Hong Thomas S, Gonzalez Jimmy, Nahass Ronald G, Brunetti Luigi
Department of Pharmacy Practice and Administration, Ernest Mario School of Pharmacy, Rutgers, The State University of New Jersey, Piscataway, NJ 08854, USA.
Jersey Shore University Hospital, Neptune, NJ 07753, USA.
Pharmacy (Basel). 2020 Nov 5;8(4):208. doi: 10.3390/pharmacy8040208.
Coronavirus disease 2019 (COVID-19) caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has caused significant health and economic havoc around the globe. One of the early agents targeted for repurposing to treat and prevent COVID-19 was hydroxychloroquine (HCQ). In this systematic review and meta-analysis, HCQ is evaluated for its potential role in decreasing mortality in hospitalized patients with COVID-19. We searched PubMed, Web of Science, and medRxiv databases using combinations of the terms "COVID-19", "SARS-CoV-2", "coronavirus", "hydroxychloroquine", and "mortality". Articles were selected for further review based on the content of their abstracts. Studies were excluded if they were of poor methodological quality, were not based in the inpatient setting, or did not have available data to assess the primary outcome of death between patients treated with HCQ versus standard of care. Once the final dataset was compiled, a meta-analysis using the random-effects model was performed. Our search identified 14 studies involving 24,780 patients of whom 12,707 patients were on HCQ alone or in combination with other adjuvant therapies. HCQ alone or in combination with other drugs did not significantly decrease mortality in hospitalized patients with COVID-19 (odds ratio [OR], 0.95; 95% CI, 0.72-1.26; = 0.732; = 91.05). Similar findings were observed in all subgroup analyses. HCQ did not significantly impact mortality in hospitalized patients with COVID-19. Additional well-designed studies are essential due to the heterogeneity in available studies.
由严重急性呼吸综合征冠状病毒2（SARS-CoV-2）引起的2019冠状病毒病（COVID-19）在全球范围内造成了严重的健康和经济破坏。羟氯喹（HCQ）是早期被重新用于治疗和预防COVID-19的药物之一。在这项系统评价和荟萃分析中，评估了HCQ在降低COVID-19住院患者死亡率方面的潜在作用。我们使用“COVID-19”、“SARS-CoV-2”、“冠状病毒”、“羟氯喹”和“死亡率”等术语组合在PubMed、科学网和medRxiv数据库中进行检索。根据摘要内容选择文章进行进一步审查。如果研究方法质量差、不是基于住院患者环境或没有可用数据来评估接受HCQ治疗的患者与标准治疗之间的主要死亡结局，则将其排除。一旦最终数据集编制完成，就使用随机效应模型进行荟萃分析。我们的检索确定了14项研究，涉及24780名患者，其中12707名患者单独使用HCQ或与其他辅助治疗联合使用。单独使用HCQ或与其他药物联合使用并没有显著降低COVID-19住院患者的死亡率（优势比[OR]，0.95；95%置信区间，0.72-1.26；P = 0.732；I² = 91.05）。在所有亚组分析中都观察到了类似的结果。HCQ对COVID-19住院患者的死亡率没有显著影响。由于现有研究存在异质性，因此需要更多设计良好的研究。
