Narrative Review of Chloroquine and Hydroxychloroquine for Treatment of Coronavirus Disease 2019

Division

South Atlantic

Hospital

Orange Park Medical Center

Document Type

Review Article

Publication Date

1-2021

Keywords

sars-cov-2, coronavirus infections, COVID-19, hydroxychloroquine, chloroquine

Disciplines

Critical Care | Infectious Disease | Respiratory Tract Diseases | Virus Diseases

Abstract

Background— There continues to be considerable interest in use of chloroquine and its derivatives for both prevention and treatment of coronavirus disease 2019 (COVID-19) caused by severe respiratory distress syndrome coronavirus 2 (SARS-CoV-2).

Purpose— To perform a brief review on the use of chloroquine and hydroxychloroquine for the treatment of COVID-19, we analyzed the results from randomized control trials and observational studies conducted in both out-patient and inpatient settings.

Data Sources— PubMed and Cochrane Review.

Study Selection— Randomized control trials and observational studies using chloroquine and hydroxychloroquine for the treatment of COVID-19, either published or pre-print available from January 01, 2020 to October 10, 2020.

Data Extraction— We identified one single arm study, 12 case control studies, and seven randomized clinical trials. One reviewer extracted data from all the published studies.

Results— One early randomized study and an underpowered observational cohort suggested a weak statistical sig-nificance in quicker negative reverse transcriptase-polymerase chain reaction assay for SARS-CoV-2; however this did not translate to reduction in 28 day all-cause mortality in the recent large scale clinical trials. Our review revealed two randomized clinical trials in favor of therapeutic used of hydroxychloroquine as compared to four randomized studies suggesting that hydroxychloroquine neither hastens the negative conversion on PCR nor expedite the clinical recovery. We conclude that use of hydroxychloroquine in these patients is non-superior to the standard of care.

Limitations— Majority of the included studies are non-randomized, open-labeled and have small sample size. Not all outcomes were comparable; and there was inconsistent control of confounding variables (such as ethnicity, socio-economic, co-morbidities, the disease severity at the time of study inclusion) which could have limited our analytical review.

Conclusions— Larger scale observational and randomized clinical trials are still warranted to study long-term outcomes and side effects of hydroxychloroquine for the treatment of coronavirus disease.

Publisher or Conference

HealthCare Research Journal

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