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Hydroxychloroquine treatment in COVID-19: a descriptive observational analysis of 30 cases from a single center in Wuhan, China

Xue et al., J. Med. Virology, June 17, 2020, doi:10.1002/jmv.26193
Jun 2020  
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30 hospitalized patients. Early use of HCQ is more effective, 43% reduction in progression from moderate to severe. "Early" is relative here, within 7 days of hospitalization.
Xue et al., 17 Jun 2020, peer-reviewed, 7 authors.
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Hydroxychloroquine treatment in COVID‐19: A descriptive observational analysis of 30 cases from a single center in Wuhan, China
Huiying Xue, Yi Liu, Pan Luo, Xiulan Liu, Lin Qiu, Dong Liu, Juan Li
Journal of Medical Virology, doi:10.1002/jmv.26193
Hydroxychloroquine (HCQ) garnered scientific attention in early February following publication of reports showing in vitro activity of chloroquine (CQ) against COVID-19. While studies are mixed on this topic, the therapeutic effect of HCQ or CQ still need more valid clinical evidence. In this descriptive observational study, we aimed to discuss the treatment response of HCQ in COVID-19 infected patients and 30 cases were included. The demographic, treatment, laboratory parameters of C-reactive protein (CRP) and interleukin-6 (IL-6) before and after HCQ therapy and clinical outcome in the 30 COVID-19 patients were assessed. In order to evaluate the effect of mediation time point, we also divided these cases into two groups, patients began administrated with HCQ within 7 days hospital (defined as early delivery group) and 7 days after hospital (defined as later delivery group). We found that, the elevated IL-6, a risk factor in severe patients were reduced to normal level after HCQ treatment. More importantly, patients treated with HCQ at the time of early hospital recovered faster than those who treated later or taken as second line choose for their obvious shorter hospitalization time. In summary, early use of HCQ was better than later use and the effect of IL-6 and CRP level can not be ruled out.
Accepted Article Discussion COVID-19, the novel coronavirus also named SARS-CoV-2, shares about 80% of the genetic sequence with SARS-CoV 7, 8 . Additionally, COVID-19 shares the same cell entry receptor, ACE2, with SARS-CoV 9 . HCQ and CQ inhibit receptor binding and membrane fusion, two key steps that are required for cell entry by coronaviruses. CQ has been shown to exert an antiviral effect during preand post-infection conditions by interfering with the glycosylation of angiotensinconverting enzyme 2 (ACE2) (the cellular receptor of SARS-CoV) and blocking virus fusion with the host cell 6, 10 . On March 31st, published data of the first completed randomized clinical trial in Wuhan investigating the efficacy of HCQ in patients with COVID-19. The clinical research included 62 patients, and reported significant difference in time to clinical recovery (TTCR) and radiologic findings between the groups. Despite this, the evidence regarding its effect remains limited 11 . A retrospective analysis of 1061 cases reported that administration of the HCQ+AZ combination before COVID-19 complications occur is safe and associated with a very low fatality rate in patients 12 . However, another retrospective study of 1317 cases reported that no significant difference was found in terms of rates of usage of HCQ or CQ between those who were found positive for SARS-CoV-2 and those who were found negative 13 . On the whole, the exact effect is highly controversial...
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Late treatment
is less effective
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