Wright Christopher, Ross Carly, Mc Goldrick Niall
Specialty Dentist, Dundee Dental Hospital and School, Scotland, UK.
Clinical Research Fellow/Specialty Registrar in Special Care Dentistry, Dundee Dental Hospital and School, Scotland, UK.
Evid Based Dent. 2020 Jun;21(2):64-65. doi: 10.1038/s41432-020-0098-2.
Data sources The authors of this rapid review did not disclose which electronic databases were included in their literature search. The inclusion and exclusion criteria for the data sources are not reported in the manuscript.Study selection The authors included six studies on the effectiveness of hydroxychloroquine or chloroquine for the prevention and treatment of COVID-19 in humans. Studies comprised of two randomised controlled trials, two non-randomised trials both of which were non-blinded and open-label and one that was uncontrolled, a prospective cohort study and an interim report. The authors did not report details of any studies that were excluded.Data extraction and synthesis The data extraction methodology was not reported and it is unclear if the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines were followed. Treatment regimens and the study outcomes were extracted where available and overall findings were presented in a table. There were no comparable outcome measures; therefore, results were deemed unsuitable to combine and no statistical analyses were carried out. A narrative synthesis of each study is presented.Results The results of the studies in this rapid review are difficult to quantify as each study had different outcome parameters. Due to the heterogeneity of the studies, results were not combined, and no statistical analysis was carried out. Narrative synthesis of each of the included studies identified important and significant limitations, precluding the studies from demonstrating a statistically significant difference in outcomes.Conclusions This review highlights the urgent need for more high quality evidence on the use of hydroxychloroquine and chloroquine in the prevention and treatment of COVID-19. The results of the studies included should be interpreted with caution due to the weak supporting data and numerous methodological limitations. The authors suggested that the studies be viewed as hypothesis-generating and should not be used in decision making around the recommendations and guidelines in the prevention and treatment of COVID-19. There are currently several ongoing randomised controlled trials looking at the effectiveness and efficacy of these drugs on COVID-19. It is hoped the outcome of these studies can help guide future recommendations and national guidelines.
数据来源 本快速综述的作者未披露其文献检索中纳入了哪些电子数据库。稿件中未报告数据来源的纳入和排除标准。
研究选择 作者纳入了六项关于羟氯喹或氯喹对人类预防和治疗新冠病毒病有效性的研究。研究包括两项随机对照试验、两项均为非盲法开放标签的非随机试验以及一项无对照试验、一项前瞻性队列研究和一份中期报告。作者未报告任何被排除研究的细节。
数据提取与综合 未报告数据提取方法,也不清楚是否遵循了系统评价和荟萃分析的首选报告项目(PRISMA)指南。在可行的情况下提取了治疗方案和研究结果,并以表格形式呈现总体研究结果。没有可比较的结局指标;因此,结果被认为不适合合并,未进行统计分析。对每项研究进行了叙述性综合。
结果 由于每项研究的结局参数不同,本快速综述中的研究结果难以量化。由于研究的异质性,未合并结果,也未进行统计分析。对每项纳入研究的叙述性综合发现了重要且显著的局限性,这使得这些研究无法证明结局存在统计学显著差异。
结论 本综述强调迫切需要更多关于羟氯喹和氯喹用于预防和治疗新冠病毒病的高质量证据。由于支持数据薄弱且存在众多方法学局限性,应谨慎解读纳入研究的结果。作者建议将这些研究视为产生假设的研究,不应将其用于围绕新冠病毒病预防和治疗的建议及指南的决策。目前有几项正在进行的随机对照试验,研究这些药物对新冠病毒病的有效性和疗效。希望这些研究的结果能够帮助指导未来的建议和国家指南。