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Other Treatments Global Adoption
Global HCQ/CQ studies
August 13, 2022
427 HCQ COVID-19 studies, 328 peer reviewed, 351 comparing treatment and control groups. HCQ is not effective when used very late with high dosages over a long period (RECOVERY/SOLIDARITY), effectiveness improves with earlier usage and improved dosing. Early treatment consistently shows positive effects. Negative evaluations typically ignore treatment time, often focusing on a subset of late stage studies. In Vitro evidence made some believe that therapeutic levels would not be attained, however that was incorrect, e.g. see [Ruiz]. Recent:
HCQ/CQ has been officially adopted for early treatment in all or part of 35 countries (52 including non-government medical organizations). Submit updates/corrections.
Aug 9
Early, Late, PrEP, PEP Covid Analysis (Preprint) (meta analysis)
meta-analysis v216
HCQ for COVID-19: real-time meta analysis of 351 studies
Details   • Meta analysis using the most serious outcome reported shows 62% [52‑70%] improvement for the 36 early treatment studies. Results are similar after exclusion based sensitivity analysis and after restriction to peer-reviewed st..
Aug 9
Meta García-Albéniz et al., European Journal of Epidemiology, doi:10.1007/s10654-022-00891-4 (preprint 1/25/22) (meta analysis)
cases, ↓28.0%, p=0.003
Systematic review and meta-analysis of randomized trials of hydroxychloroquine for the prevention of COVID-19
Details   Systematic review and meta-analysis of HCQ prophylaxis RCTs showing a statistically significant reduction in cases for pre-exposure prophylaxis. For PEP trials there were very long treatment delays - in one trial about a third of particip..
Aug 5
PrEP Polo et al., Clinical Microbiology and Infection, doi:10.1016/j.cmi.2022.07.006
symp. case, ↓51.0%, p=0.79
Daily tenofovir disoproxil fumarate/emtricitabine and hydroxychloroquine for pre-exposure prophylaxis of COVID-19: a double-blind placebo controlled randomized trial in healthcare workers
Details   Early terminated healthcare worker prophylaxis RCT in Spain, showing lower risk of symptomatic cases with HCQ prophylaxis, without statistical significance due to the small number of events.
Jul 26
Dosing Xu et al., Rapid Communications in Mass Spectrometry, doi:10.1002/rcm.9358 (Dosing)
dosing study
A study of impurities in the repurposed COVID-19 drug hydroxychloroquine sulfate by UHPLC-Q/TOF-MS and LC-SPE-NMR
Details   Analysis of HCQ from two manufacturers showing 9 different impurities, with significantly different concentrations for each manufacturer.
Jul 15
PrEP Patel et al., medRxiv, doi:10.1101/2022.07.13.22277606 (Preprint)
cases, ↓46.3%, p=0.001
Factors Associated with COVID-19 Breakthrough Infection in the Pre-Omicron Era Among Vaccinated Patients with Rheumatic Diseases: A Cohort Study
Details   Retrospective 11,468 vaccinated rheumatic disease patients in the USA, showing lower risk of COVID-19 with HCQ/CQ use compared with all other treatments. Adjusted results are only provided with respect to specific other treatments.
Jul 14
Late Malundo et al., IJID Regions, doi:10.1016/j.ijregi.2022.07.009
death, ↑24.4%, p=0.32
Predictors of Mortality among inpatients with COVID-19 Infection in a Tertiary Referral Center in the Philippines
Details   Retrospective 1,215 hospitalized patients in the Phillipines, showing no significant difference in outcomes with remdesivir or HCQ use in unadjusted results subject to confounding by indication.
Jul 3
PrEP Raabe et al., medRxiv, doi:10.1101/2022.07.01.22277058 (Preprint)
symp. case, ↓82.2%, p=0.17
Hydroxychloroquine pre-exposure prophylaxis to prevent SARS-CoV-2 among health care workers at risk for SARS-CoV-2 exposure: A nonrandomized controlled trial
Details   Small prophylaxis study with 130 healthcare workers in the USA, showing lower symptomatic cases with HCQ prophylaxis, without statistical significance. HCQ participants were significantly older. The only symptomatic HCQ patient reported h..
Jun 29
Early Nimitvilai et al., Journal of Global Infectious Diseases, doi:10.4103/jgid.jgid_281_21
progression, ↓50.9%, p=0.62
A randomized controlled trial of combined ivermectin and zinc sulfate versus combined hydroxychloroquine, darunavir/ritonavir, and zinc sulfate among adult patients with asymptomatic or mild coronavirus-19 infection
Details   RCT low-risk patients in Thailand comparing HCQ, darunavir/ritonavir, and zinc, with ivermectin and zinc, showing no significant differences. All patients recovered. 65% of patients were asymptomatic at baseline, 26% were PCR- at baseline..
May 20
Late Silva et al., Frontiers in Cellular and Infection Microbiology, doi:10.3389/fcimb.2022.899702
death, ↑46.1%, p=0.21
Clinical-Epidemiology Aspect of Inpatients With Moderate or Severe COVID-19 in a Brazilian Macroregion: Disease and Countermeasures
Details   Retrospective 395 hospitalized patients in Brazil, showing higher mortality with HCQ treatment, without statistical significance.
May 16
Early Gkioulekas et al., Authorea, Inc., doi:10.22541/au.164745391.17821933/v2 (Preprint) Frequentist and Bayesian analysis methods for case series data and application to early outpatient COVID-19 treatment case series of high risk patients
Details   Hybrid statistical framework for evaluating treatment protocols. COVID-19 treatment protocols often use risk stratification, multiple treatments, and customization based on the disease stage and the patient. Authors find strong evidence f..
May 4
Late Hong et al., PLOS ONE, doi:10.1371/journal.pone.0267645
no recov., ↓24.9%, p=0.45
Use of combined treatment of 3rd-generation cephalosporin, azithromycin and antiviral agents on moderate SARs-CoV-2 patients in South Korea: A retrospective cohort study
Details   Retrospective 25 hospitalized patients treated with cephalosporin, azithromycin, and HCQ, and 217 SOC patients in South Korea, reporting no significant differences. 5 patients receiving lopinavir/ritonavir and HCQ >5 days were excluded fo..
Apr 22
PrEP Satti et al., Cureus, doi:10.7759/cureus.24382
cases, ↓61.5%, p=0.04
Characteristics and Obstetric Outcomes in Women With Autoimmune Rheumatic Disease During the COVID-19 Pandemic in Qatar
Details   Retrospective 80 consecutive pregnant patients with autoimmune rheumatic diseases in Qatar, showing lower risk of COVID-19 cases with HCQ prophylaxis.
Apr 17
In Vitro Faísca et al., Pharmaceutics, doi:10.3390/pharmaceutics14040877 (In Vitro)
In Vitro
Enhanced In Vitro Antiviral Activity of Hydroxychloroquine Ionic Liquids against SARS-CoV-2
Details   In Vitro study showing improved antiviral activity with ionic formulations of HCQ.
Apr 16
Early Roy-García et al., medRxiv, doi:10.1101/2022.04.06.22273531 (Preprint)
progression, ↑100%, p=1.00
Efficacy and Safety of Fixed Combination of Hydroxychloroquine with Azithromycin Versus Hydroxychloroquine and Placebo in Patients with Mild COVID-19: Randomized, double blind, Placebo controlled trial
Details   Small early terminated RCT in Mexico with 31 HCQ and 31 control patients, showing higher progression with treatment. There were no hospitalizations in the HCQ and control groups. HCQ patients were older, 38 vs. 32. There were no differenc..
Apr 8
Late Hafez et al., Antibiotics, doi:10.3390/antibiotics11040498
viral+, ↓12.3%, p=0.59
Antiviral Used among Non-Severe COVID-19 Cases in Relation to Time till Viral Clearance: A Retrospective Cohort Study
Details   Retrospective hospitalized patients in the United Arab Emirates, showing no significant difference in viral clearance with different combinations of HCQ, AZ, favipiravir, and lopinavir/ritonavir.
Apr 6
PrEP Walbi et al., Journal of International Medical Research, doi:10.1177/03000605221090363 Effect of chronic hydroxychloroquine use on COVID-19 risk in patients with rheumatoid arthritis and systemic lupus erythematosus: a multicenter retrospective cohort
Details   Retrospective RA/SLE patients in Saudi Arabia. Numbers in this paper are contradictory. Figure 1 and the introduction to the results indicate 304 HCQ users, while Table 1 and later in the results shows 207 (arms switched). The subsequent ..
Apr 2
In Vitro Delandre et al., Pharmaceuticals, doi:10.3390/ph15040445 (In Vitro)
In Vitro
Antiviral Activity of Repurposing Ivermectin against a Panel of 30 Clinical SARS-CoV-2 Strains Belonging to 14 Variants
Details   In Vitro study with 30 COVID-19 strains from 14 variants, showing stronger efficacy with ivermectin compared to CQ and remdesivir, and relatively homogeneous efficacy with ivermectin regardless of strain/variant, in contrast to results fo..
Mar 31
Early Avezum et al., The Lancet Regional Health - Americas, doi:10.1016/j.lana.2022.100243
death, ↓0.7%, p=1.00
Hydroxychloroquine versus placebo in the treatment of non-hospitalised patients with COVID-19 (COPE – Coalition V): A double-blind, multicentre, randomised, controlled trial
Details   Authors have not responded to a request for the data. Outpatient RCT with 687 HCQ and 682 control patients in Brazil, showing lower hospitalization with treatment, not reaching statistical significance. Higher efficacy was seen with treat..
Mar 29
PrEP MacFadden et al., Open Forum Infectious Diseases, doi:10.1093/ofid/ofac156
cases, ↓12.0%, p=0.01
Screening Large Population Health Databases for Potential COVID-19 Therapeutics: A Pharmacopeia-Wide Association Study (PWAS) of Commonly Prescribed Medications
Details   Retrospective 26,121 cases and 2,369,020 controls ≥65yo in Canada, showing lower cases with chronic use of HCQ.
Mar 23
Late AlQahtani et al., Scientific Reports, doi:10.1038/s41598-022-08794-w
ICU, ↓23.5%, p=1.00
Randomized controlled trial of favipiravir, hydroxychloroquine, and standard care in patients with mild/moderate COVID-19 disease
Details   RCT with 54 favipiravir, 51 HCQ, and 52 SOC hospitalized patients in Bahrain, showing no significant differences. Viral clearance improved with both treatments, but did not reach statistical significance with the small sample size.
Mar 21
PrEP Oztas et al., Journal of Medical Virology, doi:10.1002/jmv.27731
hosp., ↑215.1%, p=0.36
Frequency and Severity of COVID-19 in Patients with Various Rheumatic Diseases Treated Regularly with Colchicine or Hydroxychloroquine
Details   Retrospective 317 HCQ users and 333 household contacts, showing higher risk with HCQ.
Mar 19
Dosing Ragonnet et al., Future Pharmacology, doi:10.3390/futurepharmacol2010007 (Dosing)
dosing study
Drug Repositioning in Intensive Care Patients and Pharmacokinetic Variability: The Illustration of Hydroxychloroquine
Details   Comparison of two HCQ dosing regimens, showing high inter-individual variability of HCQ concentrations (as in ), and significantly better plasma concentrations for the dosing regimen including a loading dose.
