Analgesics
Antiandrogens
Antihistamines
Azvudine
Bromhexine
Budesonide
Colchicine
Conv. Plasma
Curcumin
Famotidine
Favipiravir
Fluvoxamine
Hydroxychlor..
Ivermectin
Lifestyle
Melatonin
Metformin
Minerals
Molnupiravir
Monoclonals
Naso/orophar..
Nigella Sativa
Nitazoxanide
PPIs
Paxlovid
Quercetin
Remdesivir
Thermotherapy
Vitamins
More

Other
Feedback
Home
 
next
study
previous
study
c19hcq.org COVID-19 treatment researchHCQHCQ (more..)
Melatonin Meta
Metformin Meta
Antihistamines Meta
Azvudine Meta Molnupiravir Meta
Bromhexine Meta
Budesonide Meta
Colchicine Meta Nigella Sativa Meta
Conv. Plasma Meta Nitazoxanide Meta
Curcumin Meta PPIs Meta
Famotidine Meta Paxlovid Meta
Favipiravir Meta Quercetin Meta
Fluvoxamine Meta Remdesivir Meta
Hydroxychlor.. Meta Thermotherapy Meta
Ivermectin Meta

All Studies   Meta Analysis       

A pragmatic randomized controlled trial reports lack of efficacy of hydroxychloroquine on coronavirus disease 2019 viral kinetics

Lyngbakken et al., Nature Communications, doi:10.1038/s41467-020-19056-6, NCT04316377
Jul 2020  
  Post
  Facebook
Share
  Source   PDF   All Studies   Meta AnalysisMeta
Mortality 4% Improvement Relative Risk Improvement in viral load.. 71% HCQ  Lyngbakken et al.  LATE TREATMENT  RCT Is late treatment with HCQ beneficial for COVID-19? RCT 53 patients in Norway Improved viral reduction rate with HCQ (not stat. sig., p=0.51) c19hcq.org Lyngbakken et al., Nature Communications, Jul 2020 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 419 studies, recognized in 46 countries.
No treatment is 100% effective. Protocols combine treatments.
5,100+ studies for 112 treatments. c19hcq.org
Small RCT of nasopharyngeal viral load not showing significant differences. The rate of reduction for HCQ was 0.24 [0.03-0.46] RNA copies/mL/24h, and 0.14 [-0.10-0.37] for the control group (71% faster with HCQ but not statistically significant with the small sample size of 27 HCQ and 26 control patients). Analysis only over 96 hours. NCT04316377 (history).
risk of death, 3.7% lower, RR 0.96, p = 1.00, treatment 1 of 27 (3.7%), control 1 of 26 (3.8%), NNT 702.
improvement in viral load reduction rate, 71.0% lower, relative rate 0.29, p = 0.51, treatment 27, control 26.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Lyngbakken et al., 17 Jul 2020, Randomized Controlled Trial, Norway, peer-reviewed, median age 62.0, 11 authors, average treatment delay 8.0 days, trial NCT04316377 (history).
This PaperHCQAll
A pragmatic randomized controlled trial reports lack of efficacy of hydroxychloroquine on coronavirus disease 2019 viral kinetics
Magnus Nakrem Lyngbakken, Jan-Erik Berdal, Arne Eskesen, Dag Kvale, Inge Christoffer Olsen, Corina Silvia Rueegg, Anbjørg Rangberg, Christine Monceyron Jonassen, Torbjørn Omland, Helge Røsjø, Olav Dalgard
Nature Communications, doi:10.1038/s41467-020-19056-6
Here, we randomized 53 patients hospitalized with coronavirus disease 2019 (COVID-19) to hydroxychloroquine therapy (at a dose of 400 mg twice daily for seven days) in addition to standard care or standard care alone (ClinicalTrials.gov Identifier, NCT04316377). All severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) positive patients 18 years of age or older were eligible for study inclusion if they had moderately severe COVID-19 at admission. Treatment with hydroxychloroquine did not result in a significantly greater rate of decline in SARS-CoV-2 oropharyngeal viral load compared to standard care alone during the first five days. Our results suggest no important antiviral effect of hydroxychloroquine in humans infected with SARS-CoV-2.
