Hydroxychloroquine plus standard care compared with the standard care alone in COVID-19: a meta-analysis of randomized controlled trials

Amani, B.; Khanijahani, A.

Background & Objective: The efficacy and safety of Hydroxychloroquine (HCQ) in treating coronavirus disease COVID-19 pandemic is disputed. This study aimed to examine the efficacy and safety of HCQ plus standard of care in COVID-19 patients. Methods: PubMed, The Cochrane Library, Embase, and web of sciences were searched up to June 1, 2020. The references list of the key studies was reviewed for additional relevant resources. Clinical studies registry databases were searched for identifying potential clinical trials. The quality of the included studies was evaluated using the Cochrane Collaborations tool. Meta-analysis was performed using RevMan software (version 5.3). Results: Three randomized controlled trials with total number of 242 patients were identified eligible for meta-analysis. No significant differences were observed between HCQ and standard care in terms of viral clearance (Risk ratio [RR] = 1.03; 95% confidence interval [CI] = 0.91, 1.16; P= 0.68), disease progression (RR=0.92; 95% CI= 0.10, 0.81; P=0.94), Chest CT (RR=1.40; 95% CI= 1.03, 1.91; P=0.03). There is a significant difference between HCQ and standard care for adverse events (RR=2.88; 95% CI= 1.50, 5.54; P=0.002). Conclusion: Although the current meta-analysis failed to confirm the efficacy and safety of HCQ in the treatment of COVID-19 patients, further rigorous randomized clinical trials are necessary to evaluate conclusively the efficacy and safety of HCQ against COVID-19. Keyword: Coronavirus Disease; COVID-19; SARS-CoV-2; Hydroxychloroquine; Efficacy; Safety