Collation Of Hydroxychloroquine Virological Clearance, Effectiveness, Safety In Covid-19 Patients With Control Group (Conventional Therapy) – A Systematic Review And Meta-Analysis

Abstract

Objectives: Destitute of an effective treatment, several potential repurposed drugs have been tried in COVID-19. Despite unavailability of anecdotal evidence, several guidelines granted both Chloroquine (CQ) and Hydroxychloroquine (HCQ) in treatment. Clinical studies relating to those in COVID-19 disease has reported conflicting results. We sought to systematically evaluate the clinical effects contact, mainly in health workers [8]. On March 30, 2020 FDA issued an Emergency Use Authorization (EUA) in order to use both CQ and HCQ in the treatment of COVID-19. FDA issued EUA for the second time in the history. Formerly it was given for an investigational neuraminidase inhibitor, Peramivir during 2009-2010 to treat severely ill patients with H1N1 influenza [9]. The meta-analysis of 5 studies that reported rate of virological clearance or PCR negativity (n=312) found no benefit in HCQ arm. {OR, 1.863; 95% CI, 1.024 to 3.389; p=0.041} with a moderate heterogeneity (I 2 =70.3%, P=0.009). meta-analysis of 5 studies (n=1710) that reported about ADR outcomes found that, there exist an increased risk of ADRs in HCQ arm. {OR, 2.648; 95% CI, 2.068 to 7.717; p=0.000}, with no heterogeneity (I 2 = 0%, P=0.417). 6 studies (n=4,341) showed a significant increase in mortality in HCQ arm when compared with control arm {OR, 1.182; 95% CI, 0.981 to 1.425; p=0.079}, with substantial heterogeneity (I 2 = 82.0%, P=0.000). Conclusions: The systematic review and meta-analysis revealed a reduced antiviral efficacy in reducing mortality, ADR occurrence and has a decreased virological clearance in patients with COVID-19. in COVID-19 patients.