Author contributions M.N.L., coordinating investigator, prepared the trial protocol, handled regulatory approvals, drafted the manuscript. J.E.B., investigator, study sponsor, critically reviewed the manuscript and approved the final manuscript as submitted. A.E., investigator, inclusion of patients, critically reviewed the manuscript and approved the final manuscript as submitted. D.K., investigator, laboratory and analytical support, critically reviewed the manuscript and approved the final manuscript as submitted. I.C.O., trial statistician, prepared the trial protocol, critically reviewed the manuscript, and approved the final manuscript as submitted. C.S.R., trial statistician, critically reviewed the manuscript and approved the final manuscript as submitted. A.R., investigator, laboratory and analytical support, critically reviewed the manuscript and approved the final manuscript as submitted. C.M.J., investigator, laboratory and analytical support, critically reviewed the manuscript and approved the final manuscript as submitted. T.O., investigator, critically reviewed the manuscript and approved the final manuscript as submitted. H.R., investigator, conceived the idea for the study, prepared the trial protocol, handled regulatory approvals, critically reviewed the manuscript, and approved the final manuscript as submitted. O.D., principal investigator, prepared the trial protocol, handled regulatory approvals, inclusion of patients, critically reviewed the manuscript,..
References
Arshad, Treatment with hydroxychloroquine, azithromycin, and combination in patients hospitalized with COVID-19, Int. J. Infect. Dis
Beigel, Remdesivir for the treatment of Covid-19-preliminary report, N. Engl. J. Med. In
Bhandari, Lochner, Tornetta, Effect of continuous versus dichotomous outcome variables on study power when sample sizes of orthopaedic randomized trials are small, Arch. Orthop. Trauma Surg
Cao, A trial of Lopinavir-Ritonavir in adults hospitalized with severe Covid-19, N. Engl. J. Med
Corman, Detection of 2019 novel coronavirus (2019-nCoV) by real-time RT-PCR, Eur. Surveill
Group, Dexamethasone in hospitalized patients with covid-19-preliminary report, N. Engl. J. Med. In
Ison, End points for testing influenza antiviral treatments for patients at high risk of severe and life-threatening disease, J. Infect. Dis
Lyngbakken, Norwegian Coronavirus Disease 2019 (NO COVID-19) Pragmatic Open label Study to assess early use of hydroxychloroquine sulphate in moderately severe hospitalised patients with coronavirus disease 2019: a structured summary of a study protocol for a randomised controlled trial, Trials
Magagnoli, Outcomes of hydroxychloroquine usage in United States veterans hospitalized with COVID-19
Marovich, Mascola, Cohen, Monoclonal antibodies for prevention and treatment of COVID-19, JAMA
Saiki, Enzymatic amplification of beta-globin genomic sequences and restriction site analysis for diagnosis of sickle cell anemia, Science
Shen, Treatment of 5 critically ill patients with COVID-19 with convalescent plasma, JAMA
Tang, Hydroxychloroquine in patients with mainly mild to moderate coronavirus disease 2019: open label, randomised controlled trial, BMJ
Wang, Remdesivir and chloroquine effectively inhibit the recently emerged novel coronavirus (2019-nCoV) in vitro, Cell Res
Wang, Remdesivir in adults with severe COVID-19: a randomised, double-blind, placebo-controlled, multicentre trial, Lancet
Wolfel, Virological assessment of hospitalized patients with COVID-2019, Nature
