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Evaluation of the efficacy and safety of hydroxychloroquine in comparison with chloroquine in moderate and severe patients with COVID-19

Li et al., Science China Life Sciences, doi:10.1007/s11427-020-1871-4
Jan 2021  
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Discharge 50% Improvement Relative Risk HCQ for COVID-19  Li et al.  LATE TREATMENT Is late treatment with HCQ beneficial for COVID-19? Retrospective 28 patients in China Higher discharge with HCQ (not stat. sig., p=0.086) Li et al., Science China Life Sciences, Jan 2021 FavorsHCQ Favorscontrol 0 0.5 1 1.5 2+
HCQ for COVID-19
1st treatment shown to reduce risk in March 2020
*, now with p < 0.00000000001 from 411 studies, recognized in 46 countries.
No treatment is 100% effective. Protocols combine treatments. * >10% efficacy, ≥3 studies.
4,300+ studies for 75 treatments.
Small RCT comparing HCQ and CQ in China with 88 very late stage (17.6 days from onset to hospitalization and ~10 days to randomization) patients. The primary clinical outcomes (TTCR and TTCI) were not significantly different. Authors note that HCQ may have more promising efficacy in immune system modulation, indicated by ferritin reduction in the moderate cases and improvement of CT scores and lymphocyte counts in the severe cases. HCQ and CQ were well tolerated.
Authors also compare RCT patients to a matched sample of non-RCT patients in the same hospital, showing shorter time to discharge with CQ/HCQ, but not statistically significant due to the small size.
risk of no hospital discharge, 50.0% lower, HR 0.50, p = 0.09, treatment 14, control 14, RCT patients vs. matched sample of non-treated patients.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Li et al., 18 Jan 2021, retrospective, China, peer-reviewed, 21 authors.
This PaperHCQAll
Abstract: SCIENCE CHINA Life Sciences •LETTER TO THE EDITOR• April 2021 Vol.64 No.4: 660–663 Evaluation of the efficacy and safety of hydroxychloroquine in comparison with chloroquine in moderate and severe patients with COVID-19 1† 2† 3† 4 5 6 7 Qiuyu Li , Cheng Cui , Fei Xu , Jianping Zhao , Nan Li , Haichao Li , Tianbing Wang , 5 2,8 2 2 2 8 2 Hua Zhang , Na Liu , Yudong Wei , Xiaoye Niu , Yan Xu , Jianping Dong , Xueting Yao , 1 1 2,9 10 10 2* Xiaohong Wang , Yahong Chen , Haiyan Li , Chunli Song , Jie Qiao , Dongyang Liu & 1* Ning Shen 1 Department of Respiratory and Critical Care Medicine, Peking University Third Hospital, Beijing 100191, China; 2 Drug Clinical Trial Center, Peking University Third Hospital, Beijing 100191, China; 3 Department of Respiratory and Critical Care Medicine, the First Affiliated Hospital of Nanchang University, Nanchang 330006, China; 4 Department of Respiratory and Critical Care Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China; 5 Research Center of Clinical Epidemiology, Peking University Third Hospital, Beijing 100191, China; 6 Department of Respiratory and Critical Care Medicine, Peking University First Hospital, Beijing 100034, China; 7 Trauma Center, Peking University People’s Hospital, Beijing 100044, China; 8 Beijing Haidian Hospital, Haidian Section of Peking University Third Hospital, Beijing 100080, China; 9 Department of Cardiology, Peking University Third Hospital, Beijing 100191, China; 10 Institute of Medical Innovation, Peking University Third Hospital, Beijing 100191, China Received August 19, 2020; accepted December 18, 2020; published online January 18, 2021 Citation: Li, Q., Cui, C., Xu, F., Zhao, J., Li, N., Li, H., Wang, T., Zhang, H., Liu, N., Wei, Y., et al. (2021). Evaluation of the efficacy and safety of hydroxychloroquine in comparison with chloroquine in moderate and severe patients with COVID-19. Sci China Life Sci 64, 660–663. 10.1007/s11427-020-1871-4 Dear Editor, Since December 2019, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been rapidly spreading worldwide. Hydroxychloroquine and chloroquine are candidates for the treatment of coronavirus disease 2019 (COVID-19) owing to its antiviral effect and immunomodulation properties. However, the published results of utilizing hydroxychloroquine and chloroquine as treatment were still controversial and their efficacy and safety in patients with COVID-19 need to be further elucidated. A total of 88 laboratory-confirmed (identified by viral †Contributed equally to this work *Corresponding authors (Ning Shen, email:; Dongyang Liu, email: RNA or antibody tests) patients with COVID-19 (65 moderate and 23 severe patients with COVID-19) were included in our multicenter, randomized controlled trial (RCT). Eligible patients randomly assigned in a 1:1 ratio to orally receive hydroxychloroquine (600 mg twice a day on the first day followed by 200 mg twice a day in the last four days) plus standard care or chloroquine (500 mg twice a day for the first three days followed by 250 mg twice a day in the last two days) plus standard care (SC) for 5 days. Our study protocol is provided in the Supplementary Methods. The average age of our patients was 61.3 years old and they had a higher risk of developing severe illness. The average time interval..
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Late treatment
is less effective
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