Chloroquine and hydroxychloroquine for COVID‐19 (multiple reviews)

Added March 28, 2021

What is this? Chloroquine and hydroxychloroquine have been suggested as possible treatments for COVID-19. Several reviews have been done and details of these are available here, including citations and links to the full reviews.

What was found: Currently available research suggests that chloroquine and hydroxychloroquine are not effective as single drug treatments for COVID-19. For example, the Cochrane Review (search up to 15 September 2020) found that hydroxychloroquine does not affect how many COVID-19 patients will die when compared with usual care or placebo (9 studies, 8208 patients; including the findings of the RECOVERY trial).

Currently available research suggests that a combination of hydroxychloroquine and azithromycin does not reduce short-term mortality in patients hospitalized with COVID-19 or risk of hospitalization in outpatients with COVID-19.

What are the reviews:

Citation: Das RR, Jaiswal N, Dev N, et al. Efficacy and safety of Anti-malarial drugs (Chloroquine and Hydroxychloroquine) in treatment of COVID-19 infection: a systematic review and meta-analysis. Frontiers in Medicine. 2020;7:482.

In this rapid review, the authors searched for clinical trials and observational studies of the safety and efficacy of chloroquine and hydroxychloroquine for COVID-19 patients. They did not restrict their searches by date, type or language of publication and searched up to 5 June 2020. They included 6 clinical trials and 11 observational studies (total: 8071 participants).

Citation: Elavarasi A, Prasad M, Seth T, et al. Chloroquine and Hydroxychloroquine for the Treatment of COVID-19: a Systematic Review and Meta-analysis. Journal of General Internal Medicine. 2020:35(11):3308-14.

In this rapid review, the authors searched for studies of the efficacy of chloroquine and hydroxychloroquine for COVID-19 patients. They did not restrict their searches by language of publication and searched for studies published between December 2019 and 8 June 2020. They included 12 cohort studies and 3 randomized trials (total: 10,659 patients).

Citation: Elsawah HK, Elsokary MA, Elrazzaz MG, et al. Hydroxychloroquine for treatment of non-severe COVID‐19 patients: Systematic review and meta‐analysis of controlled clinical trials. Journal of Medical Virology. 2021;93(3):1265-75.

In this rapid review, the authors searched for trials of the efficacy and safety of hydroxychloroquine for COVID-19 patients aged ≥12 years with non-severe disease. They did their search up to 18 July 2020. They included 6 studies (609 patients).

Citation: Hazra S, Chaudhuri AG, Tiwary BK, et al. Matrix metallopeptidase 9 as a host protein target of chloroquine and melatonin for immunoregulation in COVID-19: A network-based meta-analysis. Life Sciences. 2020;257:118096.

In this rapid review, the authors searched for studies examining the use of repurposed drugs for COVID-19 patients. They did not restrict their searches by language of publication and did the search on 23 March 2020. They identified 120 differentially expressed genes and 65 drugs repurposed for COVID-19.

Citation: Kashour Z, Riaz R, Garbati MA, et al. Efficacy of chloroquine or hydroxychloroquine in COVID-19 patients: a systematic review and meta-analysis. Journal of Antimicrobial Chemotherapy. 2021;76(1):30-42.

In this rapid review, the authors searched for studies of the effects of chloroquine or hydroxychloroquine for COVID-19 patients. They did not restrict their searches by date or type of publication and did the search on 17 July 2020. They included 7 randomized trials and 14 cohort studies (total: 20,979 patients).

Citation: Million M, Gautret P, Colson P, et al. Clinical Efficacy of Chloroquine derivatives in COVID-19 Infection: Comparative meta-analysis between the Big data and the real world. New Microbes and New Infections. 2020;38:100709.

In this meta-analysis, the authors searched for comparative studies of the effects of chloroquine derivatives for COVID-19 patients. They did not restrict their searches by date or language of publication and did the search on 27 May 2020. They included 20 studies (105,040 participants).

Citation: Singh B, Ryan H, Kredo T, et al. Chloroquine or hydroxychloroquine for prevention and treatment of COVID‐19. Cochrane Database of Systematic Reviews. 2021;(2):CD013587.

In this Cochrane review, the authors searched for randomized trials of chloroquine or hydroxychloroquine for COVID-19 patients, people at risk of exposure to SARS-CoV-2 or people exposed to SARS-CoV-2. They did not restrict their searches by type or language of publication and did the search up to 15 September 2020. They included 12 trials (8569 participants) of the treatment of COVID-19 and 2 trials (3346 participants) for preventing COVID‐19 in people exposed to SARS‐CoV‐2. They found no trials of chloroquine or hydroxychloroquine for preventing COVID‐19 disease in people at risk of exposure to SARS‐CoV‐2. They identified 122 ongoing trials for treatment or prevention of COVID‐19.

Citation: Siordia JA, Bernaba M, Yoshino K, et al. Systematic and Statistical Review of COVID19 Treatment Trials. SN Comprehensive Clinical Medicine. 2020;2:1120-31.

In this rapid review, the authors searched for studies of drugs to treat COVID-19 patients. They did not restrict their searches by date or language of publication. They do not report the date of their search but the article was accepted for publication on 7 July 2020. The authors included 6 studies of hydroxychloroquine.

Citation: Thoguluva Chandrasekar V, Venkatesalu B, Patel HK, et al. Systematic review and meta‐analysis of effectiveness of treatment options against SARS‐CoV‐2 infection. Journal of Medical Virology. 2021;93(2):775-85.

In this rapid review, the authors searched for studies of a variety of interventions for COVID-19 patients. They did not restrict their searches by language of publication and searched for articles published between December 2019 and 11 May 2020. They included 12 studies of hydroxychloroquine-based treatments.

Other reviews relevant to this topic:

Citation: Bhimraj A, Morgan RL, Shumaker AH, et al. Infectious Diseases Society of America Guidelines on the Treatment and Management of Patients With COVID-19. Clinical Infectious Diseases. 2020;ciaa478.

Citation: Cortegiani A, Ingoglia G, Ippolito M, et al. A systematic review on the efficacy and safety of chloroquine for the treatment of COVID-19. Journal of Critical Care. 2020;57:279-83.

Citation: Cortegiani A, Ippolito M, Ingoglia G, et al. A systematic review on the efficacy and safety of chloroquine/hydroxychloroquine for the treatment of COVID-19. Journal of Critical Care. 2020;59:176-90.

Citation: Gbingie K, Frie K. Should chloroquine and hydroxychloroquine be used to treat COVID-19? A rapid review. BJGP Open. 2020;4(2):bjgpopen20X101069.

Citation: Singh AK, Singh A, Shaikh A, et al. Chloroquine and hydroxychloroquine in the treatment of COVID-19 with or without diabetes: A systematic search and a narrative review with a special reference to India and other developing countries. Diabetes & Metabolic Syndrome: Clinical Research & Reviews. 2020;14(3):241-6.

 

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