{ 'indexed': {'date-parts': [[2024, 3, 29]], 'date-time': '2024-03-29T15:53:45Z', 'timestamp': 1711727625334}, 'reference-count': 18, 'publisher': 'Springer Science and Business Media LLC', 'issue': '1', 'license': [ { 'start': { 'date-parts': [[2020, 10, 20]], 'date-time': '2020-10-20T00:00:00Z', 'timestamp': 1603152000000}, 'content-version': 'tdm', 'delay-in-days': 0, 'URL': 'https://creativecommons.org/licenses/by/4.0'}, { 'start': { 'date-parts': [[2020, 10, 20]], 'date-time': '2020-10-20T00:00:00Z', 'timestamp': 1603152000000}, 'content-version': 'vor', 'delay-in-days': 0, 'URL': 'https://creativecommons.org/licenses/by/4.0'}], 'content-domain': {'domain': ['link.springer.com'], 'crossmark-restriction': False}, 'abstract': '<jats:title>Abstract</jats:title><jats:p>Here, we randomized 53 patients hospitalized with ' 'coronavirus disease 2019 (COVID-19) to hydroxychloroquine therapy (at a dose of 400\u2009mg ' 'twice daily for seven days) in addition to standard care or standard care alone ' '(ClinicalTrials.gov Identifier, NCT04316377). All severe acute respiratory syndrome ' 'coronavirus 2 (SARS-CoV-2) positive patients 18 years of age or older were eligible for study ' 'inclusion if they had moderately severe COVID-19 at admission. Treatment with ' 'hydroxychloroquine did not result in a significantly greater rate of decline in SARS-CoV-2 ' 'oropharyngeal viral load compared to standard care alone during the first five days. Our ' 'results suggest no important antiviral effect of hydroxychloroquine in humans infected with ' 'SARS-CoV-2.</jats:p>', 'DOI': '10.1038/s41467-020-19056-6', 'type': 'journal-article', 'created': { 'date-parts': [[2020, 10, 20]], 'date-time': '2020-10-20T10:03:16Z', 'timestamp': 1603188196000}, 'update-policy': 'http://dx.doi.org/10.1007/springer_crossmark_policy', 'source': 'Crossref', 'is-referenced-by-count': 58, 'title': 'A pragmatic randomized controlled trial reports lack of efficacy of hydroxychloroquine on ' 'coronavirus disease 2019 viral kinetics', 'prefix': '10.1038', 'volume': '11', 'author': [ { 'ORCID': 'http://orcid.org/0000-0002-5994-9304', 'authenticated-orcid': False, 'given': 'Magnus Nakrem', 'family': 'Lyngbakken', 'sequence': 'first', 'affiliation': []}, {'given': 'Jan-Erik', 'family': 'Berdal', 'sequence': 'additional', 'affiliation': []}, {'given': 'Arne', 'family': 'Eskesen', 'sequence': 'additional', 'affiliation': []}, { 'ORCID': 'http://orcid.org/0000-0001-6410-2530', 'authenticated-orcid': False, 'given': 'Dag', 'family': 'Kvale', 'sequence': 'additional', 'affiliation': []}, {'given': 'Inge Christoffer', 'family': 'Olsen', 'sequence': 'additional', 'affiliation': []}, { 'ORCID': 'http://orcid.org/0000-0003-3720-4659', 'authenticated-orcid': False, 'given': 'Corina Silvia', 'family': 'Rueegg', 'sequence': 'additional', 'affiliation': []}, {'given': 'Anbjørg', 'family': 'Rangberg', 'sequence': 'additional', 'affiliation': []}, { 'given': 'Christine Monceyron', 'family': 'Jonassen', 'sequence': 'additional', 'affiliation': []}, {'given': 'Torbjørn', 'family': 'Omland', 'sequence': 'additional', 'affiliation': []}, { 'ORCID': 'http://orcid.org/0000-0003-2114-3134', 'authenticated-orcid': False, 'given': 'Helge', 'family': 'Røsjø', 'sequence': 'additional', 'affiliation': []}, {'given': 'Olav', 'family': 'Dalgard', 'sequence': 'additional', 'affiliation': []}], 'member': '297', 'published-online': {'date-parts': [[2020, 10, 20]]}, 'reference': [ { 'key': '19056_CR1', 'doi-asserted-by': 'publisher', 'first-page': '269', 'DOI': '10.1038/s41422-020-0282-0', 'volume': '30', 'author': 'M Wang', 'year': '2020', 'unstructured': 'Wang, M. et al. Remdesivir and chloroquine effectively inhibit the ' 'recently emerged novel coronavirus (2019-nCoV) in vitro. Cell Res. 30, ' '269–271 (2020).', 'journal-title': 'Cell Res.'}, { 'key': '19056_CR2', 'doi-asserted-by': 'publisher', 'first-page': 'm1849', 'DOI': '10.1136/bmj.m1849', 'volume': '369', 'author': 'W Tang', 'year': '2020', 'unstructured': 'Tang, W. et al. Hydroxychloroquine in patients with mainly mild to ' 'moderate coronavirus disease 2019: open label, randomised controlled ' 'trial. BMJ 369, m1849 (2020).', 'journal-title': 'BMJ'}, { 'key': '19056_CR3', 'doi-asserted-by': 'publisher', 'first-page': '1654', 'DOI': '10.1086/652498', 'volume': '201', 'author': 'MG Ison', 'year': '2010', 'unstructured': 'Ison, M. G. et al. End points for testing influenza antiviral treatments ' 'for patients at high risk of severe and life-threatening disease. J. ' 'Infect. Dis. 201, 1654–1662 (2010).', 'journal-title': 'J. Infect. Dis.'