Health Management and Economics Research Center, Health Management Research Institute, Iran University of Medical Sciences, Tehran, Iran.
John G. Rangos School of Health Sciences, Duquesne University, 600 Forbes Ave, Pittsburgh, PA, 15282, USA.
Sci Rep. 2021 Jun 7;11(1):11974. doi: 10.1038/s41598-021-91089-3.
The efficacy and safety of Hydroxychloroquine (HCQ) in treating coronavirus disease (COVID-19) is disputed. This systematic review and meta-analysis aimed to examine the efficacy and safety of HCQ in addition to standard of care (SOC) in COVID-19. PubMed, the Cochrane Library, Embase, Web of sciences, and medRxiv were searched up to March 15, 2021. Clinical studies registry databases were also searched for identifying potential clinical trials. The references list of the key studies was reviewed to identify additional relevant resources. The quality of the included studies was evaluated using the Cochrane Collaboration tool and Jadad checklist. Meta-analysis was performed using RevMan software (version 5.3). Eleven randomized controlled trials with a total number of 8161 patients were identified as eligible for meta-analysis. No significant differences were observed between the two treatment groups in terms of negative rate of polymerase chain reaction (PCR) (Risk ratio [RR]: 0.99, 95% confidence interval (CI) 0.90, 1.08; P = 0.76), PCR negative conversion time (Mean difference [MD]: - 1.06, 95% CI - 3.10, 0.97; P = 0.30), all-cause mortality (RR: 1.09, 95% CI 1.00, 1.20; P = 0.06), body temperature recovery time (MD: - 0.64, 95% CI - 1.37, 0.10; P = 0.09), length of hospital stay (MD: - 0.17, 95% CI - 0.80, 0.46; P = 0.59), use of mechanical ventilation (RR: 1.12, 95% CI 0.95, 1.32; P = 0.19), and disease progression (RR = 0.82, 95% CI 0.37, 1.85; P = 0.64). However, there was a significant difference between two groups regarding adverse events (RR: 1.81, 95% CI 1.36, 2.42; P < 0.05). The findings suggest that the addition of HCQ to SOC has no benefit in the treatment of hospitalized patients with COVID-19. Additionally, it is associated with more adverse events.
羟氯喹（HCQ）治疗冠状病毒病（COVID-19）的疗效和安全性存在争议。本系统评价和荟萃分析旨在研究 HCQ 联合标准治疗（SOC）在 COVID-19 中的疗效和安全性。检索了 PubMed、Cochrane 图书馆、Embase、Web of Sciences 和 medRxiv，检索时间截至 2021 年 3 月 15 日。还检索了临床试验注册数据库，以确定潜在的临床试验。综述了关键研究的参考文献，以确定其他相关资源。使用 Cochrane 协作工具和 Jadad 清单评估纳入研究的质量。使用 RevMan 软件（版本 5.3）进行荟萃分析。确定了 11 项符合条件的随机对照试验，共 8161 例患者纳入荟萃分析。两组在聚合酶链反应（PCR）阴性率（风险比[RR]：0.99，95%置信区间[CI]：0.90，1.08；P=0.76）、PCR 阴性转换时间（均数差[MD]：-1.06，95%CI：-3.10，0.97；P=0.30）、全因死亡率（RR：1.09，95%CI：1.00，1.20；P=0.06）、体温恢复时间（MD：-0.64，95%CI：-1.37，0.10；P=0.09）、住院时间（MD：-0.17，95%CI：-0.80，0.46；P=0.59）、机械通气使用率（RR：1.12，95%CI：0.95，1.32；P=0.19）和疾病进展（RR：0.82，95%CI：0.37，1.85；P=0.64）方面无显著差异。然而，两组之间的不良事件存在显著差异（RR：1.81，95%CI：1.36，2.42；P<0.05）。研究结果表明，HCQ 联合 SOC 治疗住院 COVID-19 患者没有益处，反而会增加不良事件。
