COVID-19 Treatment - Analysis of 53 global studies showing high effectiveness for early treatment

Positive
(meta)

Early, Late Raoult et al. (Preprint) (meta analysis - not included in the study count) Hydroxych loroquine and Azithromycin as a Treatment of COVID-19: Results of an Open-Label Non-Randomized Clinical Trial: Response to David Spencer (Elsevier) Updated meta analysis showing significant reductions in mortality and viral shedding. Mortality OR 0.53 [0.4-0.71] for clinical studies, 0.92 big data studies, 18,211 patients. Persistent viral shedding OR 0.47 [0.28-0.79], 4,540 patients.

Positive
(meta)

Early, Late

Early, Late

Raoult et al. (Preprint) (meta analysis - not included in the study count) Hydroxych loroquine and Azithromycin as a Treatment of COVID-19: Results of an Open-Label Non-Randomized Clinical Trial: Response to David Spencer (Elsevier) Updated meta analysis showing significant reductions in mortality and viral shedding. Mortality OR 0.53 [0.4-0.71] for clinical studies, 0.92 big data studies, 18,211 patients. Persistent viral shedding OR 0.47 [0.28-0.79], 4,540 patients. Meta studies are not included in the percentages or study count. Source   Study Page   Share   Tweet   Submit Corrections or Comments

Negative

Late An et al., medRxiv, doi:10.1101/2020.07.04.20146548 (Preprint) Treatment Response to Hydroxych loroquine and Antibiotics for mild to moderate COVID-19: a retrospective cohort study from South Korea Retrospective of hospitalized patients with 31 HC Q patients and 195 standard treatment patients, not showing a significant difference in terms of viral clearance or recovery. There was no mortality in either group. "It is notable that HQ plus antibiotics group had worse baseline clinical profiles (i.e. higher percentage of moderate severity patients, more patients with fever >=37.5C, higher average body temperature) and prognostic indicators such as age, LDH, lymphocyte count, and CRP". We note that propensity score matching removed almost all of the male patients in the control group (40% -> 5%) but increased the percentage of male patients in the treatment group. This provides a large advantage to the control group because there is a very large difference in severity and mortality based on gender [1]. In terms of viral RNA clearance we note that other research has found that "active viral replication drops quickly after the first week, and viable virus was not found after the second week of illness despite the persistence of PCR detection of RNA” [2].

Negative

Late treatment study (serious condition requiring hospitalization)

Late treatment study

An et al., medRxiv, doi:10.1101/2020.07.04.20146548 (Preprint) Treatment Response to Hydroxych loroquine and Antibiotics for mild to moderate COVID-19: a retrospective cohort study from South Korea Retrospective of hospitalized patients with 31 HC Q patients and 195 standard treatment patients, not showing a significant difference in terms of viral clearance or recovery. There was no mortality in either group. "It is notable that HQ plus antibiotics group had worse baseline clinical profiles (i.e. higher percentage of moderate severity patients, more patients with fever >=37.5C, higher average body temperature) and prognostic indicators such as age, LDH, lymphocyte count, and CRP". We note that propensity score matching removed almost all of the male patients in the control group (40% -> 5%) but increased the percentage of male patients in the treatment group. This provides a large advantage to the control group because there is a very large difference in severity and mortality based on gender [1]. In terms of viral RNA clearance we note that other research has found that "active viral replication drops quickly after the first week, and viable virus was not found after the second week of illness despite the persistence of PCR detection of RNA” [2]. Source   Study Page   Share   Tweet   Submit Corrections or Comments

Positive

PrEP Zhong et al. Lancent Rheumatology, 10.1016/S2665-9913(20)30227-7 (Peer Reviewed) COVID-19 in patients with rheumatic disease in Hubei province, China: a multicentre retrospective observational study Rheumatic disease patients on HC Q had a lower risk of COVID-19 than those on other disease-modifying anti-rheumatic drugs, OR 0.09 (0.01–0.94), p=0.044 after adjusting for age, sex, smoking, systemic lupus erythematosus, infection in other family members, and comorbidities. 43 patients with rheumatic disease and COVID-19 exposure.