}, { 'key': '19056_CR4', 'doi-asserted-by': 'publisher', 'first-page': '96', 'DOI': '10.1007/s004020100347', 'volume': '122', 'author': 'M Bhandari', 'year': '2002', 'unstructured': 'Bhandari, M., Lochner, H. & Tornetta, P. 3rd Effect of continuous versus ' 'dichotomous outcome variables on study power when sample sizes of ' 'orthopaedic randomized trials are small. Arch. Orthop. Trauma Surg. 122, ' '96–98 (2002).', 'journal-title': 'Arch. Orthop. Trauma Surg.'}, { 'key': '19056_CR5', 'unstructured': 'Centers for Disease Control and Prevention. Interim Clinical Guidance ' 'for Management of Patients with Confirmed Coronavirus Disease ' '(COVID-19). ' 'https://www.cdc.gov/coronavirus/2019-ncov/hcp/clinical-guidance-management-patients.html. ' 'Accessed 22 June 2020.'}, { 'key': '19056_CR6', 'unstructured': 'Recovery Collaborative Group et al. Dexamethasone in hospitalized ' 'patients with covid-19—preliminary report. N. Engl. J. Med.\xa0In press ' '(2020).'}, { 'key': '19056_CR7', 'doi-asserted-by': 'publisher', 'first-page': '1582', 'DOI': '10.1001/jama.2020.4783', 'volume': '323', 'author': 'C Shen', 'year': '2020', 'unstructured': 'Shen, C. et al. Treatment of 5 critically ill patients with COVID-19 ' 'with convalescent plasma. JAMA 323, 1582–1589 (2020).', 'journal-title': 'JAMA'}, { 'key': '19056_CR8', 'doi-asserted-by': 'publisher', 'first-page': '131', 'DOI': '10.1001/jama.2020.10245', 'volume': '324', 'author': 'M Marovich', 'year': '2020', 'unstructured': 'Marovich, M., Mascola, J. R. & Cohen, M. S. Monoclonal antibodies for ' 'prevention and treatment of COVID-19. JAMA 324, 131–132 (2020).', 'journal-title': 'JAMA'}, { 'key': '19056_CR9', 'doi-asserted-by': 'publisher', 'first-page': '1787', 'DOI': '10.1056/NEJMoa2001282', 'volume': '382', 'author': 'B Cao', 'year': '2020', 'unstructured': 'Cao, B. et al. A trial of Lopinavir-Ritonavir in adults hospitalized ' 'with severe Covid-19. N. Engl. J. Med. 382, 1787–1799 (2020).', 'journal-title': 'N. Engl. J. Med.'}, { 'key': '19056_CR10', 'doi-asserted-by': 'publisher', 'first-page': '1569', 'DOI': '10.1016/S0140-6736(20)31022-9', 'volume': '395', 'author': 'Y Wang', 'year': '2020', 'unstructured': 'Wang, Y. et al. Remdesivir in adults with severe COVID-19: a randomised, ' 'double-blind, placebo-controlled, multicentre trial. Lancet 395, ' '1569–1578 (2020).', 'journal-title': 'Lancet'}, { 'key': '19056_CR11', 'unstructured': 'Beigel, J. H. et al. Remdesivir for the treatment of ' 'Covid-19—preliminary report. N. Engl. J. Med.\xa0In press (2020).'}, { 'key': '19056_CR12', 'doi-asserted-by': 'publisher', 'first-page': '396', 'DOI': '10.1016/j.ijid.2020.06.099', 'volume': '97', 'author': 'S Arshad', 'year': '2020', 'unstructured': 'Arshad, S. et al. Treatment with hydroxychloroquine, azithromycin, and ' 'combination in patients hospitalized with COVID-19. Int. J. Infect. Dis. ' '97, 396–403 (2020).', 'journal-title': 'Int. J. Infect. Dis.'}, { 'key': '19056_CR13', 'doi-asserted-by': 'crossref', 'unstructured': 'Magagnoli, J. et al. Outcomes of hydroxychloroquine usage in United ' 'States veterans hospitalized with COVID-19. Med\xa0In press (2020).', 'DOI': '10.1101/2020.04.16.20065920'}, { 'key': '19056_CR14', 'doi-asserted-by': 'publisher', 'first-page': '465', 'DOI': '10.1038/s41586-020-2196-x', 'volume': '581', 'author': 'R Wolfel', 'year': '2020', 'unstructured': 'Wolfel, R. et al. Virological assessment of hospitalized patients with ' 'COVID-2019. Nature 581, 465–469 (2020).', 'journal-title': 'Nature'}, { 'key': '19056_CR15', 'doi-asserted-by': 'publisher', 'DOI': '10.1186/s13063-020-04420-0', 