Department of Infectious Diseases, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan, Taiwan.
Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan.
PLoS One. 2020 Dec 2;15(12):e0242763. doi: 10.1371/journal.pone.0242763. eCollection 2020.
In this study, we evaluated the efficacy of hydroxychloroquine (HCQ) against coronavirus disease 2019 (COVID-19) via a randomized controlled trial (RCT) and a retrospective study.
Subjects admitted to 11 designated public hospitals in Taiwan between April 1 and May 31, 2020, with COVID-19 diagnosis confirmed by pharyngeal real-time RT-PCR for SARS-CoV-2, were randomized at a 2:1 ratio and stratified by mild or moderate illness. HCQ (400 mg twice for 1 d or HCQ 200 mg twice daily for 6 days) was administered. Both the study and control group received standard of care (SOC). Pharyngeal swabs and sputum were collected every other day. The proportion and time to negative viral PCR were assessed on day 14. In the retrospective study, medical records were reviewed for patients admitted before March 31, 2020.
There were 33 and 37 cases in the RCT and retrospective study, respectively. In the RCT, the median times to negative rRT-PCR from randomization to hospital day 14 were 5 days (95% CI; 1, 9 days) and 10 days (95% CI; 2, 12 days) for the HCQ and SOC groups, respectively (p = 0.40). On day 14, 81.0% (17/21) and 75.0% (9/12) of the subjects in the HCQ and SOC groups, respectively, had undetected virus (p = 0.36). In the retrospective study, 12 (42.9%) in the HCQ group and 5 (55.6%) in the control group had negative rRT-PCR results on hospital day 14 (p = 0.70).
Neither study demonstrated that HCQ shortened viral shedding in mild to moderate COVID-19 subjects.
通过一项随机对照试验(RCT)和一项回顾性研究,评估羟氯喹(HCQ)治疗 2019 年冠状病毒病(COVID-19)的疗效。
2020 年 4 月 1 日至 5 月 31 日期间,台湾 11 家指定公立医院收治的经咽拭子实时 RT-PCR 检测 SARS-CoV-2 阳性的 COVID-19 患者,按 2:1 的比例随机分组,并按轻症或中度疾病分层。给予 HCQ(400mg 每日 2 次连用 1 天或 200mg 每日 2 次连用 6 天)。研究组和对照组均接受标准治疗(SOC)。每两天采集咽拭子和痰液,第 14 天评估病毒 PCR 转阴比例和时间。在回顾性研究中,回顾性分析 2020 年 3 月 31 日前入院患者的病历。
RCT 和回顾性研究分别纳入 33 例和 37 例患者。在 RCT 中,随机分组至住院第 14 天,HCQ 组和 SOC 组 rRT-PCR 转阴的中位时间分别为 5 天(95%CI:19 天)和 10 天(95%CI:212 天)(p=0.40)。第 14 天,HCQ 组和 SOC 组分别有 81.0%(17/21)和 75.0%(9/12)的患者病毒检测阴性(p=0.36)。在回顾性研究中,HCQ 组和对照组分别有 12 例(42.9%)和 5 例(55.6%)患者在住院第 14 天 rRT-PCR 检测结果阴性(p=0.70)。
两项研究均未表明 HCQ 缩短了轻症至中度 COVID-19 患者的病毒脱落时间。