Positive

Pre-Exposure Prophylaxis study (treated before exposed to the virus)

Pre-Exposure Prophylaxis study

Zhong et al. Lancent Rheumatology, 10.1016/S2665-9913(20)30227-7 (Peer Reviewed) COVID-19 in patients with rheumatic disease in Hubei province, China: a multicentre retrospective observational study Rheumatic disease patients on HC Q had a lower risk of COVID-19 than those on other disease-modifying anti-rheumatic drugs, OR 0.09 (0.01–0.94), p=0.044 after adjusting for age, sex, smoking, systemic lupus erythematosus, infection in other family members, and comorbidities. 43 patients with rheumatic disease and COVID-19 exposure. Source   Study Page   Share   Tweet   Submit Corrections or Comments

Positive

Early Scholz et al., Preprints 2020, 2020070025, doi:10.20944/preprints202007.0025.v1 (Preprint) COVID-19 Outpatients – Early Risk-Stratified Treatment with Zinc Plus Low Dose Hydroxych loroquine and Azithromycin: A Retrospective Case Series Study Early treatment with HC Q+AZ+Z results in 84% lower hospitalization and 80% lower death - hospitalization OR 0.16 (p

Positive

Early treatment study (treated soon after symptoms appear)

Early treatment study

Scholz et al., Preprints 2020, 2020070025, doi:10.20944/preprints202007.0025.v1 (Preprint) COVID-19 Outpatients – Early Risk-Stratified Treatment with Zinc Plus Low Dose Hydroxych loroquine and Azithromycin: A Retrospective Case Series Study Early treatment with HC Q+AZ+Z results in 84% lower hospitalization and 80% lower death - hospitalization OR 0.16 (p
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Positive

Late Arshad et al. Int. J. Infect. Dis., July 1 2020, doi:10.1016/j.ijid.2020.06.099 (Peer Reviewed) Treatment with Hydroxych loroquine, Azithromycin, and Combination in Patients Hospitalized with COVID-19 HC Q decreases mortality from 26.4% to 13.5% (HC Q) or 20.1% (HC Q+AZ). Propensity matched HC Q HR 0.487, p=0.009. Michigan 2,541 patients retrospective. Before propensity matching the HC Q group average age is 5 years younger and the percentage of male patients is 4% higher which is likely to favor the treatment and the control respectively in the before-propensity matching results.

Positive

Late treatment study (serious condition requiring hospitalization)

Late treatment study

Arshad et al. Int. J. Infect. Dis., July 1 2020, doi:10.1016/j.ijid.2020.06.099 (Peer Reviewed) Treatment with Hydroxych loroquine, Azithromycin, and Combination in Patients Hospitalized with COVID-19 HC Q decreases mortality from 26.4% to 13.5% (HC Q) or 20.1% (HC Q+AZ). Propensity matched HC Q HR 0.487, p=0.009. Michigan 2,541 patients retrospective. Before propensity matching the HC Q group average age is 5 years younger and the percentage of male patients is 4% higher which is likely to favor the treatment and the control respectively in the before-propensity matching results.

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Positive

Late Mikami et al. J. Gen. Intern. Med., doi:10.1007/s11606-020-05983-z (Peer Reviewed) Risk Factors for Mortality in Patients with COVID-19 in New York City HC Q decreases mortality, HR 0.53 (CI 0.41–0.67). IPTW adjustment does not significantly change HR 0.53 (0.41-0.68). Retrospective 6,000 patients in New York City.