Mar 18
Late Ebongue et al., Travel Medicine and Infectious Disease, doi:10.1016/j.tmaid.2022.102292
death, ↓43.0%, p=0.04
Factors predicting in-hospital all-cause mortality in COVID 19 patients at the Laquintinie Hospital Douala, Cameroon
Details   Retrospective 580 hospitalized COVID+ patients in Cameroon, showing lower mortality with HCQ+AZ treatment.
Mar 17
Late Uyaroğlu et al., Acta Medica, doi:10.32552/2022.ActaMedica.719
death, ↑200.0%, p=1.00
Comparison of Favipiravir to Hydroxychloroquine Plus Azithromycin in the Treatment of Patients with Non-critical COVID-19: A Single-center, Retrospective, Propensity Score-matched Study
Details   PSM retrospective 260 late stage hospitalized COVID-19 pneumonia patients in Turkey, showing no significant difference between favipiravir and HCQ.
Mar 11
Late Salehi et al., Research Square, doi:10.21203/ (Preprint)
death, ↑14.5%, p=0.44
Risk factors of death in mechanically ventilated COVID-19 patients: a retrospective multi-center study
Details   Retrospective 125 mechanically ventilated ICU patients in Iran, showing no significant difference with HCQ treatment in unadjusted results.
Mar 10
Late Azaña Gómez et al., Medicina Clínica, doi:10.1016/j.medcli.2022.01.008
death, ↓35.8%, p<0.0001
Mortality risk factors in patients with SARS-CoV-2 infection and atrial fibrillation: Data from the SEMI-COVID-19 registry
Details   Retrospective 1,816 COVID-19 patients with atrial fibrillation in Spain, showing lower mortality with HCQ treatment.
Mar 4
PrEP Del Amo, J., medRxiv, doi:10.1101/2022.03.02.22271710 (Preprint)
symp. case, ↓51.0%, p=0.79
Daily tenofovir disoproxil fumarate/emtricitabine and hydroxychloroquine for pre-exposure prophylaxis of COVID-19: a double-blind placebo controlled randomized trial in healthcare workers
Details   PrEP RCT with 231 HCQ, 220 TDF/FTC+HCQ, 233 TDF/FTC, and 223 placebo healthcare workers in Spain, Bolivia, and Venezuela, showing lower risk of symptomatic COVID-19 in all treatment arms, without statistical significance. Only 907 of the ..
Mar 3
Late Tsanovska et al., Infectious Disorders - Drug Targets, doi:10.2174/1871526522666220303121209
death, ↓57.9%, p=0.03
Hydroxychloroquine (HCQ) treatment for hospitalized patients with COVID- 19.
Details   PSM prospective study of 260 COVID-19 patients in Bulgaria, showing lower mortality, ventilation, and ICU admission with HCQ treatment.
Mar 2
Late Soto et al., PLOS ONE, doi:10.1371/journal.pone.0264789
death, ↑6.0%, p=0.46
Mortality and associated risk factors in patients hospitalized due to COVID-19 in a Peruvian reference hospital
Details   Retrospective 1,418 very late stage (46% mortality) patients in Peru, showing no significant difference with HCQ. There is strong confounding by indication, for example 48% of patients with baseline SpO2 <70% were treated compared with 22..
Feb 26
Late Rouamba et al., International Journal of Infectious Diseases, doi:10.1016/j.ijid.2022.02.034
death, ↓80.0%, p<0.0001
Assessment of Recovery Time, Worsening and Death, among COVID-19 inpatients and outpatients, under treatment with Hydroxychloroquine or Chloroquine plus Azithromycin Combination in Burkina Faso
Details   Retrospective 863 COVID-19 patients in Burkina Faso, showing lower mortality, lower progression for outpatients, and faster viral clearance with HCQ/CQ treatment. Only the lower mortality was statistically significant. NCT04445441.
Feb 23
PrEP Opdam et al., Clinical Pharmacology & Therapeutics, doi:10.1002/cpt.2551
hosp., ↓45.0%, p=0.18
Identification of Risk Factors for COVID‐19 Hospitalization in Patients with Anti‐Rheumatic Drugs: Results from a Multicenter Nested Case Control Study
Details   Retrospective 81 cases and 396 controls among rheumatic disease patients in the Netherlands, showing lower risk of hospitalization with HCQ prophylaxis, without statistical significance.
Feb 18
Late Hall et al., The Annals of Thoracic Surgery, doi:10.1016/j.athoracsur.2022.01.043
death, ↓11.2%, p=0.31
Multi-institutional Analysis of 505 COVID-19 Patients Supported with ECMO: Predictors of Survival
Details   Retrospective 505 ECMO patients showing no significant difference in mortality in unadjusted results.
Feb 16
PrEP Ugarte-Gil et al., Annals of the Rheumatic Diseases, doi:10.1136/annrheumdis-2021-221636
severe case, ↓44.4%, p=0.007
Characteristics associated with poor COVID-19 outcomes in individuals with systemic lupus erythematosus: data from the COVID-19 Global Rheumatology Alliance
Details   Retrospective 1,606 SLE patients showing lower risk of severe COVID-19 outcomes with HCQ/CQ use.
Feb 13
Late Beaumont et al., Infectious Diseases Now, doi:10.1016/j.idnow.2022.02.001
death/int., ↓14.1%, p=0.55
Factors associated with hospital admission and adverse outcome for COVID-19: role of social factors and medical care
Details   Retrospective 296 hospitalized patients in France, showing no significant difference with HCQ treatment.
Feb 3
Late Albanghali et al., Journal of Infection and Public Health, doi:10.1016/j.jiph.2022.02.001
death, ↑34.6%, p=0.46
Clinical Characteristics and Treatment Outcomes of Mild to Moderate Covid-19 Patients in Saudi Arabia: A Single Centre Study
Details   Retrospective 811 hospitalized COVID+ patients in Saudi Arabia, showing higher mortality with HCQ treatment in unadjusted results subject to confounding by indication.
Jan 31
Late Omma et al., The Journal of Infection in Developing Countries, doi:10.3855/jidc.14933
death, ↓28.2%, p=0.30
Hydroxychloroquine shortened hospital stay and reduced intensive care unit admissions in hospitalized COVID-19 patients
Details   Retrospective 393 hospitalized COVID-19 patients in Turkey, showing lower ICU admission and shorter hospitalization time with HCQ. There was no significant difference for mortality. Severity was higher in the HCQ group with greater baseli..
Jan 27
PrEP Strangfeld et al., Annals of the Rheumatic Diseases, doi:10.1136/annrheumdis-2020-219498
death, ↓48.0%, p<0.0001
Factors associated with COVID-19-related death in people with rheumatic diseases: results from the COVID-19 Global Rheumatology Alliance physician-reported registry
Details   Retrospective 3,729 rheumatic disease patients showing lower risk of mortality with HCQ/CQ use (HCQ/CQ vs. no DMARD therapy).
Jan 23
PrEP Erden et al., Bratislava Medical Journal, doi:10.4149/BLL_2022_018
death, ↑150.0%, p=1.00
COVID-19 outcomes in patients with antiphospholipid syndrome: a retrospective cohort study
Details   Retrospective 9 COVID-19 patients with antiphospholipid syndrome in Turkey, showing no significant differences based on existing HCQ treatment.
Jan 21
Late Lavilla Olleros et al., PLOS ONE, doi:10.1371/journal.pone.0261711
death, ↓36.2%, p<0.0001
Use of glucocorticoids megadoses in SARS-CoV-2 infection in a spanish registry: SEMI-COVID-19
Details   Retrospective 14,921 hospitalized patients in Spain, showing lower mortality with HCQ treatment.
Jan 20
Late Alwafi et al., Cureus, doi:10.7759/cureus.21442
viral+, ↓14.7%, p=0.65
Negative Nasopharyngeal SARS-CoV-2 PCR Conversion in Response to Different Therapeutic Interventions
Details   Retrospective 93 hospitalized patients in Saudi Arabia, 45 treated with CQ/HCQ, showing no significant difference in viral clearance. More patients treated with CQ/HCQ had severe cases at baseline (20% vs. 2%).
Jan 13
Late Tu et al., Infectious Diseases & Immunity, doi:10.1097/ID9.0000000000000037
death, ↓17.2%, p=0.81
Risk Factors for Severity and Mortality in Adult Patients Confirmed with COVID-19 in Sierra Leone: A Retrospective Study
Details   Retrospective 180 hospitalized COVID-19 patients in Sierra Leone, showing no significant difference with HCQ treatment in unadjusted results, however HCQ was significantly more likely to be used for severe patients (33% vs. 12%).
Jan 13
Early Tyson et al., Preprint (Preprint)
death, ↓99.8%, p<0.0001
Low Rates of Hospitalization and Death in 4,376 COVID-19 Patients Given Early Ambulatory Medical and Supportive Care. A Case Series and Observational Study.
Details   Retrospective 4,376 patients with mild/moderate COVID-19 in the USA treated with multiple medications including HCQ/ivermectin, favipiravir, vitamin C, D, quercetin, zinc, mAbs, budesonide, dexamethasone, prednisone, and colchicine (exact..
Jan 11
Late AbdelGhaffar et al., PLOS ONE, doi:10.1371/journal.pone.0262348
death, ↓99.9%, p<0.0001
Prediction of mortality in hospitalized Egyptian patients with Coronavirus disease-2019: A multicenter retrospective study
Details   Retrospective 3,712 hospitalized patients in Egypt, showing lower mortality with HCQ treatment in unadjusted results. According to the official treatment protocol, HCQ was recommended with higher risk and/or more serious cases.
Jan 7
PrEP Juneja et al., Journal of Basic and Clinical Physiology and Pharmacology, doi:10.1515/jbcpp-2021-0221
severe case, ↑141.8%, p=0.59
Hydroxychloroquine pre-exposure prophylaxis provides no protection against COVID-19 among health care workers: a cross-sectional study in a tertiary care hospital in North India
Details   Retrospective 2,200 healthcare workers in India, 996 taking HCQ prophylaxis, showing no significant differences. There were large differences in the occupation of participants and therefore exposure, and the authors make no adjustments.
Dec 23
PEP McKinnon et al., International Journal of Infectious Diseases, doi:10.1016/j.ijid.2021.12.343
symp. case, ↓2.5%, p=1.00
Safety and Tolerability of Hydroxychloroquine in healthcare workers and first responders for the prevention of COVID-19: WHIP COVID-19 Study
Details   HCQ prophylaxis RCT with 201 weekly HCQ patients, 197 daily HCQ patients, and 200 control patients, concluding the prophylaxis is safe. There were no grade 3 or 4 AEs, SAEs, ER visits, or hospitalizations. There was only 4 confirmed cases..
Dec 4
PrEP Rao et al., Expert Review of Anti-infective Therapy, doi:10.1080/14787210.2022.2015326
cases, ↓11.0%, p=0.68
Hydroxychloroquine as pre-exposure prophylaxis against COVID-19 infection among healthcare workers: a prospective cohort study
Details   Prospective PrEP study with low risk healthcare workers in India showing RR=0.89 [0.53-1.52]. There were no significant adverse effects. Only mean age and gender distribution are provided for baseline characteristics, no severity informat..
