Virological and clinical cure in COVID-19 patients treated with hydroxychloroquine: A systematic review and meta-analysis.

羟氯喹治疗新型冠状病毒肺炎患者的病毒学和临床治愈: 系统综述和荟萃分析。

  • 影响因子:1.94
  • DOI:10.1002/jmv.25898
  • 作者列表:"Sarma P","Kaur H","Kumar H","Mahendru D","Avti P","Bhattacharyya A","Prajapat M","Shekhar N","Kumar S","Singh R","Singh A","Dhibar DP","Prakash A","Medhi B
  • 发表时间:2020-07-01

:Following the demonstration of the efficacy of hydroxychloroquine against severe acute respiratory syndrome coronavirus 2 in vitro, many trials started to evaluate its efficacy in clinical settings. However, no systematic review and meta-analysis have addressed the issue of the safety and efficacy of hydroxychloroquine (HCQ) in coronavirus disease 2019. We conducted a systematic review and meta-analysis with the objectives of evaluation of safety and efficacy of HCQ alone or in combination in terms of "time to clinical cure," "virological cure," "death or clinical worsening of disease," "radiological progression," and safety. RevMan was used for meta-analysis. We searched 16 literature databases out of which seven studies (n = 1358) were included in the systematic review. In terms of clinical cure, two studies reported possible benefit in "time to body temperature normalization" and one study reported less "cough days" in the HCQ arm. Treatment with HCQ resulted in less number of cases showing the radiological progression of lung disease (odds ratio [OR], 0.31, 95% confidence interval [CI], 0.11-0.9). No difference was observed in virological cure (OR, 2.37, 95% CI, 0.13-44.53), death or clinical worsening of disease (OR, 1.37, 95% CI, 1.37-21.97), and safety (OR, 2.19, 95% CI, 0.59-8.18), when compared with the control/conventional treatment. Five studies reported either the safety or efficacy of HCQ + azithromycin. Although seems safe and effective, more data are required for a definitive conclusion. HCQ seems to be promising in terms of less number of cases with radiological progression with a comparable safety profile to control/conventional treatment. We need more data to come to a definite conclusion.


随着羟氯喹体外抗新型冠状病毒疗效的证实,许多试验开始在临床上评价其疗效。然而,没有系统综述和荟萃分析解决羟氯喹 (HCQ) 治疗冠状病毒疾病 2019 的安全性和有效性问题。我们进行了系统综述和荟萃分析,目的是评价HCQ单独或联合治疗的安全性和疗效,包括 “临床治愈时间” 、 “病毒学治愈” 、 “疾病死亡或临床恶化” 、 “放射学进展” 和安全性。采用RevMan软件进行meta分析。我们检索了 16 个文献数据库,其中 7 项研究 (n = 1358) 被纳入系统综述。在临床治愈方面,两项研究报告了 “体温正常化时间” 的可能获益,一项研究报告了HCQ组的 “咳嗽天数” 较少。HCQ治疗导致肺部疾病放射学进展的病例数较少 (比值比 [OR],0.31,95% 置信区间 [CI],0.11-0.9)。在病毒学治愈 (OR,2.37,95% CI,0.13-44.53),疾病死亡或临床恶化 (or,1.37,95% CI,1.37-21.97) 方面没有观察到差异,与对照/常规治疗相比,安全性 (OR,2.19,95% CI,0.59-8.18)。5 项研究报道了hcq + 阿奇霉素的安全性或有效性。虽然看起来安全有效,但需要更多的数据才能得出明确的结论。就放射学进展的病例数量较少而言,HCQ似乎是有希望的,其安全性与对照/常规治疗相当。我们需要更多的数据来得出明确的结论。



作者列表:["Lim J","Jeon S","Shin HY","Kim MJ","Seong YM","Lee WJ","Choe KW","Kang YM","Lee B","Park SJ"]

METHODS::Since mid-December of 2019, coronavirus disease 2019 (COVID-19) infection has been spreading from Wuhan, China. The confirmed COVID-19 patients in South Korea are those who came from or visited China. As secondary transmissions have occurred and the speed of transmission is accelerating, there are rising concerns about community infections. The 54-year old male is the third patient diagnosed with COVID-19 infection in Korea. He is a worker for a clothing business and had mild respiratory symptoms and intermittent fever in the beginning of hospitalization, and pneumonia symptoms on chest computerized tomography scan on day 6 of admission. This patient caused one case of secondary transmission and three cases of tertiary transmission. Hereby, we report the clinical findings of the index patient who was the first to cause tertiary transmission outside China. Interestingly, after lopinavir/ritonavir (Kaletra, AbbVie) was administered, β-coronavirus viral loads significantly decreased and no or little coronavirus titers were observed.

作者列表:["Zhang W","Du RH","Li B","Zheng XS","Yang XL","Hu B","Wang YY","Xiao GF","Yan B","Shi ZL","Zhou P"]

METHODS::In December 2019, a novel coronavirus (2019-nCoV) caused an outbreak in Wuhan, China, and soon spread to other parts of the world. It was believed that 2019-nCoV was transmitted through respiratory tract and then induced pneumonia, thus molecular diagnosis based on oral swabs was used for confirmation of this disease. Likewise, patient will be released upon two times of negative detection from oral swabs. However, many coronaviruses can also be transmitted through oral-fecal route by infecting intestines. Whether 2019-nCoV infected patients also carry virus in other organs like intestine need to be tested. We conducted investigation on patients in a local hospital who were infected with this virus. We found the presence of 2019-nCoV in anal swabs and blood as well, and more anal swab positives than oral swab positives in a later stage of infection, suggesting shedding and thereby transmitted through oral-fecal route. We also showed serology test can improve detection positive rate thus should be used in future epidemiology. Our report provides a cautionary warning that 2019-nCoV may be shed through multiple routes.

翻译标题与摘要 下载文献
作者列表:["Cheng ZJ","Shan J"]

METHODS::There is a current worldwide outbreak of a new type of coronavirus (2019-nCoV), which originated from Wuhan in China and has now spread to 17 other countries. Governments are under increased pressure to stop the outbreak spiraling into a global health emergency. At this stage, preparedness, transparency, and sharing of information are crucial to risk assessments and beginning outbreak control activities. This information should include reports from outbreak sites and from laboratories supporting the investigation. This paper aggregates and consolidates the virology, epidemiology, clinical management strategies from both English and Chinese literature, official news channels, and other official government documents. In addition, by fitting the number of infections with a single-term exponential model, we report that the infection is spreading at an exponential rate, with a doubling period of 1.8 days.