The Outcome of Hydroxychloroquine in Patients Treated for COVID-19: Systematic Review and Meta-Analysis.
The Outcome of Hydroxychloroquine in Patients Treated for COVID-19: Systematic Review and Meta-Analysis.
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DOI：
10.1155/2020/4312519
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发表时间：
2020
影响因子：
2.2
通讯作者：
Zeleke Negera G
中科院分区：
文献类型：
--
作者：
Ayele Mega T;Feyissa TM;Dessalegn Bosho D;Kumela Goro K;Zeleke Negera G
由严重急性呼吸综合征冠状病毒2型（SARS-CoV-2）引起的2019年冠状病毒病大流行（COVID - 19）在全球范围内造成了前所未有的公共卫生挑战。尽管全球做出了紧急和广泛的努力，但现有证据表明，用于治疗COVID-19的药物尚无定论。为COVID-19治疗患者联合或不联合阿奇霉素（AZ）使用羟氯喹（HCQ）的临床安全性和有效性提供最新证据。数据源。检索时间为2019/12/30 ~ 2020/05/23，检索时间为PubMed、Cochrane CENTRAL、LITCOVID、Web of Science、SCOPUS、BioRxiv、Embase、MedRxiv和Wiley在线图书馆。研究选择。三位研究者评估了研究的质量。数据提取。有关研究特征、效应估计和研究质量的数据由两名独立审稿人提取，并由第三名审稿人进行交叉检查。合成数据。共纳入6782例（HCQ组3623例，HCQ + AZ组1020例，对照组2139例）。将HCQ与标准护理进行病毒学疗效、疾病进展、死亡率和不良反应的比较。并比较HCQ与HCQ + AZ在QTc延长、入住重症监护病房和死亡率方面的差异。研究发现，HCQ不会改变病毒学治愈率（OR = 0.78; 95% CI: 0.39-1.56）和死亡风险（OR = 1.26; 95% CI: 0.66-2.39）。总死亡率为5.8% （95% CI: 0.9%-10.8%）。此外，HCQ不影响疾病进展（OR = 0.9; 95% CI: 0.36-2.29），但导致不良反应的风险较高（OR = 2.35; 95% CI: 1.15-4.8）。HCQ还与HCQ + AZ进行了比较，在QTc延长500 ms以上（OR = 1.11; 95% CI: 0.54-2.28）、入住重症监护病房（OR = 0.92; 95% CI: 0.52-1.63）和死亡率（OR = 0.88; 95% CI: 0.55-1.43）方面均无差异。然而，在单组研究的分析中，约11.2% （95% CI: 7.0%-15.5%）的患者QTc绝对增加大于500 ms， 4.1% （95% CI: 1.1%-7.1%）的患者停药。这项荟萃分析和系统评价包括有限数量的设计不良的COVID-19患者研究，结果显示HCQ是不可忍受的、不安全的、无效的。同样，在降低死亡率和ICU住院率方面，HCQ + AZ联合治疗与单独使用HCQ没有差异。
The pandemic of coronavirus disease 2019 (COVID‐19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) resulted in an unprecedented public health challenge worldwide. Despite urgent and extensive global efforts, the existing evidence is inconclusive regarding the medications used for the treatment of COVID-19. To generate an up-to-date evidence for the clinical safety and efficacy of hydroxychloroquine (HCQ) with or without azithromycin (AZ) among patients treated for COVID-19. Data Source. PubMed, Cochrane CENTRAL, LITCOVID, Web of Science, SCOPUS, BioRxiv, Embase, MedRxiv, and Wiley online library were searched from 2019/12/30 to 2020/05/23. Study Selection. Three investigators assessed the quality of the studies. Data Extraction. Data about study characteristics, effect estimates, and the quality of the studies were extracted by two independent reviewers and cross-checked by the third reviewer. Data Synthesis. The data of 6,782 (HCQ group, 3623; HCQ + AZ group, 1,020; control group, 2139) participants were included. HCQ was compared with standard care for virologic efficacy, disease progression, mortality, and adverse effects. HCQ was also compared with HCQ + AZ for QTc prolongation, admission to the intensive care unit, and mortality. The study found HCQ did not alter the rate of virologic cure (OR = 0.78; 95% CI: 0.39–1.56) and the risk of mortality (OR = 1.26; 95% CI: 0.66–2.39). The pooled prevalence for mortality was 5.8% (95% CI: 0.9%–10.8%). Moreover, HCQ did not impact disease progression (OR = 0.9; 95% CI: 0.36–2.29) but resulted in a higher risk of adverse effects (OR = 2.35; 95% CI: 1.15–4.8). HCQ was also compared against HCQ + AZ, and no difference was observed in QTc prolongation above 500 ms (OR = 1.11; 95% CI: 0.54–2.28), admission to the intensive care unit (OR = 0.92; 95% CI: 0.52–1.63), and mortality (OR = 0.88; 95% CI: 0.55–1.43). However, in the analysis of single-arm studies, about 11.2% (95% CI: 7.0%–15.5%) of patients have developed an absolute increase of QTc greater than 500 ms, and 4.1% (95% CI: 1.1%–7.1%) of patients discontinued their medication. This meta-analysis and systematic review, which included a limited number of poorly designed studies of patients with COVID-19, revealed HCQ is intolerable, unsafe, and not efficacious. Similarly, HCQ + AZ combination was not different from HCQ alone in curbing mortality and ICU admission.
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影响因子：
5.5
作者：
Chorin, Ehud;Wadhwani, Lalit;Jankelson, Lior
通讯作者：
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DOI：
10.1016/j.ijantimicag.2020.105949
发表时间：
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