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All Studies   Meta Analysis    Recent:   
0 0.5 1 1.5 2+ Viral clearance 66% Improvement Relative Risk HCQ  Purwati et al.  LATE TREATMENT  DB RCT Is late treatment with HCQ beneficial for COVID-19? Double-blind RCT 240 patients in Indonesia (July - August 2020) Improved viral clearance with HCQ (p<0.000001) Purwati et al., Biochemistry Research .., Feb 2021 Favors HCQ Favors control

A Randomized, Double-Blind, Multicenter Clinical Study Comparing the Efficacy and Safety of a Drug Combination of Lopinavir/Ritonavir-Azithromycin, Lopinavir/Ritonavir-Doxycycline, and Azithromycin-Hydroxychloroquine for Patients Diagnosed with Mild to Moderate COVID-19 Infections

Purwati et al., Biochemistry Research International, doi:10.1155/2021/6685921
Feb 2021  
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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.
RCT 754 patients comparing HCQ+AZ along with other treatment groups using lopinavir/ritonavir and doxycycline to a control group taking AZ, finding significantly faster viral clearance with all treatment groups. (The labels in Figure 2 appear to be reversed).
risk of no viral clearance, 66.3% lower, RR 0.34, p < 0.001, treatment 38 of 121 (31.4%), control 111 of 119 (93.3%), NNT 1.6, day 7.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Purwati et al., 9 Feb 2021, Double Blind Randomized Controlled Trial, Indonesia, peer-reviewed, 29 authors, study period July 2020 - August 2020.
This PaperHCQAll
A Randomized, Double-Blind, Multicenter Clinical Study Comparing the Efficacy and Safety of a Drug Combination of Lopinavir/Ritonavir-Azithromycin, Lopinavir/Ritonavir-Doxycycline, and Azithromycin-Hydroxychloroquine for Patients Diagnosed with Mild to Moderate COVID-19 Infections
Purwati, Budiono, Brian Eka Rachman, Yulistiani, Andang Miatmoko, Nasronudin, Soroy Lardo, Yongki Iswandi Purnama, Mafidhatul Laely, Ike Rochmad, Taufik Ismail, Sri Wulandari, Dwi Setyawan, Alfian Nur Rosyid, Herley Windo Setiawan, Prastuti Asta Wulaningrum, Tri Pudy Asmarawati, Erika Marfiani, Shinta Karina Yuniati, Muhammad Rabiul Fuadi, Pepy Dwi Endraswari, Purwaningsih, Eryk Hendrianto, Deya Karsari, Aristika Dinaryanti, Nora Ertanti, Igo Syaiful Ihsan, Disca Sandyakala Purnama, Yuni Indrayani
Biochemistry Research International, doi:10.1155/2021/6685921
ritonavir and 500 mg of azithromycin; and Group E treated with a 400/100 mg dose of lopinavir/ritonavir and 200 mg of doxycycline. Results. 754 subjects participated in this study: 694 patients (92.4%) who presented mild symptoms and 57 patients (7.6%) classified as suffering from a moderate case of COVID-19. On the third day after treatment, 91.7%-99.2% of the subjects in Groups A-E were confirmed negative by a PCR swab test compared to 26.9% in the Control group. Observation of all groups which experienced a significant decrease in virus load between day 1 and day 7 was undertaken. Other markers, such as CRP and IL-6, were significantly lower in all treatment groups (p < 0.05 and p < 0.0001) than in the Control group. Furthermore, IL-10 and TNF-α levels were significantly elevated in all treatment groups (p < 0.0001). e administration of azithromycin to the Control group increased CRP and IL-6 levels, while reduced IL-10 and TNF-α on day 7 (p < 0.0001) compared with day 1. Decreases in ALT and AST levels were observed in all groups (p < 0.0001). ere was an increase in creatinine in the serum level of the Control, C, D, and E groups (p < 0.05), whereas the BUN level was elevated in all groups (p < 0.0001). Conclusions. e study findings suggest that the administration of lopinavir/ritonavir-doxycycline, lopinavir/ritonavir-azithromycin, and azithromycinhydroxychloroquine as a dual drug combination produced a significantly rapid PCR conversion rate to negative in three-day treatment of mild to moderate COVID-19 cases. Further studies should involve observation of older patients with severe clinical symptoms in order to collate significant amounts of demographic data.
Ethical Approval e researchers conducted the clinical trials across multicenter sites through collaboration between Universitas Airlangga, the Indonesian Intelligence Agency (BIN), and the Indonesian National Army (TNI-AD). is study was conducted in strict accordance with the approved clinical trial protocols (PPUK) provided by BPOM (No. PP. with an additional letter of approval from the National Institute of Health Research and Development, Indonesian Ministry of Health (Balitbangkes Kementerian Kesehatan RI), and ethical approval no. 159/KEP/2020 issued by the Ethics Committee of Universitas Airlangga Hospital (RS UNAIR) on June 23, 2020. e documents submitted to secure PPUK clearance can be found at the following URL:� registry_trial_detail&code_trial�11202034090121TX6YYSS. Conflicts of Interest e authors declare no conflicts of interest regarding this work.
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Hundt, Deng, Ciarleglio, Nathanson, Lim, Abnormal liver tests in COVID-19: a retrospective observational cohort study of 1827 patients in a major US hospital network, Hepatology
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Kim, Kim, Kwon, Lopinavir-ritonavir versus hydroxychloroquine for viral clearance and clinical improvement in patients with mild to moderate coronavirus disease 2019, e Korean Journal of Internal Medicine
Li, Akbarshahi, Bjermer, Uller, Azithromycin induces anti-viral effects in cultured bronchial epithelial cells from COPD patients, Scientific Reports
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Wang, Wu, Zhang, C-reactive protein level may predict the risk of COVID-19 aggravation, Open Forum Infectious Diseases
Wu, Zhao, Qu, Detectable serum SARS-CoV-2 viral load (RNAaemia) is closely associated with drastically elevated interleukin 6 (IL-6) level in critically ill COVID-19 patients, medRxiv
Xu, Yu, Shen, Analysis of inflammatory parameters and disease severity for 88 hospitalized COVID-19 patients in Wuhan, China, International Journal of Medical Sciences
Yao, Ye, Zhang, In vitro antiviral activity and projection of optimized dosing design of hydroxychloroquine for the treatment of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), Clinical Infectious Diseases
Zengyu, Huang, Guo, Association of inflammatory markers with the severity of COVID-19: a metaanalysis, International Journal of Infectious Diseases
Zhang, Wang, Yue, Nucleocapsid protein of SARS-CoV activates interleukin-6 expression through cellular transcription factor NF-κB, Virology
Zhang, Zhou, Yan, Correlation between cytokines and coagulation-related parameters in patients with coronavirus disease 2019 admitted to ICU, Clinica Chimica Acta
Late treatment
is less effective
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