Nov 26
Late Ferreira et al., Revista da Associação Médica Brasileira, doi:10.1590/1806-9282.20210661
death, ↑151.5%, p=0.03
Outcomes associated with Hydroxychloroquine and Ivermectin in hospitalized patients with COVID-19: a single-center experience
Details   Retrospective 230 hospitalized patients in Brazil showing higher mortality with HCQ treatment. Authors note that the treatments were more likely to be offered to sicker patients. Authors indicate that they do not know when medication was ..
Nov 23
Late Calderón et al., PAMJ - Clinical Medicine, doi:10.11604/pamj-cm.2021.7.15.30981
death, ↑214.8%, p=0.38
Treatment with hydroxychloroquine vs nitazoxanide in patients with COVID-19: brief report
Details   Planned RCT of HCQ vs. HCQ+nitazoxanide which was aborted due to the retracted Surgisphere paper. Authors retrospectively analyze a small set of HCQ vs. nitazoxanide patients (which were protocol deviations in the planned RCT), showing re..
Nov 23
PrEP Ahmed et al., BioMed Research International, doi:10.1155/2021/1676914
cases, ↓99.3%, p=0.08
Factors Affecting the Incidence, Progression, and Severity of COVID-19 in Type 1 Diabetes Mellitus
Details   Retrospective type 1 diabetes patients in Saudi Arabia showing reduced risk of cases with HCQ prophylaxis.
Nov 17
PrEP Samajdar et al., Journal of the Association of Physicians India, 69:11
cases, ↓74.5%, p<0.0001
Ivermectin and Hydroxychloroquine for Chemo-Prophylaxis of COVID-19: A Questionnaire Survey of Perception and Prescribing Practice of Physicians vis-a-vis Outcomes
Details   Physician survey in India with 164 ivermectin prophylaxis, 129 HCQ prophylaxis, and 81 control patients, showing significantly lower COVID-19 cases with treatment. Details of the treatment and control groups and the definition of cases ar..
Nov 12
Late Schmidt et al., JAMA Network Open, doi:10.1001/jamanetworkopen.2021.34330
death, ↑333.0%, p=0.0001
Association Between Androgen Deprivation Therapy and Mortality Among Patients With Prostate Cancer and COVID-19
Details   Retrospective 1,106 prostate cancer patients, showing higher mortality with HCQ treatment.
Nov 11
Late Cortez et al., Western Pacific Surveillance and Response Journal, doi:10.5365/wpsar.2021.12.4.852
death, ↓15.0%, p=1.00
Clinical characteristics and outcomes of COVID-19 patients in a tertiary hospital in Baguio City, Philippines
Details   Retrospective 280 hospitalized patients in the Philippines, 25 treated with HCQ, not showing any significant differences in unadjusted results.
Nov 5
Early Chechter et al., medRxiv, doi:10.1101/2021.11.05.21265569 (Preprint)
hosp., ↓94.7%, p=0.004
Evaluation of patients treated by telemedicine in the COVID-19 pandemic by a private clinic in Sao Paulo, Brazil: A non-randomized clinical trial preliminary study
Details   Prospective study of 187 telemedicine patients in Brazil. 74 presenting with moderate symptoms were offered treatment with HCQ+AZ, 12 did not accept HCQ (taking AZ only), forming a control group. There was lower hospitalization and improv..
Nov 2
Late Sarhan et al., Journal of Infection and Public Health, doi:10.1016/j.jiph.2021.10.024
death, ↓25.7%, p=0.39
Efficacy of the early treatment with tocilizumab-hydroxychloroquine and tocilizumab-remdesivir in severe COVID-19 Patients
Details   Small 108 patient RCT comparing HCQ vs. remdesivir in very late stage treatment. All patients received tocilizumab. There were significant unadjusted baseline differences in ventilation and ICU admission. NCT04779047. REC-H-PhBSU-21011.
Oct 28
Late Shousha et al., World Journal of Gastroenterology, doi:10.3748/wjg.v27.i40.6951
death, ↓11.5%, p=0.87
Hepatic and gastrointestinal disturbances in Egyptian patients infected with coronavirus disease 2019: A multicentre cohort study
Details   Retrospective 547 hospitalized COVID+ patients in Egypt, showing no significant differences with CQ/HCQ treatment in unadjusted analysis. Treatments were applied according to patient conditions, demographics, and comorbidities as per the ..
Oct 25
Late Guglielmetti et al., Scientific Reports, doi:10.1038/s41598-021-00243-4
death, ↓28.0%, p=0.10
Treatment for COVID-19—a cohort study from Northern Italy
Details   Retrospective 600 hospitalized patients in Italy, showing lower mortality with HCQ treatment, without reaching statistical significance (p = 0.1).
Oct 6
PrEP Belmont et al.,, NCT04354870 (Preprint)
symp. case, ↓78.6%, p=0.21
Details   Prospective study of HCQ prophylaxis in the USA, with 56 HCQ patients and 24 control patients, showing no significant differences. NCT04354870
Oct 5
Late Atipornwanich et al., SSRN Electronic Journal, doi:10.2139/ssrn.3936499
death, ↓56.2%, p=0.07
Various Combinations of Favipiravir, Lopinavir-Ritonavir, Darunavir-Ritonavir, High-Dose Oseltamivir, and Hydroxychloroquine for the Treatment of COVID-19: A Randomized Controlled Trial (FIGHT-COVID-19 Study)
Details   RCT 320 patients in Thailand, showing significantly lower progression with HCQ for moderate/severe patients, and faster viral clearance with mild patients (statistically significant for 800mg). There are two sets of results - for moderate..
Oct 1
Late Babalola et al., Research Square, doi:10.21203/ (Preprint)
no disch., ↑54.5%, p=0.20
A Randomized Controlled Trial of Ivermectin Monotherapy Versus Hydroxychloroquine, Ivermectin, and Azithromycin Combination Therapy in Covid-19 Patients in Nigeria
Details   Small RCT with 61 patients in Nigeria, all patients treated with ivermectin, zinc, and vitamin C, showing no significant improvements in recovery with the addition of HCQ+AZ. PACTR202108891693522.
Oct 1
PrEP Fung et al., PLoS ONE, doi:10.1371/journal.pone.0266922 (preprint 10/1/2021)
death, ↓13.0%, p=0.15
Effect of common maintenance drugs on the risk and severity of COVID-19 in elderly patients
Details   Retrospective database analysis of 374,229 patients in the USA, showing no significant difference with HCQ use, however authors do not adjust for the very different baseline risk for systemic autoimmune disease patients. Other research sh..
Sep 30
Late Menardi et al., PharmAdvances, doi:10.36118/pharmadvances.2021.15
death, ↓35.2%, p=0.12
A retrospective analysis on pharmacological approaches to COVID-19 patients in an Italian hub hospital during the early phase of the pandemic
Details   Retrospective 277 hospitalized patients in Italy, showing lower mortality with HCQ treatment, not reaching statistical significance, and subject to confounding by indication.
Sep 15
Late Uygen et al., Northern Clinics of Istanbul, doi:10.14744/nci.2021.65471
viral- time, ↓12.2%, p=0.05
Effect of Hydroxychloroquine Use on the Length Of Hospital Stay in Children Diagnosed With Covid 19
Details   Retrospective 40 pediatric hospitalized patients, 15 treated with HCQ, showing 7.2 vs. 8.2 days until PCR-, not quite reaching statistical significance.
Sep 15
Late Çivriz Bozdağ et al., Turk. J. Haematol., doi:10.4274/tjh.galenos.2021.2021.0287
death, ↑399.2%, p=0.003
Clinical Characteristics and Outcome of COVID-19 in Turkish Hematological Malignancy Patients
Details   Retrospective 340 patients with hematological malignancy in Turkey, showing higher mortality with HCQ treatment. Confounding by time is likely because more HCQ patients were earlier in time when overall treatment protocols were significan..
Sep 14
Late Alotaibi et al., International Journal of General Medicine, 2021:14
death, ↑133.5%, p=0.05
Effectiveness and Safety of Favipiravir Compared to Hydroxychloroquine for Management of Covid-19: A Retrospective Study
Details   Retrospective hospitalized patients in Saudi Arabia, showing lower mortality with favipiravir compared to HCQ, not quite reaching statistical significance. Authors do not indicate the factors behind which therapy was chosen. May be subjec..
Sep 14
PrEP Agarwal et al., medRxiv, doi:10.1101/2021.09.13.21262971 (Preprint)
hosp., ↓94.8%, p=0.61
Low dose hydroxychloroquine prophylaxis for COVID-19 - a prospective study
Details   Small prophylaxis trial with 29 low dose HCQ and 455 control healthcare workers in India, showing no statistically significant differences.
Sep 14
Early Accinelli et al., Travel Medicine and Infectious Disease, doi:10.1016/j.tmaid.2021.102163 Hydroxychloroquine / azithromycin in COVID-19: The association between time to treatment and case fatality rate
Details   Retrospective 1,265 outpatients in Peru treated with HCQ+AZ showing mortality associated with treatment delay. Mortality was six times lower than the national average.
Sep 9
Early Sawanpanyalert et al., Southeast Asian Journal of Tropical Medicine and Public Health, 52:4
progression, ↓42.0%, p=0.37
Assessment of outcomes following implementation of antiviral treatment guidelines for COVID-19 during the first wave in Thailand
Details   Retrospective 744 hospitalized patients in Thailand, showing lower risk of a poor outcome for favipiravir treatment within 4 days of symptom onset. Early treatment with CQ/HCQ and lopinavir/ritonavir or darunavir/ritonavir also showed low..
Sep 1
Late Karruli et al., Microbial Drug Resistance, doi:10.1089/mdr.2020.0489
death, ↓4.8%, p=1.00
Multidrug-Resistant Infections and Outcome of Critically Ill Patients with Coronavirus Disease 2019: A Single Center Experience
Details   Retrospective 32 ICU patients, showing no significant difference with HCQ treatment in unadjusted results.
Aug 27
PrEP Cordtz et al., Journal of Clinical Medicine, doi:10.3390/jcm10173842
hosp., ↓40.0%, p=0.39
Incidence of COVID-19 Hospitalisation in Patients with Systemic Lupus Erythematosus: A Nationwide Cohort Study from Denmark
Details   Retrospective 2,533 SLE patients in Denmark showing no significant difference in hospitalization risk for COVID-19 cases with HCQ treatment.
Aug 25
Early Rodrigues et al., International Journal of Antimicrobial Agents, doi:10.1016/j.ijantimicag.2021.106428
hosp., ↑200.0%, p=1.00
Hydroxychloroquine plus azithromycin early treatment of mild COVID-19 in outpatient setting: a randomized, double-blinded, placebo-controlled clinical trial evaluating viral clearance
Details   RCT 84 low risk patients, 42 treated with HCQ/AZ, showing no significant differences. There was only one hospitalization which was in the treatment arm.
Aug 25
PrEP Naggie et al., medRxiv, doi:10.1101/2021.08.19.21262275 (Preprint)
symp. case, ↓23.5%, p=0.18
Hydroxychloroquine for pre-exposure prophylaxis of COVID-19 in health care workers: a randomized, multicenter, placebo-controlled trial (HERO-HCQ)
Details   RCT 1,360 healthcare workers in the USA showing OR 0.75 [0.49-1.15] for confirmed or suspected COVID-19 clinical infection by day 30. There were no significant safety issues. Authors note that pooling the results with the COVID PREP study..
