Evaluation of the efficacy and safety of hydroxychloroquine in comparison with chloroquine in moderate and severe patients with COVID-19
Li et al.
, Evaluation of the efficacy and safety of hydroxychloroquine in comparison with chloroquine in moderate and..
, Science China Life Sciences, doi:10.1007/s11427-020-1871-4
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.
Abstract: SCIENCE CHINA
•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
Qiuyu Li , Cheng Cui , Fei Xu , Jianping Zhao , Nan Li , Haichao Li , Tianbing Wang ,
Hua Zhang , Na Liu , Yudong Wei , Xiaoye Niu , Yan Xu , Jianping Dong , Xueting Yao ,
Xiaohong Wang , Yahong Chen , Haiyan Li , Chunli Song , Jie Qiao , Dongyang Liu &
Department of Respiratory and Critical Care Medicine, Peking University Third Hospital, Beijing 100191, China;
Drug Clinical Trial Center, Peking University Third Hospital, Beijing 100191, China;
Department of Respiratory and Critical Care Medicine, the First Affiliated Hospital of Nanchang University, Nanchang 330006, China;
Department of Respiratory and Critical Care Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and
Technology, Wuhan 430030, China;
Research Center of Clinical Epidemiology, Peking University Third Hospital, Beijing 100191, China;
Department of Respiratory and Critical Care Medicine, Peking University First Hospital, Beijing 100034, China;
Trauma Center, Peking University People’s Hospital, Beijing 100044, China;
Beijing Haidian Hospital, Haidian Section of Peking University Third Hospital, Beijing 100080, China;
Department of Cardiology, Peking University Third Hospital, Beijing 100191, China;
Institute of Medical Innovation, Peking University Third Hospital, Beijing 100191, China
Received August 19, 2020; accepted December 18, 2020; published online January 18, 2021
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. https://doi.org/
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: firstname.lastname@example.org; Dongyang Liu,
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
is less effective
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