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0 0.5 1 1.5 2+ Recovery time 29% Improvement Relative Risk Viral clearance -183% HCQ for COVID-19  Niwas et al.  LATE TREATMENT Is late treatment with HCQ beneficial for COVID-19? Retrospective 29 patients in India Faster recovery with HCQ (p=0.0082) Niwas et al., Advances in Respiratory .., Nov 2020 Favors HCQ Favors control

Clinical outcome, viral response and safety profile of chloroquine in COVID-19 patients — initial experience

Niwas et al., Advances in Respiratory Medicine, doi:10.5603/ARM.a2020.0139
Nov 2020  
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HCQ for COVID-19
1st treatment shown to reduce risk in March 2020
*, now known with p < 0.00000000001 from 422 studies, recognized in 42 countries.
No treatment is 100% effective. Protocols combine complementary and synergistic treatments. * >10% efficacy in meta analysis with ≥3 clinical studies.
4,000+ studies for 60+ treatments.
Retrospective 12 hospitalized patients in India treated with CQ and 17 controls, showing faster recovery with treatment. There was no significant difference in viral clearance. The CQ group mean age was 41.3 vs. 47.6 for controls.
Viral load measured by PCR may not accurately reflect infectious virus measured by viral culture. Porter show that viral load early in infection was correlated with infectious virus, but viral load late in infection could be high even with low or undetectable infectious virus. Assessing viral load later in infection may underestimate reductions in infectious virus with treatment.
This study is excluded in the after exclusion results of meta analysis: excessive unadjusted differences between groups.
recovery time, 29.2% lower, relative time 0.71, p = 0.008, treatment mean 6.3 (±2.7) n=12, control mean 8.9 (±2.2) n=17.
risk of no viral clearance, 183.3% higher, RR 2.83, p = 0.55, treatment 2 of 12 (16.7%), control 1 of 17 (5.9%).
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Niwas et al., 1 Nov 2020, retrospective, India, peer-reviewed, mean age 45.5, 17 authors. Contact:
This PaperHCQAll
Clinical Outcome, Viral Response and Safety Profile of Chloroquine in COVID-19 Patients—Initial Experience
Ram Shahul Niwas, Aneesa Shahul S, M K Garg, Vijaya Lakshmi Nag, Pradeep Kumar Bhatia, Naveen Dutt, Nishant Chauhan, Jaykaran Charan, Shahir Asfahan, Praveen Sharma, Pankaj Bhardwaj, Mithu Banerjee, Pawan Garg, Binit Sureka, Gopal Krishna Bohra, Maya Gopalakrishnan, Sanjeev Misra
Advances in Respiratory Medicine, doi:10.5603/arm.a2020.0139
Introduction: Chloroquine and its analogues are currently being investigated for the treatment and post exposure prophylaxis of COVID-19 due to its antiviral activity and immunomodulatory activity. Material and methods: Confirmed symptomatic cases of COVID-19 were included in the study. Patients were supposed to receive chloroquine (CQ) 500 mg twice daily for 7 days. Due to a change in institutional protocol, initial patients received chloroquine and subsequent patients who did not receive chloroquine served as negative controls. Clinical effectiveness was determined in terms of timing of symptom resolution and conversion rate of reverse transcriptase polymerase chain reaction (RT-PCR) on day 14 and day 15 of admission. Results: Twelve COVID-19 patients formed the treatment arm and 17 patients were included in the control arm. The duration of symptoms among the CQ treated group (6.3 ± 2.7 days) was significantly (p-value = 0.009) lower than that of the control group (8.9 ± 2.2 days). There was no significant difference in the rate of RT-PCR negativity in both groups. 2 patients out of 12 developed diarrhea in the CQ therapy arm. Conclusion: The duration of symptoms among the treated group (with chloroquine) was significantly lower than that of the control group. RT-PCR conversion was not significantly different between the 2 groups.
Conflict of interest None declared.
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Late treatment
is less effective
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