Aug 24
PrEP Patil et al., Research Square, doi:10.21203/ (Preprint)
death, ↓65.9%, p=0.10
A Prospective Longitudinal Study Evaluating The Influence of Immunosuppressives and Other Factors On COVID-19 in Autoimmune Rheumatic Diseases
Details   Prospective study of 9,212 autoimmune rheumatic disease patients showing lower mortality with HCQ, without reaching statistical significance. Authors incorrectly state "HCQ use did not influence occurrence of COVID-19 (RR = 0.909, CI..
Aug 16
Late Eldeen et al., Microbes and Infectious Diseases, doi:10.21608/mid.2021.85877.1177 Comparative study between the therapeutic effect of remdesivir versus hydroxychloroquine in COVID-19 hospitalized patients
Details   Small study comparing 25 HCQ and 25 remdesivir hospitalized patients, reporting faster viral clearance with remdesivir. The article proof is missing the results for the HCQ group. Confounding by time is likely - remdesivir patients were a..
Aug 14
N/A Tai et al., Pharmaceutics, doi:10.3390/pharmaceutics13081260 Nebulised Isotonic Hydroxychloroquine Aerosols for Potential Treatment of COVID-19
Details   Analysis of HCQ solutions suitable for nebulization for COVID-19.
Aug 10
PEP Shabani et al., Pulmonary Pharmacology & Therapeutics, doi:10.1016/j.pupt.2021.102069
symp. case, ↓19.0%, p=1.00
Evaluation of the Prophylactic Effect of Hydroxychloroquine on People in Close-Contact with Patients with Covid-19
Details   Small PEP trial with 51 HCQ patients, not showing a significant difference in cases. IRCT20130917014693N10.
Aug 5
PrEP Stricker et al., Journal of Infection and Public Health, doi:10.1016/j.jiph.2021.08.001 (meta analysis)
death, ↓75.0%, p<0.0001
Hydroxychloroquine Pre-Exposure Prophylaxis for COVID-19 in Healthcare Workers from India: A Meta-Analysis
Details   Meta analysis of 11 HCQ PrEP studies in India covering 7,616 healthcare workers, showing significantly lower cases with treatment.
Aug 4
Late Özuygur Ermiş et al., Turkish Journal of Medical Sciences, doi:10.3906/sag-2009-64 The Efficacy of Hydroxychloroquine and Azithromycin Combination Therapy on Hospital Mortality in COVID 19 Pneumonia Patients
Details   Retrospective 370 hospitalized patients, 222 receiving HCQ+AZ and 148 receiving HCQ, showing mortality OR 0.61 [0.23-1.59], p = 0.31 for the addition of AZ.
Aug 4
PrEP Bhatt et al., medRxiv, doi:10.1101/2021.08.02.21260750 (Preprint)
cases, ↑49.3%, p=0.02
Hydroxychloroquine Prophylaxis against Coronavirus Disease-19: Practice Outcomes among Health-Care Workers
Details   Observational study of 927 low-risk healthcare workers in India, 731 volunteering for weekly HCQ prophylaxis, showing higher cases with treatment in unadjusted results. Clinical outcome was in the protocol, however no information on which..
Aug 4
Late Alghamdi et al., Saudi Pharmaceutical Journal, doi:10.1016/j.jsps.2021.08.008
death, ↑39.2%, p=0.52
Clinical characteristics and treatment outcomes of severe (ICU) COVID-19 patients in Saudi Arabia: A single centre study
Details   Retrospective 171 ICU patients in Saudi Arabia showing no significant difference for HCQ treatment in unadjusted results.
Jul 31
Late Barra et al., medRxiv, doi:10.1101/2021.07.30.21261220 (Preprint)
death, ↓10.8%, p=1.00
COVID-19 in hospitalized patients in 4 hospitals in San Isidro, Buenos Aires, Argentina
Details   Retrospective 668 hospitalized patients in Argentina, 18 treated with HCQ, not showing a significant difference in unadjusted results.
Jul 29
Early Sobngwi et al., medRxiv, doi:10.1101/2021.07.25.21260838 (Preprint)
no recov., ↓51.6%, p=0.44
Doxycycline is a safe alternative to Hydroxychloroquine + Azithromycin to prevent clinical worsening and hospitalization in mild COVID-19 patients: An open label randomized clinical trial (DOXYCOV)
Details   RCT 194 mild/asymptomatic low-risk patients in Cameroon, 97 treated with HCQ+AZ and 97 treated with doxycycline, showing 2.1% symptomatic patients at day 10 with HCQ+AZ, versus 4.3% with doxycycline, but without statistical significance. ..
Jul 20
PrEP Küçükakkaş et al., Research Square, doi:10.21203/ (Preprint)
ICU, ↑42.9%, p=1.00
The effect of hydroxychloroquine against SARS-CoV-2 infection in rheumatoid arthritis patients
Details   Retrospective 17 rheumatoid arthritis COVID-19+ patients, 7 on HCQ treatment, showing no significant differences. They study reports only including hospitalized patients, but the results include non-hospitalized patients. Results do not r..
Jul 16
Late Alhamlan et al., medRxiv, doi:10.1101/2021.07.13.21260428 (Preprint)
death, ↑52.0%, p=0.57
Epidemiology and Clinical Characteristics in Individuals with Confirmed SARS-CoV-2 Infection During the Early COVID-19 Pandemic in Saudi Arabia
Details   Retrospective hospitalized patients in Saudi Arabia showing higher mortality with most treatments although not reaching statistical significance. Confounding by indication, time, or other factors is likely (a 19x higher risk with lopinavi..
Jul 13
Late Barrat-Due et al., Annals of Internal Medicine, doi:10.7326/M21-0653
death, ↑120.0%, p=0.35
Evaluation of the Effects of Remdesivir and Hydroxychloroquine on Viral Clearance in COVID-19
Details   Small RCT in Norway with 52 HCQ and 42 remdesivir patients, showing no significant differences with treatment. Add-on trial to WHO Solidarity. NCT04321616.
Jul 13
Late Tamura et al., Diabetology & Metabolic Syndrome, doi:10.1186/s13098-021-00695-8
death, ↑299.0%, p=0.04
Outcome and death risk of diabetes patients with Covid-19 receiving pre-hospital and in-hospital metformin therapies
Details   Retrospective 188 hospitalized patients in Brazil, showing higher risk of mortality with HCQ. Relatively few patients received HCQ. The results are likely subject to confounding by indication with treatment more likely for severe cases, a..
Jul 12
Late Arabi et al., Intensive Care Medicine
death, ↑44.5%, p=0.01
Lopinavir-ritonavir and hydroxychloroquine for critically ill patients with COVID-19: REMAP-CAP randomized controlled trial
Details   Very late stage RCT with 50 ICU patients treated with HCQ, 255 lopinavir-ritonavir patients, and 27 combined therapy patients, showing higher mortality with all treatments.
Jul 10
Late Roger et al., Anaesthesia Critical Care & Pain Medicine, doi:10.1016/j.accpm.2021.100931
death, 0.0%, p=0.94
French Multicentre Observational Study on SARS-CoV-2 infections Intensive care initial management: the FRENCH CORONA Study
Details   Prospective study of 966 ICU patients in France, 289 treated with HCQ, showing no significant difference with treatment. Time based confounding is likely because HCQ became increasingly controversial and less used over the time covered, w..
Jul 6
Late Jacobs et al., The Annals of Thoracic Surgery, doi:10.1016/j.athoracsur.2021.06.026
death, ↓6.6%, p=0.74
Multi-institutional Analysis of 200 COVID-19 Patients treated with ECMO:Outcomes and Trends
Details   Prospective study of 200 ECMO patients showing no significant difference in unadjusted results for HCQ treatment. Time based confounding is likely because HCQ became increasingly controversial and less used over the time covered (as shown..
Jul 1
PrEP Shaw et al., Journal of Drugs in Dermatology, doi:10.36849/JDD.5843
cases, ↓13.0%, p=0.006
COVID-19 in Individuals Treated With Long-Term Hydroxychloroquine: A Propensity Score-Matched Analysis of Cicatricial Alopecia Patients
Details   PSM retrospective 144 alopecia patients in the USA, showing lower risk of COVID-19 with HCQ prophylaxis. The supplemental appendix is not available.
Jun 30
Late Taieb et al., J. Clin. Med. 2021, doi:10.3390/jcm10132954
no disch., ↓38.7%, p=0.02
Hydroxychloroquine and Azithromycin Treatment of Hospitalized Patients Infected with SARS-CoV-2 in Senegal from March to October 2020
Details   Retrospective 926 patients in Senegal, 674 treated with HCQ+AZ, showing significantly higher hospital discharge at day 15 with treatment.
Jun 24
Late Gerlovin et al., American Journal of Epidemiology, doi:10.1093/aje/kwab183
death, ↑22.0%, p=0.18
Pharmacoepidemiology, Machine Learning and COVID-19: An intent-to-treat analysis of hydroxychloroquine, with or without azithromycin, and COVID-19 outcomes amongst hospitalized US Veterans
Details   Retrospective 1,769 hospitalized patients in the USA showing no significant differences for HCQ, and higher intubation for HCQ+AZ.
Jun 21
In Silico Yadav et al., Research Square, doi:10.21203/ (Preprint)
In Silico
Repurposing the Combination Drug of Favipiravir, Hydroxychloroquine and Oseltamivir as a Potential Inhibitor Against SARS-CoV-2: A Computational Study
Details   In Silico study showing stronger inhibition of SAR-CoV-2 for HCQ+favipiravir+oseltamivir compared to any of these alone or combinations of two of these drugs.
Jun 18
Late Schwartz et al., CMAJ Open, doi:10.9778/cmajo.20210069
ICU, ↑133.3%, p=1.00
Assessing the efficacy and safety of hydroxychloroquine as outpatient treatment of COVID-19: a randomized controlled trial
Details   Small early terminated late treatment RCT not showing significant differences. The HCQ group was a median of 7 days from symptom onset at baseline, which may not include the delay delivering the medication. From the 4 HCQ hospitalizations..
Jun 18
In Vitro Purwati et al., PLOS One, doi:10.1371/journal.pone.0252302 (In Vitro)
In Vitro
An in vitro study of dual drug combinations of anti-viral agents, antibiotics, and/or hydroxychloroquine against the SARS-CoV-2 virus isolated from hospitalized patients in Surabaya, Indonesia
Details   In Vitro study of combinations of drugs showing antiviral efficacy of HCQ alone and in combination with AZ, favipiravir, and doxycycline. No high levels of cytotoxicity were observed, and authors conclude that using a combination of drugs..
Jun 11
Late Turrini et al., Vaccines, 10.3390/vaccines9060640
death, ↓9.8%, p=0.15
Clinical Course and Risk Factors for In-Hospital Mortality of 205 Patients with SARS-CoV-2 Pneumonia in Como, Lombardy Region, Italy
Details   Retrospective 205 patients in Italy, 160 treated with HCQ, showing lower mortality with treatment in multivariate analysis, but not reaching statistical significance.
Jun 9
Late Saib et al., PLOS ONE, doi:10.1371/journal.pone.0252388
death/int., ↑125.0%, p=0.23
Lack of efficacy of hydroxychloroquine and azithromycin in patients hospitalized for COVID-19 pneumonia: A retrospective study
Details   203 hospitalized patients in France, not showing significant differences with treatment. Confounding by indication is likely. Authors do not discuss confounding.
