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The Role of Hydroxychloroquine in Covid-19 Treatment: A Systematic Review and Meta-Analysis Publisher Pubmed



Shamshirian A1, 2 ; Hessami A3, 4 ; Heydari K2, 3 ; Alizadehnavaei R2 ; Ebrahimzadeh MA5 ; Yip GW6 ; Ghasemian R7 ; Sedaghat M8 ; Baradaran H9 ; Yazdi SM10 ; Aboufazeli E11 ; Jafarpour H3 ; Dadgostar E12 ; Tirandazi B13 Show All Authors
Authors
  1. Shamshirian A1, 2
  2. Hessami A3, 4
  3. Heydari K2, 3
  4. Alizadehnavaei R2
  5. Ebrahimzadeh MA5
  6. Yip GW6
  7. Ghasemian R7
  8. Sedaghat M8
  9. Baradaran H9
  10. Yazdi SM10
  11. Aboufazeli E11
  12. Jafarpour H3
  13. Dadgostar E12
  14. Tirandazi B13
  15. Sadeghnezhad R14
  16. Karimifar K15
  17. Eftekhari A15
  18. Shamshirian D16
Show Affiliations
Authors Affiliations
  1. 1. Department of Medical Laboratory Sciences, Student Research Committee, School of Allied Medical Science, Mazandaran University of Medical Sciences, Sari, Iran
  2. 2. Gastrointestinal Cancer Research Center, Non-Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
  3. 3. Student Research Committee, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
  4. 4. Systematic Review and Meta-Analysis Expert Group (SRMEG), Universal Scientific Education and Research Network (USERN), Tehran, Iran
  5. 5. Pharmaceutical Sciences Research Center, Department of Medicinal Chemistry, School of Pharmacy, Mazandaran University of Medical Science, Sari, Iran
  6. 6. Department of Anatomy, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
  7. 7. Antimicrobial Resistance Research Center, Department of Infectious Diseases, Mazandaran University of Medical Sciences, Sari, Iran
  8. 8. Department of Internal Medicine, Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  9. 9. Clinical Pharmacy Department, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
  10. 10. Student Research Committee, Kashan University of Medical Sciences, Kashan, Iran
  11. 11. Department of Research and Development, IRAN NAJO Pharmaceutical Company, Tehran, Iran
  12. 12. Department of Psychiatry, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
  13. 13. Department of Physical Medicine and Rehabilitation, Neuromusculoskeletal Research Center, Iran University of Medical Sciences, Tehran, Iran
  14. 14. Student Research Committee, Faculty of Health, Health Sciences Research Center, Mazandaran University of Medical Sciences, Sari, Iran
  15. 15. Student Research Committee, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
  16. 16. Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran

Source: Annals of the Academy of Medicine Singapore Published:2020


Abstract

Objective: A systematic review and meta-analysis was carried out to examine the role of hydroxychloroquine (HCQ) in the treatment of COVID-19. Methods: We performed a systematic search in PubMed, Scopus, Embase, Cochrane-Library, Web of Science, Google Scholar, and medRxiv pre-print databases using available MeSH terms for COVID-19 and hydroxychloroquine. Data from all studies that focused on the effectiveness of HCQ with or without the addition of azithromycin (AZM) in confirmed COVID-19 patients, which were published up to 12 September 2020, were collated for analysis using CMA v.2.2.064. Results: Our systematic review retrieved 41 studies. Among these, 37 studies including 45,913 participants fulfilled the criteria for subsequent meta-analysis. The data showed no significant difference in treatment efficacy between the HCQ and control groups (RR: 1.02, 95% CI, 0.81–1.27). Combination of HCQ with AZM also did not lead to improved treatment outcomes (RR: 1.26, 95% CI, 0.91–1.74). Furthermore, the mortality difference was not significant, neither in HCQ treatment group (RR: 0.86, 95% CI, 0.71–1.03) nor in HCQ plus AZM treatment group (RR: 1.28, 95% CI, 0.76–2.14) in comparison to controls. Meta-regression analysis showed that age was the factor that significantly affected mortality (P<0.00001). Conclusion: The meta-analysis found that there was no clinical benefit of using either HCQ by itself or in combination with AZM for the treatment of COVID-19 patients. Hence, it may be prudent for clinicians and researchers to focus on other therapeutic options that may show greater promise in this disease. © 2020, Academy of Medicine Singapore. All rights reserved.
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