Chen Jun, Liu Danping, Liu Li, Liu Ping, Xu Qingnian, Xia Lu, Ling Yun, Huang Dan, Song Shuli, Zhang Dandan, Qian Zhiping, Li Tao, Shen Yinzhong, Lu Hongzhou
Department of Infection and Immunity, Shanghai Public Health Clinical Center, Fudan University, Shanghai 201508, China.
Zhejiang Da Xue Xue Bao Yi Xue Ban. 2020 May 25;49(2):215-219. doi: 10.3785/j.issn.1008-9292.2020.03.03.
To evaluate the efficacy and safety of hydroxychloroquine (HCQ) in the treatment of patients with moderate coronavirus disease 2019 (COVID-19).
We prospectively enrolled 30 treatment-naïve patients with confirmed COVID-19 after informed consent at Shanghai Public Health Clinical Center. The patients were randomized 1:1 to HCQ group and the control group. Patients in HCQ group were given HCQ 400 mg per day for 5 days plus conventional treatments, while those in the control group were given conventional treatment only. The primary endpoint was negative conversion rate of SARS-CoV-2 nucleic acid in respiratory pharyngeal swab on days 7 after randomization. This study has been approved by the Ethics Committee of Shanghai Public Health Clinical Center and registered online (NCT04261517).
One patient in HCQ group developed to severe during the treatment. On day 7, nucleic acid of throat swabs was negative in 13 (86.7%) cases in the HCQ group and 14 (93.3%) cases in the control group (>0.05). The median duration from hospitalization to virus nucleic acid negative conservation was 4 (1,9) days in HCQ group, which is comparable to that in the control group [2 (1,4) days, Z=1.27, >0.05]. The median time for body temperature normalization in HCQ group was 1 (0,2) day after hospitalization, which was also comparable to that in the control group [1 (0,3) day]. Radiological progression was shown on CT images in 5 cases (33.3%) of the HCQ group and 7 cases (46.7%) of the control group, and all patients showed improvement in follow-up examinations. Four cases (26.7%) of the HCQ group and 3 cases (20%) of the control group had transient diarrhea and abnormal liver function (>0.05).
The prognosis of COVID-19 moderate patients is good. Larger sample size study are needed to investigate the effects of HCQ in the treatment of COVID-19. Subsequent research should determine better endpoint and fully consider the feasibility of experiments such as sample size.
评估羟氯喹(HCQ)治疗中度新型冠状病毒肺炎(COVID-19)患者的疗效和安全性。
在上海公共卫生临床中心,经知情同意后,前瞻性纳入30例初治确诊COVID-19患者。患者按1:1随机分为HCQ组和对照组。HCQ组患者给予HCQ 400mg/d,共5天,加常规治疗,而对照组仅给予常规治疗。主要终点是随机分组后第7天呼吸道咽拭子中SARS-CoV-2核酸的转阴率。本研究已获上海公共卫生临床中心伦理委员会批准并在线注册(NCT04261517)。
HCQ组1例患者在治疗期间病情进展为重症。第7天,HCQ组13例(86.7%)患者咽拭子核酸转阴,对照组14例(93.3%)患者咽拭子核酸转阴(>0.05)。HCQ组从住院到病毒核酸转阴的中位时间为4(1,9)天,与对照组[2(1,4)天,Z=1.27,>0.05]相当。HCQ组体温恢复正常的中位时间为住院后1(0,2)天,也与对照组[1(0,3)天]相当。HCQ组5例(33.3%)患者和对照组7例(46.7%)患者的CT图像显示有影像学进展,所有患者在随访检查中均有改善。HCQ组4例(26.7%)患者和对照组3例(20%)患者出现短暂腹泻和肝功能异常(>0.05)。
中度COVID-19患者预后良好。需要更大样本量的研究来探讨HCQ治疗COVID-19的效果。后续研究应确定更好的终点,并充分考虑样本量等实验的可行性。