Jun 8
Late Singh et al., medRxiv, doi:0.1101/2021.06.06.21258091 (Preprint)
death, ↓47.5%, p=0.45
Safety and efficacy of antiviral therapy alone or in combination in COVID-19 - a randomized controlled trial (SEV COVID Trial)
Details   Very small early terminated RCT in India, showing lower mortality but without statistical significance with the very small sample size. Time since symptom onset is not provided. The recovery percentage for non-severe group B (86.7%) does ..
Jun 7
PrEP Badyal et al., Journal of the Association of Physicians of India, Volume 69, June 2021
cases, ↓60.1%, p<0.0001
Hydroxychloroquine for SARS CoV2 Prophylaxis in Healthcare Workers – A Multicentric Cohort Study Assessing Effectiveness and Safety
Details   Prophylaxis study with 12,089 Indian healthcare workers, showing lower risk of COVID-19 cases with treatment, and increasingly lower risk for longer durations of HCQ prophylaxis. The appendices are not currently available.
Jun 4
Late Lagier et al., Therapeutics and Clinical Risk Management, doi:10.2147/TCRM.S364022
death, ↓32.0%, p=0.004
Outcomes of 2,111 COVID-19 hospitalised patients treated with 2 hydroxychloroquine/azithromycin and other regimens in Marseille, France: a 3 monocentric retrospective analysis
Details   Retrospective 2,011 hospitalized patients in France, median age 67, showing lower mortality with HCQ+AZ, and further benefit with the addition of zinc.
Jun 4
Late Byakika-Kibwika et al., Research Square, doi:10.21203/ (Preprint)
recov. time, 0.0%, p=0.91
Safety and Efficacy of Hydroxychloroquine for Treatment of Non-Severe COVID-19 in Adults in Uganda: A Randomized Open Label Phase II Clinical Trial
Details   Small 105 patient RCT in Uganda showing no significant differences. No mortality was reported. The patients were very young (median age 32), recovering in a median time of 3 days with standard of care, so there is little room for a treatm..
Jun 3
Late Sivapalan et al., European Respiratory Journal, doi:10.1183/13993003.00752-2021
death, ↓92.0%, p=0.32
Azithromycin and hydroxychloroquine in hospitalised patients with confirmed COVID-19–a randomised double-blinded placebo-controlled trial
Details   Early terminated late stage (8 days from onset, 59% on oxygen) RCT not showing statistically significant differences. NCT04322396 ProPAC-COVID. NNF20SA0062834.
Jun 1
PrEP Korkmaz et al., Authorea, doi:10.22541/au.162257516.68665404/v1 (Preprint)
death, ↓82.1%, p=0.19
The effect of Hydroxychloroquine use due to rheumatic disease on the risk of Covid-19 infection and its course
Details   Retrospective 683 patients in a rheumatology department, 384 chronic HCQ users and 299 control patients, showing no mortality for HCQ users vs. 2 deaths in the control group, and significantly fewer cases for HCQ users.
Jun 1
PrEP Kamstrup et al., International Journal of Infectious Diseases, doi:10.1016/j.ijid.2021.05.076
hosp., ↑44.0%, p=0.25
Hydroxychloroquine as a primary prophylactic agent against sars-cov-2 infection: a cohort study
Details   Retrospective HCQ users in Denmark, not showing a significant difference, however authors do not adjust for the very different baseline risk for systemic autoimmune disease patients. Authors appear unaware of research in the area, for exa..
May 31
Late Ramírez-García et al., Archivos de Medicina Universitaria
death, ↓67.0%, p<0.0001
Hydroxychloroquine and Tocilizumab in the Treatment of COVID-19: A Longitudinal Observational Study
Details   Retrospective 403 hospitalized patients in Spain, showing lower mortality with treatment, however authors do not adjust for the differences between the groups. Confounding by indication is likely.
May 31
Late Smith et al., medRxiv, doi:10.1101/2021.05.28.21258012 (Preprint)
death, ↓27.2%, p=0.002
Observational Study on 255 Mechanically Ventilated Covid Patients at the Beginning of the USA Pandemic
Details   Retrospective 255 mechanical ventilation patients in USA, showing that weight-adjusted HCQ+AZ improved survival by over 100%. QTc prolongation did not correlate with cumulative HCQ dose or HCQ serum level. Although authors mention immorta..
May 29
Dosing Ali et al., Journal of Pharmaceutical Research International, doi:10.9734/jpri/2020/v32i830468 (Dosing)
dosing study
Optimizing the Use of Hydroxychloroquine in the Management of COVID-19 Given Its Pharmacological Profile
Details   Review of the mechanisms of action, pharmacokinetics and toxicity of HCQ, recommending use as early as possible with a loading dose in 3-4 divided doses to minimize toxicity, and daily maintenance divided into two doses, continued until r..
May 27
Early Million et al., Reviews in Cardiovascular Medicine, doi:10.31083/j.rcm2203116 (preprint 5/27/2021)
death, ↓83.0%, p=0.0007
Early Treatment with Hydroxychloroquine and Azithromycin in 10,429 COVID-19 Outpatients: A Monocentric Retrospective Cohort Study
Details   Retrospective 10,429 outpatients in France, 8,315 treated with HCQ+AZ a median of 4 days from symptom onset, showing significantly lower mortality with treatment.
May 17
PrEP Syed et al., Cureus, doi:10.7759/cureus.20572 (preprint 5/17/2021)
symp. case, ↑59.7%, p=0.41
Pre-exposure Prophylaxis With Various Doses of Hydroxychloroquine Among Healthcare Personnel With High-Risk Exposure to COVID-19: A Randomized Controlled Trial
Details   Small PrEP RCT of low risk healthcare workers, showing no significant differences. Authors report that there was no hospitalization, ICU care, or death from COVID-19, however table 3 of the preprint shows severe events labeled as "re..
May 16
PrEP Rojas-Serrano et al., medRxiv, doi:10.1101/2021.05.14.21257059 (Preprint)
symp. case, ↓82.0%, p=0.12
Hydroxychloroquine For Prophylaxis Of COVID-19 In Health Workers: A Randomized Clinical Trial
Details   Early terminated HCQ PrEP RCT with 62 HCQ and 65 placebo patients, showing 82% lower cases with treatment, p = 0.12. NCT04318015. If the trial is continued and the same event rate is observed, statistical significance will be reached afte..
May 12
Early Drancourt et al., Viruses, doi:10.3390/v13050890 SARS-CoV-2 Persistent Viral Shedding in the Context of Hydroxychloroquine-Azithromycin Treatment
Details   Retrospective 3,737 patients in France, showing lower risk of persistent viral shedding with HCQ+AZ treatment.
May 10
Late Sammartino et al., PLOS One, doi:10.1371/journal.pone.0251262
death, ↑240.0%, p=0.002
Predictors for inpatient mortality during the first wave of the SARS-CoV-2 pandemic: A retrospective analysis
Details   Retrospective 1,108 hospitalized patients in New York showing significantly higher mortality with HCQ treatment. Time based confounding is very likely because HCQ became increasingly controversial and less used over the time covered (Mar ..
May 8
Review Vigbedor et al., Journal of Applied Pharmaceutical Science, doi:10.7324/JAPS.2021.110825 (Review)
Review of four major biomolecular target sites for COVID-19 and possible inhibitors as treatment interventions
Details   Review of major target sites in SARS-CoV-2 and the host organism along with potential inhibitors.
May 1
Late De Rosa et al., J. Clin. Med., doi:10.3390/jcm10091951
death, ↓35.0%, p=0.02
Risk Factors for Mortality in COVID-19 Hospitalized Patients in Piedmont, Italy: Results from the Multicenter, Regional, CORACLE Registry
Details   Retrospective 1,538 hospitalized patients in Italy, showing only HCQ associated with reduced mortality. Authors analyze mortality amongst those that were alive at day 7 to avoid survival time bias due to drug recording requiring a minimum..
Apr 30
Late Çiyiltepe et al., South. Clin. Ist. Euras., doi:10.14744/scie.2021.89847
death, ↓3.2%, p=0.85
The Effect of Pre-admission Hydroxychloroquine Treatment on COVID-19-Related Intensive Care Follow-up in Geriatric Patients
Details   Retrospective 147 ICU patients in Turkey, showing no significant difference in outcomes based on HCQ treatment before ICU admission. This is not very informative, for example we do not know if HCQ treated patients were much less likely to..
Apr 30
Late Bosaeed et al., Infect. Dis. Ther., doi:10.1007/s40121-021-00496-6
death, ↓3.7%, p=0.91
Favipiravir and Hydroxychloroquine Combination Therapy in Patients with Moderate to Severe COVID19 (FACCT Trial): An Open-Label, Multicenter, Randomized, Controlled Trial
Details   RCT 254 very late stage (93% on oxygen, 17% in ICU at baseline) hospitalized patients in Saudi Arabia not showing significant differences with HCQ+favipiravir treatment. Only SaO2 < 94% patients were eligible, however the actual SaO2 of e..
Apr 29
Late Haji Aghajani et al., Journal of Medical Virology, doi:10.1002/jmv.27053
death, ↓19.5%, p=0.09
Decreased in-hospital mortality associated with aspirin administration in hospitalized patients due to severe COVID-19
Details   Retrospective 991 hospitalized patients in Iran, showing lower mortality with HCQ, not reaching statistical significance.
Apr 29
Late Aghajani et al., Journal of Medical Virology, doi:10.1002/jmv.27053
death, ↓19.5%, p=0.09
Decreased In-Hospital Mortality Associated with Aspirin Administration in Hospitalized Patients Due to Severe COVID-19
Details   Retrospective 991 hospitalized patients in Iran focusing on aspirin use but also showing results for HCQ, remdesivir, and favipiravir.
Apr 28
Late Kokturk et al., Respiratory Medicine, doi:10.1016/j.rmed.2021.106433
death, ↑3.8%, p=0.97
The predictors of COVID-19 mortality in a nationwide cohort of Turkish patients
Details   Retrospective 1,500 hospitalized late stage (median SaO2 87.7) patients in Turkey, showing no significant difference with HCQ treatment.
Apr 27
Late Réa-Neto et al., Scientific Reports, doi:10.1038/s41598-021-88509-9
death, ↑57.0%, p=0.20
An open-label randomized controlled trial evaluating the efficacy of chloroquine/hydroxychloroquine in severe COVID-19 patients
Details   Early terminated very late stage (99% on oxygen, 81% in ICU, 18% on mechanical ventilation at baseline) RCT with 24 CQ patients, 29 HCQ, and 52 control patients, showing worse clinical outcomes with treatment. NCT04420247.
Apr 26
Late Mohandas et al.,
death, ↑81.0%, p=0.007
Clinical review of COVID-19 patients presenting to a quaternary care private hospital in South India: A retrospective study
Details   Retrospective 3,345 hospitalized patients in India, 11.5% treated with HCQ, showing unadjusted higher mortality with treatment. Confounding by indication and time based confounding (due to declining use over the period when overall treatm..
