Virological and Clinical Cure in Covid‐19 Patients Treated with Hydroxychloroquine: A Systematic Review and Meta‐Analysis

Abstract

Background: Following the demonstration of efficacy of hydroxychloroquine against SARS‐CoV‐2 in‐vitro, many trials started to evaluate its efficacy in clinical settings. However, no systematic review and meta‐analysis has addressed the issue of safety and efficacy of hydroxychloroquine (HCQ) in COVID‐19. Methods: We conducted a systematic review and metaanalysis 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. Result: We searched 16 literature databases out of which seven studies (n=1358) were included in the systematic review. In terms of clinical cure, 2 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 radiological progression of lung disease (OR 0.31, 0.11‐0.9). No difference was observed in virological cure (OR 2.37, 0.13‐44.53), death or clinical worsening of disease (OR 1.37, 1.37‐21.97) and safety (OR 2.19, 0.59‐8.18), when compared to the control/conventional treatment. Five studies reported either the safety or efficacy of HCQ + Azithromycin. Although seems safe and effective, more data is required for a definitive conclusion. 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.