PSM) 53% 0.47 [0.36-0.62] death 581 (n) 581 (n) Go 55% 0.45 [0.22-0.91] death n/a n/a Bubenek-Tur.. (ICU) 22% 0.78 [0.64-0.95] death n/a n/a Alosaimi (PSM) -400% 5.00 [0.25-101] death 2/37 0/37 REMAP-CAP Higgins (RCT) -51% 1.51 [0.98-2.29] death 16/41 107/311 Alshamrani (PSM) 50% 0.50 [0.17-1.30] death 6/161 50/653 Delgado 26% 0.74 [0.61-0.90] death 1,239 (n) 8,399 (n) Spivak (RCT) -73% 1.73 [0.52-5.78] hosp. 7/152 4/150 Aweimer 40% 0.60 [0.29-1.25] death 4/9 104/140 Krishnan 40% 0.60 [0.40-1.10] death case control AlQadheeb (ICU) 35% 0.65 [0.51-0.84] death 37/92 466/756 Yilgwan 93% 0.07 [0.03-0.14] death 1,039 (n) 2,423 (n) Burhan (ICU) -1% 1.01 [0.88-1.16] death 84/123 294/436 Meeus 36% 0.64 [0.46-0.88] death 59/352 916/3,533 Tau​2​ = 0.08, I​2​ = 76.7%, p < 0.0001 Late treatment 32% 0.68 [0.64-0.73] 10,737/91,285 9,412/63,855 32% lower risk Chatterjee 67% 0.33 [0.20-0.56] cases 12/68 206/387 Improvement, RR [CI] Treatment Control Bhattacharya 81% 0.19 [0.07-0.53] cases 4/54 20/52 Ferreira 47% 0.53 [0.39-0.72] cases population-based cohort Zhong 91% 0.09 [0.01-0.94] cases 7/16 20/27 Desbois 17% 0.83 [0.27-2.58] cases 3/27 23/172 Kadnur 62% 0.38 [0.15-0.85] cases 10/258 15/100 Khurana 51% 0.49 [0.24-0.98] cases 6/22 88/159 Ferri 63% 0.37 [0.16-0.83] cases 9/994 16/647 Grau-Pujol (RCT) 11% 0.89 [0.06-14.2] cases 1/142 1/127 COVID PREP Rajasingham (RCT) 50% 0.50 [0.03-7.97] hosp. 1/989 1/494 Gentry 91% 0.09 [0.00-1.52] death 0/10,703 7/21,406 PATCH Abella (RCT) 5% 0.95 [0.25-3.63] cases 4/64 4/61 Yadav 82% 0.18 [0.04-0.81] hosp. 2/279 9/221 Goenka 87% 0.13 [0.02-0.85] IgG+ 1/77 115/885 Arleo 50% 0.50 [0.06-4.02] death 1/20 5/50 Behera 28% 0.72 [0.32-1.24] cases 7/19 179/353 Datta 22% 0.78 [0.42-1.45] cases 16/146 19/135 Mathai 90% 0.10 [0.05-0.21] cases 10/491 22/113 Revollo (PSM) 23% 0.77 [0.35-1.68] cases 16/69 65/418 Jung 59% 0.41 [0.02-9.97] death 0/649 1/1,417 Gönenli 30% 0.70 [0.20-2.46] progression 3/148 12/416 Cordtz 24% 0.76 [0.23-2.52] hosp. population-based cohort Khoubnasabjafari 17% 0.83 [0.44-1.59] cases 34/1,436 12/422 Strangfeld 48% 0.52 [0.37-0.71] death 27/426 124/739 Bae (PSM) 30% 0.70 [0.41-1.18] cases 16/743 91/2,698 Pham 20% 0.80 [0.15-2.79] death 2/14 5/28 Dev 26% 0.74 [0.61-0.90] cases 260 (n) 499 (n) Seet (RCT) 35% 0.65 [0.43-0.99] symp. case 29/432 64/619 Alegiani -8% 1.08 [0.79-1.46] death case control Alzahrani 59% 0.41 [0.02-9.55] death 0/14 1/33 Rojas-Serrano (RCT) 82% 0.18 [0.02-1.59] symp. case 1/62 6/65 Syed (RCT) -60% 1.60 [0.63-4.04] symp. case 10/48 6/46 Korkmaz 82% 0.18 [0.01-3.72] death 0/385 2/299 Badyal 60% 0.40 [0.31-0.50] cases 247/617 611/1,473 Shaw (PSM) 13% 0.87 [0.80-0.96] cases 45 (n) 99 (n) Bhatt -49% 1.49 [1.05-2.13] cases 167/731 30/196 McCullough 52% 0.48 [0.27-0.87] cases 13/101 32/120 Patil 66% 0.34 [0.10-1.22] death 5,266 (n) 3,946 (n) HERO-HCQ Naggie (RCT) 24% 0.76 [0.51-1.14] symp. case 41/683 53/676 Cordtz 40% 0.60 [0.19-1.87] hosp. 1,170 (n) 1,363 (n) Agarwal 95% 0.05 [0.00-3401] hosp. 0/29 17/455 Belmont 79% 0.21 [0.02-2.25] symp. case 1/56 2/24 Ahmed 99% 0.01 [0.00-1.77] cases case control WHIP COVID-19 McKinnon (RCT) 2% 0.98 [0.09-10.7] symp. case 2/365 1/178 Ugarte-Gil 44% 0.56 [0.36-0.85] severe case 665 (n) 230 (n) Opdam 45% 0.55 [0.23-1.30] hosp. case control MacFadden 12% 0.88 [0.79-0.97] cases n/a n/a HOPE Tirupakuzhi.. (RCT) -196% 2.96 [0.12-72.3] progression 1/211 0/203 Raabe 82% 0.18 [0.02-1.86] symp. case 1/59 2/21 Yadav 20% 0.80 [0.70-1.00] seropositive 1,255 (n) 969 (n) EPICOS Polo (RCT) 51% 0.49 [0.00-2.29] symp. case 3/224 5/211 Becetti 37% 0.63 [0.33-1.20] cases 26/314 49/386 Loucera 69% 0.31 [0.17-0.57] death 320 (n) 15,648 (n) Oku 92% 0.08 [0.00-1.27] death 0/14 11/206 Sahebari 56% 0.44 [0.12-0.83] cases 10/108 56/368 Obrișcă 87% 0.13 [0.02-0.69] cases 10/81 5/14 Isnardi 34% 0.66 [0.33-1.17] death 11/361 72/1,554 Sukumar 38% 0.62 [0.25-1.53] cases case control Shahrin -88% 1.88 [0.91-3.47] cases 43/230 11/106 Shukla 5% 0.95 [0.64-1.34] PASC 22/76 184/603 Nasri (RCT) 92% 0.08 [0.01-0.76] symp. case 0/70 6/73 Llanos-Cuen.. (RCT) -69% 1.69 [0.41-7.11] cases 5/36 3/32 Mathew 20% 0.80 [0.20-3.20] death 23 (n) 41 (n) Chevalier 35% 0.65 [0.30-1.20] death 7/55 109/535 COVAD Sen 40% 0.60 [0.30-1.10] PASC n/a n/a Dulcey 21% 0.79 [0.52-1.20] cases 322 (n) 645 (n) Finkelstein (PSM) 21% 0.79 [0.69-0.91] cases Klebanov 31% 0.69 [0.22-2.19] death Scirocco 41% 0.59 [0.18-1.90] death/int. 183 (n) 444 (n) Tau​2​ = 0.15, I​2​ = 79.4%, p < 0.0001 PrEP 42% 0.58 [0.51-0.67] 842/32,725 2,398/63,907 42% lower risk Boulware (RCT) 17% 0.83 [0.58-1.18] cases 49/414 58/407 Improvement, RR [CI] Treatment Control BCN-PEP-CoV2 Mitjà (RCT) 46% 0.54 [0.16-1.80] death 4/1,196 8/1,301 Polat 57% 0.43 [0.21-0.88] cases 12/138 14/70 Dhibar 44% 0.56 [0.22-1.41] symp. case 6/132 15/185 Simova 93% 0.07 [0.01-0.57] cases 0/156 3/48 HCQ COVID-19 PEP Barnabas (RCT) -4% 1.04 [0.07-16.5] hosp. 1/407 1/422 Shabani 19% 0.81 [0.14-4.67] symp. case 2/51 3/62 Dhibar (RCT) 27% 0.73 [0.40-1.35] symp. case 17/574 24/594 Tau​2​ = 0.00, I​2​ = 0.0%, p = 0.006 PEP 30% 0.70 [0.54-0.90] 91/3,068 126/3,089 30% lower risk All studies 38% 0.62 [0.59-0.66] 11,867/149,433 12,960/165,611 38% lower risk HCQ COVID-19 studies after exclusions c19hcq.org October 2023 Tau​2​ = 0.11, I​2​ = 78.9%, p < 0.0001 Effect extraction pre-specified(most serious outcome, see appendix) Favors HCQ Favors control