Apr 24
Late Corradini et al., Internal and Emergency Medicine, doi:10.1007/s11739-021-02742-8
death, ↓70.2%, p<0.0001
Clinical factors associated with death in 3044 COVID-19 patients managed in internal medicine wards in Italy: results from the SIMI-COVID-19 study of the Italian Society of Internal Medicine (SIMI)
Details   Retrospective 3,044 hospitalized COVID-19 patients in Italy, showing HCQ significantly associated with survival in light, mild, and moderate cases in multivariable analysis, but not in severe cases.
Apr 23
Late Toya et al., SSRN (Preprint) A Cross-Country Analysis of the Determinants of COVID-19 Fatalities
Details   Country based analysis finding lower mortality with the use of HCQ.
Apr 22
Late Reis et al., JAMA Network Open, doi:10.1001/jamanetworkopen.2021.6468
death, ↓66.0%, p=1.00
Effect of Early Treatment With Hydroxychloroquine or Lopinavir and Ritonavir on Risk of Hospitalization Among Patients With COVID-19 The TOGETHER Randomized Clinical Trial
Details   Early terminated RCT in Brazil showing lower mortality and hospitalization with HCQ, but not reaching statistical significance. Although the title includes "early treatment", treatment was relatively late, with most patients bei..
Apr 15
PrEP Alzahrani et al., Rheumatology International , doi:10.1007/s00296-021-04857-9
death, ↓58.7%, p=1.00
Clinical characteristics and outcome of COVID-19 in patients with rheumatic diseases
Details   Retrospective 47 rheumatic disease patients not finding significant differences with HCQ.
Apr 15
PrEP Alegiani et al., Rheumatology, doi:10.1093/rheumatology/keab348
death, ↑8.0%, p=0.64
Risk of COVID-19 hospitalization and mortality in rheumatic patients treated with hydroxychloroquine or other conventional DMARDs in Italy
Details   Retrospective database analysis case control study of rheumatic patients. When compared with other cDMARDs, HCQ users had significantly lower hospitalization, however there was no significant difference in mortality. Results differ signif..
Apr 14
PrEP Seet et al., International Journal of Infectious Diseases, doi:10.1016/j.ijid.2021.04.035
symp. case, ↓35.1%, p=0.047
Positive impact of oral hydroxychloroquine and povidone-iodine throat spray for COVID-19 prophylaxis: an open-label randomized trial
Details   Prophylaxis RCT in Singapore with 3,037 low risk patients, showing lower serious cases, lower symptomatic cases, and lower confirmed cases of COVID-19 with all treatments (ivermectin, HCQ, PVP-I, and Zinc + vitamin C) compared to vitamin ..
Apr 8
Late Gadhiya et al., BMJ Open, doi:10.1136/bmjopen-2020-042549
death, ↑4.8%, p=0.89
Clinical characteristics of hospitalised patients with COVID-19 and the impact on mortality: a single-network, retrospective cohort study from Pennsylvania state
Details   Retrospective 283 patients in the USA showing higher mortality with all treatments (not statistically significant). Confounding by indication is likely. In the supplementary appendix, authors note that the treatments were usually given fo..
Apr 7
Late Mulhem et al., BMJ Open, doi:10.1136/bmjopen-2020-042042
death, ↑28.3%, p=0.10
3219 hospitalised patients with COVID-19 in Southeast Michigan: a retrospective case cohort study
Details   Retrospective database analysis of 3,219 hospitalized patients in the USA. Very different results in the time period analysis (Table S2), and results significantly different to other studies for the same medications (e.g., heparin OR 3.06..
Apr 6
Early Mokhtari et al., International Immunopharmacology, doi:10.1016/j.intimp.2021.107636
death, ↓69.7%, p<0.0001
Clinical outcomes of patients with mild COVID-19 following treatment with hydroxychloroquine in an outpatient setting
Details   Retrospective 28,759 adult outpatients with mild COVID-19 in Iran, 7,295 treated with HCQ, showing significantly lower hospitalization and mortality with treatment.
Apr 5
Safety Edington et al., European Journal of Internal Medicine, doi:10.1016/j.ejim.2021.03.028
safety analysis
Safety of treatment with chloroquine and hydroxychloroquine: A ten-year systematic review and meta-analysis
Details   Safety analysis of CQ and HCQ covering 46 RCTs with 23,132 patients, showing no mortality attributed to CQ/HCQ. Authors conclude that the data reinforces that CQ and HCQ have a good safety profile though caution is advised when using high..
Mar 31
Late Alghamdi et al., Antibiotics, doi:10.3390/antibiotics10040365
death, ↑6.9%, p=0.88
Clinical Efficacy of Hydroxychloroquine in Patients with COVID-19: Findings from an Observational Comparative Study in Saudi Arabia
Details   Retrospective 775 hospitalized patients in Saudi Arabia showing no significant difference. There was no adjustment for severity or comorbidities. Confounding by indication is likely.
Mar 26
Safety Faruqui et al., Indian J. Med. Res., doi:10.4103/ijmr.IJMR_2294_20
safety analysis
Safety of hydroxychloroquine in healthcare workers for COVID-19 prophylaxis
Details   Retrospective 1303 health care workers finding that HCQ prophylaxis was well tolerated. 20% reported an adverse event, mostly gastrointestinal. 1.5% received treatment for adverse effects, with none requiring hospitalization.
Mar 24
PrEP Dev et al., Transactions of The Royal Society of Tropical Medicine and Hygiene, doi:10.1093/trstmh/trab047
cases, ↓26.0%, p=0.003
Risk factors and frequency of COVID-19 among healthcare workers at a tertiary care centre in India: a case–control study
Details   Retrospective case control study of 3,100 healthcare workers in India showing lower cases with HCQ prophylaxis, and an inverse association between the number of HCQ doses taken and the risk of COVID-19 cases. Low risk population with no m..
Mar 23
Late Barry et al., International Journal of Infectious Diseases, doi:10.1016/j.ijid.2021.03.058
death, ↓98.9%, p=0.60
Clinical Characteristics and Outcomes of Hospitalized COVID-19 Patients in a MERS-CoV Referral Hospital during the Peak of the Pandemic
Details   605 hospitalized patients in Saudi Arabia showing no mortality with HCQ (only 6 patients received HCQ).
Mar 17
Late Stewart et al., PLoS ONE, doi:10.1371/journal.pone.0248128
death, ↑18.0%, p=0.27
COVID-19 Evidence Accelerator: A parallel analysis to describe the use of Hydroxychloroquine with or without Azithromycin among hospitalized COVID-19 patients
Details   Collection of seven retrospective database analyses in the USA, showing higher mortality with treatment (not statistically significant). Results contradict strong evidence from the RECOVERY/SOLIDARITY trials, suggesting substantial confou..
Mar 17
In Vitro Dang et al., bioRxiv, doi:10.1101/2021.03.16.435741 (Preprint) (In Vitro)
In Vitro
Structural basis of anti-SARS-CoV-2 activity of hydroxychloroquine: specific binding to NTD/CTD and disruption of LLPS of N protein
Details   Microscopy/spectroscopy study showing that HCQ binds to both N-terminal domain and C-terminal domain of SARS-CoV-2 nucleocapsid protein to inhibit their interactions with nucleic acids and disrupt NA-induced liquid-liquid phase separation..
Mar 12
Early Roy et al., medRxiv, doi:10.1101/2021.03.08.21252883 (Preprint)
recov. time, ↓2.4%, p=0.96
Outcome of Different Therapeutic Interventions in Mild COVID-19 Patients in a Single OPD Clinic of West Bengal: A Retrospective study
Details   Retrospective database analysis of 56 mild COVID-19 patients, all treated with vitamin C, vitamin D, and zinc, comparing ivermectin + doxycycline (n=14), AZ (n=13), HCQ (n=14), and SOC (n=15), finding that all groups recover quickly, and ..
Mar 9
PrEP Vivanco-Hidalgo et al., Eurosurveillance, doi:/10.2807/1560-7917.ES.2021.26.9.2001202
hosp., ↑46.0%, p=0.10
Incidence of COVID-19 in patients exposed to chloroquine and hydroxychloroquine: results from a population-based prospective cohort in Catalonia, Spain, 2020
Details   Retrospective database analysis of chronic HCQ users and matched control patients, failing to match or adjust for the very different baseline risk for systemic autoimmune disease patients. Other research shows that the risk of COVID-19 fo..
Mar 8
Late Martin-Vicente et al., medRxiv, doi:10.1101/2021.03.08.21253121 (Preprint)
death, ↓59.3%, p=0.41
Absent or insufficient anti-SARS-CoV-2 S antibodies at ICU admission are associated to higher viral loads in plasma, antigenemia and mortality in COVID-19 patients
Details   Retrospective 92 ICU patients with almost all treated with HCQ and only one non-HCQ treated patient that died, showing unadjusted non-statistically significant lower mortality with treatment.
Mar 4
Late Salvador et al., Cureus, doi:10.7759/cureus.13687
death, ↓32.9%, p=0.10
Clinical Features and Prognostic Factors of 245 Portuguese Patients Hospitalized With COVID-19
Details   Prospective study of 245 hospitalized patients, 121 treated with HCQ, showing lower (non-statistically significant) mortality and higher ventilation at 30 days. Confounding by indication is likely.
Mar 2
PrEP Pham et al., Rheumatology Advances in Practice, 10.1093/rap/rkab014
death, ↓19.7%, p=0.77
Failure of chronic hydroxychloroquine in preventing severe complications of COVID-19 in patients with rheumatic diseases
Details   Tiny retrospective database analysis of hospitalized COVID-19 patients with rheumatologic disease containing 14 chronic HCQ and 28 control patients. Patients are very poorly matched. Bias against HCQ is clear in the abstract which mention..
Feb 28
Early Thakar et al., Indian J. Med. Res., doi:10.4103/ijmr.IJMR_3665_20 Chloroquine nasal drops in asymptomatic & mild COVID-19: An exploratory randomized clinical trial
Details   Small RCT for CQ nasal drops suggesting efficacy in preventing infection, while no significant difference was seen for patients that already had mild COVID-19.
Feb 28
PrEP Bhandari et al., International Journal of Medicine and Public Health, doi:10.5530/ijmedph.2021.1.4 A Preventive Study on Hydroxychloroquine Prophylaxis against COVID-19 in Health Care Workers at a Tertiary Care Center in North India
Details   Retrospective 4,239 healthcare workers using HCQ prophylaxis showing no mortality, 8 mild symptomatic cases, and 85 asymptomatic cases, with the cases occuring mostly in the first week.
Feb 26
Early Amaravadi et al., medRxiv, doi:10.1101/2021.02.22.21252228 (Preprint)
no recov., ↓60.0%, p=0.13
Hydroxychloroquine for SARS-CoV-2 positive patients quarantined at home: The first interim analysis of a remotely conducted randomized clinical trial
Details   Tiny early-terminated 34 patient RCT for outpatient treatment showing faster recovery with treatment (not statistically significant). All patients recovered (3 control patients recovered after crossover to the treatment arm) - as per prot..
Feb 26
Late Tanriverdi et al., Turkish Journal of Medical Sciences, doi:doi:10.3906/sag-2005-82 Hydroxychloroquine plus azithromycin and early hospital admission are beneficial in COVID-19 patients: Turkish experience with real-life data
Details   Retrospective 83 hospitalized patients in Turkey confirming that earlier treatment is better, and showing that the addition of AZ to HCQ reduced hospitalization time.
