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
Recovery time 29% improvement lower risk ← → higher 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) c19early.org Niwas et al., Advances in Respiratory .., Nov 2020 0 0.5 1 1.5 2+ RR
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.
Lower risk for mortality, hospitalization, progression, recovery, cases, and viral clearance.
No treatment is 100% effective. Protocols combine treatments.
6,300+ studies for 210+ treatments. c19early.org
Meta Analysis
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 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.
This study is excluded in the after exclusion results of meta analysis: excessive unadjusted differences between groups.
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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: rniwasaiims@gmail.com.
$0 $500 $1,000+ Efficacy vs. cost for COVID-19 treatment protocols c19early.org December 2025 India United Kingdom Russia USA Sudan Angola Colombia Kenya Mozambique Pakistan Argentina Vietnam Peru Philippines Spain Brazil Italy France Japan China Uzbekistan Nepal Ethiopia Iran Ghana Mexico South Korea Germany Bangladesh Saudi Arabia Algeria Morocco Yemen Poland Uganda Venezuela Nigeria Egypt Bolivia Taiwan Zambia Fiji Bosnia-Herzegovina Ukraine Côte d'Ivoire Bulgaria Greece Slovakia Singapore Iceland New Zealand Czechia Mongolia Israel Trinidad and Tobago Hong Kong North Macedonia Belarus Qatar Panama Serbia CAR Chad Syria India favored low-cost treatments.The average efficacy of treatments was moderate.Low-cost treatments improve early treatment, andprovide complementary/synergistic benefits. More effective More expensive 75% 50% 25% ≤0%
$0 $500 $1,000+ Efficacy vs. cost for COVID-19treatment protocols worldwide c19early.org December 2025 India United Kingdom Russia USA Sudan Angola Colombia Kenya Mozambique Pakistan Argentina Vietnam Peru Philippines Spain Brazil Italy France Japan China Uzbekistan Nepal Ethiopia Iran Ghana Mexico South Korea Germany Bangladesh Saudi Arabia Algeria Morocco Yemen Poland Thailand Uganda Venezuela Nigeria Egypt Bolivia Taiwan Zambia Fiji Ukraine Côte d'Ivoire Eritrea Bulgaria Greece Slovakia Singapore New Zealand Czechia Mongolia Israel Trinidad and Tobago North Macedonia Belarus Qatar Panama Benin Serbia CAR Syria India favored low-cost treatments.The average efficacy was moderate.Low-cost protocols improve early treatment,and add complementary/synergistic benefits. More effective More expensive 75% 50% 25% ≤0%
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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