Results
Seven randomized clinical trials (RCTs) and 14 cohort studies were included (20 979 patients). Thirteen studies (1 RCT and 12 cohort studies) with 15 938 hospitalized patients examined the effect of HCQ on short-term mortality. The pooled adjusted OR was 1.05 (95% CI 0.96–1.15, I2 = 0%). Six cohort studies examined the effect of the HCQ+azithromycin combination with a pooled adjusted OR of 1.32 (95% CI 1.00–1.75, I2 = 68.1%). Two cohort studies and four RCTs found no effect of HCQ on viral clearance. One small RCT demonstrated improved viral clearance with CQ and HCQ. Three cohort studies found that HCQ had no significant effect on mechanical ventilation/ICU admission. Two RCTs found no effect for HCQ on hospitalization risk in outpatients with COVID-19.
Conclusions
Moderate certainty evidence suggests that HCQ, with or without azithromycin, lacks efficacy in reducing short-term mortality in patients hospitalized with COVID-19 or risk of hospitalization in outpatients with COVID-19.
Zakariya Kashour, Muhammad Riaz, Musa A Garbati, Oweida AlDosary, Haytham Tlayjeh, Dana Gerberi, M Hassan Murad, M Rizwan Sohail, Tarek Kashour, Imad M Tleyjeh, Efficacy of chloroquine or hydroxychloroquine in COVID-19 patients: a systematic review and meta-analysis, Journal of Antimicrobial Chemotherapy, Volume 76, Issue 1, January 2021, Pages 30–42,
https://doi.org/10.1093/jac/dkaa403