Feb 26
Early Giraud-Gatineau et al., Research Square, (Preprint) The Need for Early Management in Patients With COVID-19
Details   Review of early treatment of COVID-19 at IHU Méditerranée Infection in France, including HCQ+AZ treatment, comparing outcomes to those for all of France. Age-standardized mortality was lower with early treatment for all periods of the epi..
Feb 23
Late Beltran Gonzalez et al., Infectious Disease Reports, doi:10.3390/idr14020020 (preprint 2/23/2021)
death, ↓62.6%, p=0.27
Efficacy and Safety of Ivermectin and Hydroxychloroquine in Patients with Severe COVID-19: A Randomized Controlled Trial
Details   RCT late stage severe condition (93% SOFA ≥ 2, 96% APACHE ≥ 8) high comorbidity hospitalized patients in Mexico with 33 HCQ and 37 control patients not finding significant differences. NCT04391127.
Feb 20
PrEP Bae et al., Viruses 2021, doi:10.3390/v13020329
cases, ↓30.3%, p=0.18
Recent Hydroxychloroquine Use Is Not Significantly Associated with Positive PCR Results for SARS-CoV-2: A Nationwide Observational Study in South Korea
Details   Retrospective database analysis of prior HCQ usage in South Korea, showing non-statistically significantly lower mortality and cases with treatment.
Feb 19
Late Lamback et al., The Brazilian Journal of Infectious Diseases, doi:10.1016/j.bjid.2021.101549
death, ↓8.9%, p=0.83
Hydroxychloroquine with azithromycin in patients hospitalized for mild and moderate COVID-19
Details   Retrospective 193 hospitalized patients in Brazil not finding a significant difference with HCQ. The control group was composed of patients refusing HCQ or with contraindications. Time based confounding is very likely because HCQ became m..
Feb 18
Late Awad et al., American Journal of Health-System Pharmacy, doi:10.1093/ajhp/zxab056
death, ↑19.1%, p=0.60
Impact of hydroxychloroquine on disease progression and ICU admissions in patients with SARS-CoV-2 infection
Details   This paper has inconsistent values - the number of treatment and control patients differs in the text and Table 1, we have used treatment 188 and control 148. Retrospective 336 hospitalized patients in the USA showing higher mortality, IC..
Feb 15
PrEP Mahto et al., American Journal of Blood Research, 11:1
IgG+, ↓26.9%, p=0.38
Seroprevalence of IgG against SARS-CoV-2 and its determinants among healthcare workers of a COVID-19 dedicated hospital of India
Details   Retrospective 689 healthcare workers in India, showing no significant difference in IgG positivity with HCQ prophylaxis in unadjusted results.
Feb 11
Late Lora-Tamayo et al., J. Infection, doi:10.1016/j.jinf.2021.02.011
death, ↓50.5%, p<0.0001
Early Lopinavir/ritonavir does not reduce mortality in COVID-19 patients: results of a large multicenter study
Details   Lopinavir/ritonavir retrospective study also showing univariate results for HCQ, with significantly lower mortality.
Feb 10
Early, Late Desai et al., J. Clinical Medicine, doi:10.3390/jcm10040686 The Use of Antiviral Agents against SARS-CoV-2: Ineffective or Time and Age Dependent Result? A Retrospective, Observational Study among COVID-19 Older Adults
Details   Retrospective 143 COVID-19 hospitalized patients >65yo, showing adjusted OR for antiviral treatment starting within 6 days of 0.44 [0.2-0.9], p = 0.02, compared to treatment started later.
Feb 9
Late Thompson et al., NCT04332991 (Preprint)
death, ↑6.2%, p=0.85
Outcomes Related to COVID-19 Treated With Hydroxychloroquine Among In-patients With Symptomatic Disease (ORCHID)
Details   Late stage (65% on oxygen at baseline) low-dose RCT, not showing significant differences with treatment.
Feb 9
Meta Lounnas e al., Archives of Microbiology & Immunology, doi: (meta analysis)
Revisiting a Meta-analysis Shows that Hydroxychloroquine with Azithromycin may be Efficient in Covid-19 patients
Details   Analysis of the Fiolet meta analysis and correction of bias evaluation, showing HCQ RR 0.45 [0.31-0.59], and HCQ+AZ RR 0.34 [0.06-0.61].
Feb 9
Late Purwati et al., Biochemistry Research International, doi:10.1155/2021/6685921
viral+, ↓66.3%, p<0.0001
A Randomized, Double-Blind, Multicenter Clinical Study Comparing the Efficacy and Safety of a Drug Combination of Lopinavir/Ritonavir-Azithromycin, Lopinavir/Ritonavir-Doxycycline, and Azithromycin-Hydroxychloroquine for Patients Diagnosed with Mild to Moderate COVID-19 Infections
Details   RCT 754 patients comparing HCQ+AZ along with other treatment groups using lopinavir/ritonavir and doxycycline to a control group taking AZ, finding significantly faster viral clearance with all treatment groups. (The labels in Figure 2 ap..
Feb 5
PrEP Fitzgerald et al., medRxiv, doi:10.1101/2021.02.03.21251069 (Preprint)
cases, ↓8.5%, p=0.54
Risk Factors for Infection and Health Impacts of the COVID-19 Pandemic in People with Autoimmune Diseases
Details   Retrospective 4666 people with autoimmune or inflammatory conditions, showing HCQ adjusted risk of COVID-19 OR 0.91 [0.68-1.23]. Results are not adjusted for the significantly different risk of COVID-19 depending on the type and severity ..
Feb 5
Late Hernandez-Cardenas et al., medRxiv, doi:10.1101/2021.02.01.21250371 (Preprint)
death, ↓12.0%, p=0.66
Hydroxychloroquine for the treatment of severe respiratory infection by COVID-19: a randomized controlled trial
Details   Very late stage RCT with 214 patients, mean SpO2 65%, 162 on mechanical ventilation, showing no significant difference in mortality. Patients not intubated at baseline show greater improvement, HR 0.43 [0.09-2.03]. Table 4 shows different..
Feb 5
Late Ouedraogo et al., Revue des Maladies Respiratoires, doi:10.1016/j.rmr.2021.02.001
death, ↓33.0%, p=0.38
Factors associated with the occurrence of acute respiratory distress and death in patients with COVID-19 in Burkina Faso
Details   Retrospective 456 patients in Burkina Faso showing lower risk of ARDS (p=0.001) and mortality (p=0.38) with HCQ.
Feb 1
Review Alexander et al., medRxiv, doi:10.1101/2021.01.28.21250706 (Review) (Preprint)
Early Multidrug Outpatient Treatment of SARS-CoV-2 Infection (COVID-19) and Reduced Mortality Among Nursing Home Residents
Details   Review of studies on treatment of COVID-19 for nursing home residents, concluding that there is a large >60% mortality risk reduction associated with multidrug treatment using two or more intracellular anti-infectives (HCQ and either AZM ..
Feb 1
Late Ubaldo et al., Critical Care Research and Practice, 10.1155/2021/7510306
death, ↓18.4%, p=0.64
COVID-19: A Single-Center ICU Experience of the First Wave in the Philippines
Details   Retrospective ICU patients in the Philippines showing unadjusted HCQ RR 0.82, p = 0.64.
Jan 31
PrEP Naderi et al., Immunopathologia Persa, doi:10.34172/ipp.2021.29 (Preprint) Prophylactic effects of hydroxychloroquine on the incidence of COVID-19 in patients with rheumatic arthritis: an observational cohort study
Details   Prospective observational study of 215 RA patients treated with HCQ showing 9 cases, 1 hospitalization (without ICU/intubation), and no mortality.
Jan 31
Late Roig et al., Revista Espanola de Quimioterapia, doi:10.37201/req/130.2020
death, ↓15.6%, p=0.76
Clinical and pharmacological data in COVID-19 hospitalized nonagenarian patients
Details   Retrospective 79 hospitalized nonagenarian patients showing unadjusted HCQ mortality RR 0.84, p = 0.76.
Jan 29
Late Di Castelnuovo et al., Journal of Healthcare Engineering, doi:10.1155/2021/5556207 (preprint 1/29/2021)
death, ↓40.0%, p<0.0001
Disentangling the Association of Hydroxychloroquine Treatment with Mortality in Covid-19 Hospitalized Patients through Hierarchical Clustering
Details   Retrospective 4,396 hospitalized patients in Italy showing significantly lower mortality with HCQ treatment, and identifying greater efficacy for a subgroup of patients in clustering analysis.
Jan 27
PrEP Trefond et al., Revue du Rhumatisme, doi:10.1016/j.rhum.2021.09.004 (preprint 1/27/2021)
death, ↑16.6%, p=0.80
Effet d’un traitement par hydroxychloroquine prescrit comme traitement de fond de rhumatismes inflammatoires chroniques ou maladies auto-immunes systémiques sur les tests diagnostiques et l’évolution de l’infection à SARS CoV-2: étude de 871 patients
Details   Retrospective 71 chronic HCQ patients compared with 191 matched controls, analyzing only those with a highly suspected or confirmed diagnosis of COVID-19. No significant difference was found in outcomes, however matching failed with extre..
Jan 26
Safety Eftekhar et al., medRxiv, doi:10.1101/2021.01.16.21249941 (Preprint)
safety analysis
Hydroxychloroquine and azithromycin: As a double edge sword for COVID-19?
Details   Retrospective 172 hospitalized patients, 83% treated and HCQ+AZ and 17% with HCQ, not finding a significant difference in QTc prolongation, but recommending careful monitoring for the use of HCQ+AZ; especially in males, patients with high..
Jan 25
Early Dabbous et al., Archives of Virology, doi:10.1007/s00705-021-04956-9 Efficacy of favipiravir in COVID-19 treatment: a multi-center randomized study
Details   This study was retracted.
Jan 25
In Silico Hussein et al., Journal of Molecular Structure, doi:10.1016/j.molstruc.2021.129979
In Silico
Molecular Docking Identification for the efficacy of Some Zinc Complexes with Chloroquine and Hydroxychloroquine against Main Protease of COVID-19
Details   Molecular dynamics analysis recommending Zn (CQ) Cl2(H2O) and Zn (HCQ) Cl2(H2O) as potential inhibitors for COVID-19 Mpro. Zn (HCQ) Cl2(H2O) exhibited a strong binding to the main protease receptor, forming eight hydrogen bonds.
Jan 24
Early Zelenko, Z., Preprint (Preprint) Nebulized Hydroxychloroquine for COVID-19 Treatment: 80x Improvement in Breathing
Details   Report on the use of nebulized HCQ showing much more rapid improvement compared to tablets, with 95% of patients experiencing improved breathing within 1 hour. Author notes that the effectiveness of HCQ is time and dose dependent, with a ..
Jan 23
PrEP Cifuentes et al., Medicina Clínica (English Edition), doi:10.1016/j.medcle.2020.10.012 Incidence of COVID-19 in patients under chronic treatment with hydroxychloroquine
Details   Retrospective 3,817 chronic HCQ patients showing 4.4% COVID-19 positive rate, 1.3% severe. There is no comparison with a control group. Authors note that there was a 3.6% incidence among 2,032,863 patients in one of the regions (Castilla ..
