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Beneficial effects exerted by hydroxychloroquine in treating COVID-19 patients via protecting multiple organs

Yu et al., Science China Life Sciences, 2020 Aug 3, doi:10.1007/s11427-020-1782-1
Aug 2020  
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Progression to critical 83% Improvement Relative Risk Mortality, HCQ early vs... 85% HCQ for COVID-19  Yu et al.  LATE TREATMENT Is late treatment with HCQ beneficial for COVID-19? Retrospective 2,882 patients in China Lower progression with HCQ (p=0.049) Yu et al., Science China Life Sciences.., Aug 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 411 studies, recognized in 46 countries.
No treatment is 100% effective. Protocols combine treatments. * >10% efficacy, ≥3 studies.
4,400+ studies for 79 treatments.
Retrospective 2,882 patients in China, median age 62, 278 receiving HCQ, median 10 days post hospitalization, showing that HCQ treatment can reduce systemic inflammation and inhibit the cytokine storm, thus protecting multiple organs from inflammatory injuries, such as detoxification in the liver and attenuation of cardiac injury. IL-6 levels significantly reduced after HCQ treatment, p<0.05, and elevated after HCQ withdrawal. The significantly lower dose used here is potentially related to the different observations from the RECOVERY trial results. Authors suggest that treatment should be started as soon as possible.
The 550 patients that were critically ill at baseline are reported in a separate paper. For the non-critically-ill patients at baseline, the proportion of patients that became critically ill was significantly lower for those treated with HCQ.
For the subset of patients that started HCQ treatment early only 1.4% died versus 3.9% for HCQ started late and 9.1% for control patients.
risk of progression to critical, 82.5% lower, RR 0.17, p = 0.049, treatment 1 of 231 (0.4%), control 32 of 1,291 (2.5%), NNT 49, baseline critical cohort reported separately in Yu et al.
risk of death, 85.0% lower, RR 0.15, p = 0.02, treatment 1 of 73 (1.4%), control 238 of 2,604 (9.1%), NNT 13, HCQ treatment started early vs. non-HCQ.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Yu et al., 3 Aug 2020, retrospective, China, peer-reviewed, median age 62.0, 6 authors.
This PaperHCQAll
Abstract: SCIENCE CHINA Life Sciences •LETTER TO THE EDITOR• February 2021 Vol.64 No.2: 330–333 Beneficial effects exerted by hydroxychloroquine in treating COVID-19 patients via protecting multiple organs 1 1 1 2 2,3* Bo Yu , Chenze Li , Peng Chen , Jia Li , Hualiang Jiang 1 & Dao-Wen Wang 1* Division of Cardiology, Department of Internal Medicine and Hubei Key Laboratory of Genetics and Molecular Mechanisms of Cardiological Disorders, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China; State Key Laboratory of Drug Research, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai 201203, China; 3 Shanghai Institute for Advanced Immunochemical Studies and School of Life Science and Technology, Shanghai Tech University, Shanghai 2 201210, China Received May 10, 2020; accepted July 25, 2020; published online August 3, 2020 Citation: Yu, B., Li, C., Chen, P., Li, J., Jiang, H., and Wang, D.W. (2021). Beneficial effects exerted by hydroxychloroquine in treating COVID-19 patients via protecting multiple organs. Sci China Life Sci 64, 330–333. Dear Editor, The coronavirus disease 2019 (COVID-19) pandemic caused by widespread infection with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Chen et al., 2020; Guan et al., 2020) has led to a global health crisis. More than 3.5 million infections and 246,838 deaths have occurred as of May 4, 2020 (Saqrane and El Mhammedi, 2020), with a rapid upward trend. Many COVID-19 patients suffer from complicated systemic injuries such as cardiac (Chen et al., 2020) and hepatic (Huang et al., 2020) damages. There are currently no specific drugs on the market to treat COVID-19-induced systemic injuries (Ni et al., 2020). A study by our group has demonstrated that hydroxychloroquine (HCQ) administration dramatically reduces the fatality of critically ill COVID-19 patients (Yu et al., 2020). In the present study, we investigated whether HCQ treatment has the ability to protect multiple organs from injuries caused by SARS-CoV-2. In this retrospective study, we extracted data of 2,882 patients (1,427 males and 1,455 females) who were clinically confirmed to have COVID-19 between February 1, 2020, and April 4, 2020, at the Tongji Hospital, Wuhan, China *Corresponding authors (Dao-Wen Wang, email:; Hualiang Jiang, email: (IRBID: TJ-IRB20200229). The median age of all the patients was 62 (50–69) years. Of the 2,882 patients, 550 were diagnosed as critically ill and 2,332 as non-critically ill COVID-19 patients. Additionally, 278 patients (48 critical and 230 non-critical) received oral HCQ treatment (200 mg twice a day) for 7–10 days and comprised the HCQ group; the remaining 2,604 patients did not receive the HCQ treatment and comprised the NHCQ group (Figure S1 in Supporting Information). In all the HCQ-treated patients, the median time to start HCQ administration was 10 (5–15) days after hospitalization. The baseline characteristics of the patients in these two groups are listed in Table S1 in Supporting Information. In total, of the 2,882 COVID-19 patients, 247 died (fatality rate, 8.6%); all the deaths occurred in critically ill patients (44.9%), including 9/48 (18.8%) patients from the HCQ group and 238/502 (47.4%) patients from the NHCQ group (P<0.001) (Yu et al., 2020). In the HCQ..
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Late treatment
is less effective
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