Treatment of COVID-19 patients with hydroxychloroquine or chloroquine: A retrospective analysis
et al., Research Square, doi:10.21203/rs.3.rs-119202/v1, Jan 2021
HCQ for COVID-19
1st treatment shown to reduce risk in
March 2020, now with p < 0.00000000001 from 424 studies, used in 59 countries.
No treatment is 100% effective. Protocols
combine treatments.
6,200+ studies for
200+ treatments. c19early.org
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Small retrospective database analysis of 37 late stage patients hospitalized in an intensive care center in China, not finding a significant difference in viral shedding. Pateints were all in serious condition. There was only one death however the group is not specified. Confounding by indication is likely.
Viral load measured by PCR may not accurately reflect infectious virus measured by viral culture. Porter et al. 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.
Standard of Care (SOC) for COVID-19 in the study country,
China, is average with moderate efficacy for approved treatments2.
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time to viral-, 40.0% higher, relative time 1.40, p = 0.06, treatment 18, control 19.
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| Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates |
Li et al., 12 Jan 2021, retrospective, database analysis, China, preprint, 5 authors.
Treatment of COVID-19 patients with hydroxychloroquine or chloroquine: A retrospective analysis
doi:10.21203/rs.3.rs-119202/v1
Background There is an urgent need for an effective treatment to cure patients with COVID-19 and reduce the duration of viral shedding.
Methods We conducted a retrospective study using data from the electronic medical records of patients with confirmed SARS-CoV-2 infection who were hospitalized in the E1-4 intensive care center of Guanggu Hospital, Wuhan City, Hubei Province, China, from February 11, 2020, to March 23, 2020. According to the diagnostic results, the hospitalized patients were divided into the experimental group treated with hydroxychloroquine (HCQ) or chloroquine (CQ) and the control group only treated with conventional therapy without HCQ or CQ. The main outcome was the clearance rate of SARS-CoV-2.
Results A total of 37 patients were evaluated. Eighteen patients were assigned to the HCQ or CQ group, and 19 were assigned to the routine treatment group. Treatment with HCQ or CQ was not associated with a difference from routine treatment in the viral shedding duration (median, 14 days vs. 10 days; hazard ratio for viral shedding, 0.393; 95% confidence interval [CI], 0.151 to 1.022; P=0.056). No significant difference in the viral shedding rate was observed between the groups at any time point (7 days, 14 days, 21 days, 28 days and the end point).
Conclusion Although this is a retrospective analysis, the results suggest that treatment with HCQ or CQ had no impact on the duration of viral shedding.
Declaration of competing interests The authors have no conflicts of interest or financial ties to disclose.
References
Colson, Rolain, Raoult, Chloroquine for the 2019 novel coronavirus SARS-CoV-2
Sun, Lu, Xu, Understanding of COVID-19 based on current evidence, J
Touret, De Lamballerie, Of chloroquine and COVID-19, J]. Antiviral Res, doi:10.1016/j.antiviral.2020.104762
Zhou, Yu, Du, Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study
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Late treatment
is less effective
is less effective