Jan 18
Late Li et al., Science China Life Sciences, doi:10.1007/s11427-020-1871-4
no disch., ↓50.0%, p=0.09
Evaluation of the efficacy and safety of hydroxychloroquine in comparison with chloroquine in moderate and severe patients with COVID-19
Details   Small RCT comparing HCQ and CQ in China with 88 very late stage (17.6 days from onset to hospitalization and ~10 days to randomization) patients. The primary clinical outcomes (TTCR and TTCI) were not significantly different. Authors note..
Jan 13
PrEP Khoubnasabjafari et al., Postgraduate Medical Journal, doi:10.1136/postgradmedj-2020-139561
cases, ↓16.7%, p=0.59
Prevalence of COVID-19 in patients with rheumatoid arthritis (RA) already treated with hydroxychloroquine (HCQ) compared with HCQ-naive patients with RA: a multicentre cross-sectional study
Details   Survey analysis of 1,858 RA patients in Iran, showing no significant difference in cases with HCQ prophylaxis.
Jan 12
Late Li et al., Research Square, doi:10.21203/ (Preprint)
viral- time, ↑40.0%, p=0.06
Treatment of COVID-19 patients with hydroxychloroquine or chloroquine: A retrospective analysis
Details   Small retrospective database analysis of 37 late stage patients hospitalized in an intensive care center in China, not finding a significant difference in viral shedding. Pateints were all in serious condition. There was only one death ho..
Jan 10
PrEP Rangel et al., Journal of the American Academy of Dermatology, doi:10.1016/j.jaad.2020.10.098
death, ↓25.1%, p=0.77
Chronic Hydroxychloroquine Therapy and COVID-19 Outcomes: A Retrospective Case-Control Analysis
Details   Retrospective 50 COVID-19 patients that take chronic HCQ, compared to a matched sample of patients not taking chronic HCQ, showing lower mortality and ICU admission, and shorter hospitalization for HCQ patients, but not statistically sign..
Jan 8
Late Yegerov et al., medRxiv, doi:10.1101/2021.01.06.20249091 (Preprint)
death, ↓95.3%, p=1.00
Epidemiological and Clinical Characteristics, and Virologic Features of COVID-19 Patients in Kazakhstan: a Nation-Wide, Retrospective, Cohort Study
Details   Retrospective 1,072 hospitalized patients in Kazakhstan showing no mortality for HCQ treated patients, however only 23 patients received treatment - this result is not statistically significant.
Jan 7
In Silico Baildya et al., Journal of Molecular Structure, doi:10.1016/j.molstruc.2021.129891
In Silico
Inhibitory capacity of Chloroquine against SARS-COV-2 by effective binding with Angiotensin converting enzyme-2 receptor: An insight from molecular docking and MD-simulation studies
Details   Molecular docking study of 16 drugs showing CQ had the highest binding affinity with ACE2, and molecular dynamics study of the docked CQ-ACE2 structure. Authors conclude that CQ binds reasonably strongly with ACE2 and the stable ACE2-CQ m..
Jan 6
In Silico Noureddine et al., Journal of King Saud University - Science, doi:10.1016/j.jksus.2020.101334
In Silico
Quantum chemical studies on molecular structure, AIM, ELF, RDG and antiviral activities of hybrid hydroxychloroquine in the treatment of COVID-19: molecular docking and DFT calculations
Details   In silico analysis of hydroxychloroquine and hydroxychloroquine sulfate predicting that hydroxychloroquine sulfate is more stable and effective for COVID-19.
Jan 4
Safety Gautret et al., International Journal of Antimicrobial Agents, doi:10.1016/j.ijantimicag.2020.106236
safety analysis
Safety profile of hydroxychloroquine and azithromycin combined treatment in COVID-19 patients
Details   Report on the safety of HCQ+AZ with 3,737 COVID-19 patients. 138 had contraindications and treatment was discontinued in 12 cases due to QTc prolongation. There were no cases of torsade de pointe or sudden death.
Jan 2
Late Sarfaraz et al., medRxiv, doi:10.1101/2020.12.28.20248920 (Preprint)
death, ↑45.0%, p=0.07
Determinants of in-hospital mortality in COVID-19; a prospective cohort study from Pakistan
Details   Retrospective 186 hospitalized patients in Pakistan showing unadjusted HCQ mortality RR 1.45, p = 0.07. Confounding by indication is likely.
Jan 1
Late Lotfy et al., Turk. Thorac. J., doi:10.5152/TurkThoracJ.2021.20180
death, ↑24.8%, p=0.76
Use of Hydroxychloroquine in Patients with COVID-19: A Retrospective Observational Study
Details   Retrospective 202 patients in Saudi Arabia not showing significant differences with treatment. No information is provided on how patients were selected for treatment, there may be significant confounding by indication. Time varying confou..
Jan 1
Late Sands et al., International Journal of Infectious Diseases, doi:/10.1016/j.ijid.2020.12.060
death, ↑69.9%, p=0.01
No clinical benefit in mortality associated with hydroxychloroquine treatment in patients with COVID-19
Details   Retrospective database analysis of 1,669 patients in the US showing OR 1.81, p = 0.01. Confounding by indication is likely. COVID-19 was determined via PCR+ results, therefore authors include patients asymptomatic for COVID-19, but in th..
Dec 31
Late Mahale et al., Indian Journal of Critical Care Medicine, doi:10.5005/jp-journals-10071-23599
death, ↓28.7%, p=0.36
A Retrospective Observational Study of Hypoxic COVID-19 Patients Treated with Immunomodulatory Drugs in a Tertiary Care Hospital
Details   Retrospective 134 hospitalized COVID-19 patients in India, showing no significant difference with HCQ treatment in unadjusted results.
Dec 31
Review Matada et al., Bioorganic & Medicinal Chemistry, doi:10.1016/j.bmc.2020.115973 (Review)
A comprehensive review on the biological interest of quinoline and its derivatives
Details   Review of quinolone and derivatives, natural and drug sources, and biological activity.
Dec 31
Late Psevdos et al., Open Forum Infectious Diseases, doi:10.1093/ofid/ofaa439.721
death, ↑63.5%, p=0.52
Corona Virus Disease-19 (COVID-19) in a Veterans Affairs Hospital at Suffolk County, Long Island, New York
Details   Retrospective 67 hospitalized patients in the USA showing non-statistically significant unadjusted increased mortality with HCQ. Confounding by indication is likely. Time varying confounding is likely. HCQ became controversial and was sus..
Dec 31
Late Texeira et al., Open Forum Infectious Diseases, doi:10.1093/ofid/ofaa439.560
death, ↑79.3%, p=0.10
Characteristics and outcomes of COVID-19 patients admitted to a regional health system in the southeast
Details   Retrospective 161 hospitalized patients in the USA showing non-statistically significant unadjusted increased mortality with HCQ. Confounding by indication is likely. Time varying confounding is likely. HCQ became controversial and was su..
Dec 31
Late Vernaz et al., Swiss Medical Weekly, doi:10.4414/smw.2020.20446
death, ↓15.3%, p=0.71
Early experimental COVID-19 therapies: associations with length of hospital stay, mortality and related costs
Details   Retrospective 840 hospitalized patients in Switzerland showing non-statistically significant lower mortality with HCQ but significantly longer hospitalization times. Confounding by indication is likely. PSM fails to adjust for severity wi..
Dec 30
Review McCullough et al., Reviews in Cardiovascular Medicine, doi:10.31083/j.rcm.2020.04.264 (Review)
Multifaceted highly targeted sequential multidrug treatment of early ambulatory high-risk SARS-CoV-2 infection (COVID-19)
Details   Review urging early treatment of COVID-19 with sequential multidrug treatment that has been shown to be safe and effective. Proposed treatment includes zinc, vitamin D & C, quercetin, and depending on age, comorbidities, and symptoms may ..
Dec 30
Early Procter et al., Reviews in Cardiovascular Medicine, doi:10.31083/j.rcm.2020.04.260 Clinical outcomes after early ambulatory multidrug therapy for high-risk SARS-CoV-2 (COVID-19) infection
Details   Retrospective 922 outpatients, with 320 treated early due to age>50 or comorbidities, showing 2.2% hospitalization and 0.3% death, which authors note is considerably lower than reported in other studies in their region. At least two of zi..
Dec 29
Late Güner et al., Journal of Infection and Public Health, doi:10.1016/j.jiph.2020.12.017
ICU, ↓77.3%, p=0.16
Comparing ICU Admission Rates of Mild/Moderate COVID-19 Patients Treated with Hydroxychloroquine, Favipiravir, and Hydroxychloroquine plus Favipiravir
Details   Retrospective 824 hospitalized patients in Turkey showing lower ICU admission for HCQ vs. favipiravir.
Dec 28
PrEP Cordtz et al., Rheumatology, doi:10.1093/rheumatology/keaa897
hosp., ↓24.0%, p=0.67
Incidence and severeness of COVID-19 hospitalisation in patients with inflammatory rheumatic disease: a nationwide cohort study from Denmark
Details   Retrospective 58,052 rheumatic disease patients in Denmark showing that RA patients have a higher risk of COVID-19 hospitalization in general. HCQ treated patients show lower risk, although this is not statistically significant with only ..
Dec 24
Late Chari et al., Blood, doi:10.1182/blood.2020008150
death, ↓33.1%, p=0.17
Clinical features associated with COVID-19 outcome in multiple myeloma: first results from the International Myeloma Society data set
Details   Retrospective multiple myeloma patients showing lower mortality with HCQ treatment, unadjusted RR 0.67, p = 0.17 (data is in the supplementary material).
Dec 23
Early Su et al., BioScience Trends, doi:10.5582/bst.2020.03340
progression, ↓84.9%, p=0.006
Efficacy of early hydroxychloroquine treatment in preventing COVID-19 pneumonia aggravation, the experience from Shanghai, China
Details   85% lower disease progression with early use of HCQ. Retrospective 616 patients in China showing adjusted progression HR 0.15, p = 0.006.
Dec 23
Late Taccone et al., The Lancet Regional Health - Europe, doi:10.1016/j.lanepe.2020.100019
death, ↓24.7%, p=0.02
The role of organizational characteristics on the outcome of COVID-19 patients admitted to the ICU in Belgium
Details   Retrospective 1,747 ICU patients in Belgium showing lower mortality with HCQ, multivariate mixed effects analysis HCQ aOR 0.64 [0.45-0.92].
Dec 22
Late Cangiano et al., Aging, doi:10.18632/aging.202307
death, ↓73.4%, p=0.03
Mortality in an Italian nursing home during COVID-19 pandemic: correlation with gender, age, ADL, vitamin D supplementation, and limitations of the diagnostic tests
Details   73% lower mortality with HCQ. Analysis of 98 PCR+ nursing home residents in Italy, mean age 90, showing HCQ mortality RR 0.27, p = 0.03. Subject to confounding by contraindication. The paper provides the p value for regression but not the..
Dec 19
PrEP Huh et al., International Journal of Infectious Diseases, doi:10.1016/j.ijid.2020.12.041
progression, ↑251.0%, p=0.11
Association of prescribed medications with the risk of COVID-19 infection and severity among adults in South Korea
Details   Retrospective database analysis with 17 cases for existing HCQ users and 5 severe cases, showing no significant difference for cases and higher risk for severe cases. However, HCQ users are likely systemic autoimmune disease patients and ..