'volume': '21', 'author': 'MN Lyngbakken', 'year': '2020', 'unstructured': 'Lyngbakken, M. N. et al. Norwegian Coronavirus Disease 2019 (NO ' 'COVID-19) Pragmatic Open label Study to assess early use of ' 'hydroxychloroquine sulphate in moderately severe hospitalised patients ' 'with coronavirus disease 2019: a structured summary of a study protocol ' 'for a randomised controlled trial. Trials 21, 485 (2020).', 'journal-title': 'Trials'}, { 'key': '19056_CR16', 'unstructured': 'Royal College of Physicians. National Early Warning Score (NEWS) 2: ' 'standardising the assessment of acute-illness severity in the NHS. ' 'Updated report of a working party. ' 'https://www.rcplondon.ac.uk/projects/outputs/national-early-warning-score-news-2. ' 'Accessed 1 April 2020.'}, { 'key': '19056_CR17', 'first-page': '2000045', 'volume': '25', 'author': 'VM Corman', 'year': '2020', 'unstructured': 'Corman, V. M. et al. Detection of 2019 novel coronavirus (2019-nCoV) by ' 'real-time RT-PCR. Eur. Surveill. 25, 2000045 (2020).', 'journal-title': 'Eur. Surveill.'}, { 'key': '19056_CR18', 'doi-asserted-by': 'publisher', 'first-page': '1350', 'DOI': '10.1126/science.2999980', 'volume': '230', 'author': 'RK Saiki', 'year': '1985', 'unstructured': 'Saiki, R. K. et al. Enzymatic amplification of beta-globin genomic ' 'sequences and restriction site analysis for diagnosis of sickle cell ' 'anemia. Science 230, 1350–1354 (1985).', 'journal-title': 'Science'}], 'container-title': 'Nature Communications', 'original-title': [], 'language': 'en', 'link': [ { 'URL': 'https://www.nature.com/articles/s41467-020-19056-6.pdf', 'content-type': 'application/pdf', 'content-version': 'vor', 'intended-application': 'text-mining'}, { 'URL': 'https://www.nature.com/articles/s41467-020-19056-6', 'content-type': 'text/html', 'content-version': 'vor', 'intended-application': 'text-mining'}, { 'URL': 'https://www.nature.com/articles/s41467-020-19056-6.pdf', 'content-type': 'application/pdf', 'content-version': 'vor', 'intended-application': 'similarity-checking'}], 'deposited': { 'date-parts': [[2022, 12, 6]], 'date-time': '2022-12-06T01:23:10Z', 'timestamp': 1670289790000}, 'score': 1, 'resource': {'primary': {'URL': 'https://www.nature.com/articles/s41467-020-19056-6'}}, 'subtitle': [], 'short-title': [], 'issued': {'date-parts': [[2020, 10, 20]]}, 'references-count': 18, 'journal-issue': {'issue': '1', 'published-online': {'date-parts': [[2020, 12]]}}, 'alternative-id': ['19056'], 'URL': 'http://dx.doi.org/10.1038/s41467-020-19056-6', 'relation': {}, 'ISSN': ['2041-1723'], 'subject': [ 'General Physics and Astronomy', 'General Biochemistry, Genetics and Molecular Biology', 'General Chemistry', 'Multidisciplinary'], 'container-title-short': 'Nat Commun', 'published': {'date-parts': [[2020, 10, 20]]}, 'assertion': [ { 'value': '12 July 2020', 'order': 1, 'name': 'received', 'label': 'Received', 'group': {'name': 'ArticleHistory', 'label': 'Article History'}}, { 'value': '25 September 2020', 'order': 2, 'name': 'accepted', 'label': 'Accepted', 'group': {'name': 'ArticleHistory', 'label': 'Article History'}}, { 'value': '20 October 2020', 'order': 3, 'name': 'first_online', 'label': 'First Online', 'group': {'name': 'ArticleHistory', 'label': 'Article History'}}, { 'value': 'The authors declare no competing interests.', 'order': 1, 'name': 'Ethics', 'group': {'name': 'EthicsHeading', 'label': 'Competing interests'}}], 'article-number': '5284'}
Late treatment
is less effective
Please send us corrections, updates, or comments. c19early involves the extraction of 100,000+ datapoints from thousands of papers. Community updates help ensure high accuracy. Treatments and other interventions are complementary. All practical, effective, and safe means should be used based on risk/benefit analysis. No treatment 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.
  or use drag and drop   
Submit