Positive

Late treatment study (serious condition requiring hospitalization)

Late treatment study

Mikami et al. J. Gen. Intern. Med., doi:10.1007/s11606-020-05983-z (Peer Reviewed) Risk Factors for Mortality in Patients with COVID-19 in New York City HC Q decreases mortality, HR 0.53 (CI 0.41–0.67). IPTW adjustment does not significantly change HR 0.53 (0.41-0.68). Retrospective 6,000 patients in New York City. Source   Study Page   Share   Tweet   Submit Corrections or Comments

Positive

PrEP Ferreira et al., J. Medical Virology, July 9, 2020, doi:10.1002/jmv.26286 (preprint 6/29) (Peer Reviewed) Chronic treatment with hydroxych loroquine and SARS-CoV-2 infection Chronic treatment with HC Q provides protection against COVID, odds ratio 0.51 (0.37-0.70). Note that patients with SLE, RA, and other autoimmune conditions have a significantly increased susceptibility to and incidence of infections, so the actual benefit may be significantly higher [1, 2, 3, 4, 5, 6, 7].

Positive

Pre-Exposure Prophylaxis study (treated before exposed to the virus)

Pre-Exposure Prophylaxis study

Ferreira et al., J. Medical Virology, July 9, 2020, doi:10.1002/jmv.26286 (preprint 6/29) (Peer Reviewed) Chronic treatment with hydroxych loroquine and SARS-CoV-2 infection Chronic treatment with HC Q provides protection against COVID, odds ratio 0.51 (0.37-0.70). Note that patients with SLE, RA, and other autoimmune conditions have a significantly increased susceptibility to and incidence of infections, so the actual benefit may be significantly higher [1, 2, 3, 4, 5, 6, 7]. Source   Study Page   Share   Tweet   Submit Corrections or Comments

Positive

Early Lagier et al. Travel Med. Infect. Dis. 101791, Jun 25, 2020, doi:10.1016/j.tmaid.2020.101791 (Peer Reviewed) Outcomes of 3,737 COVID-19 patients treated with hydroxych loroquine/azithromycin and other regimens in Marseille, France: A retrospective analysis Early treatment leads to significantly better clinical outcome and faster viral load reduction. Matched sample mortality HR 0.41 p-value 0.048. Retrospective 3,737 patients.

Positive

Early treatment study (treated soon after symptoms appear)

Early treatment study

Lagier et al. Travel Med. Infect. Dis. 101791, Jun 25, 2020, doi:10.1016/j.tmaid.2020.101791 (Peer Reviewed) Outcomes of 3,737 COVID-19 patients treated with hydroxych loroquine/azithromycin and other regimens in Marseille, France: A retrospective analysis Early treatment leads to significantly better clinical outcome and faster viral load reduction. Matched sample mortality HR 0.41 p-value 0.048. Retrospective 3,737 patients.

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In Vitro

In Vitro Wang et al. BioRxiv, doi:10.1101/2020.06.22.164665 (Preprint) (In Vitro) (not included in the study count) Ch loroquine and hydroxych loroquine as ACE2 blockers to inhibit viropexis of COVID-19 Spike pseudotype virus In vitro study, not included in the study count or percentages. C Q and HC Q inhibit the entry of COVID-19 spike pseudotype virus using ACE2 high expressed HEK293T cells.

In Vitro

In Vitro

In Vitro

Wang et al. BioRxiv, doi:10.1101/2020.06.22.164665 (Preprint) (In Vitro) (not included in the study count) Ch loroquine and hydroxych loroquine as ACE2 blockers to inhibit viropexis of COVID-19 Spike pseudotype virus In vitro study, not included in the study count or percentages. C Q and HC Q inhibit the entry of COVID-19 spike pseudotype virus using ACE2 high expressed HEK293T cells. Source   Study Page   Share   Tweet   Submit Corrections or Comments

Positive

Early Chen et al. medRxiv, doi:10.1101/2020.06.19.20136093 (Preprint) Efficacy and safety of ch loroquine or hydroxych loroquine in moderate type of COVID-19: a prospective open-label randomized controlled study Significantly faster clinical recovery and shorter time to RNA negative (from 7.0 days to 2.0 days (HC Q), p=0.01. 67 patients with mild/moderate cases.

Positive

Early treatment study (treated soon after symptoms appear)

Early treatment study

Chen et al. medRxiv, doi:10.1101/2020.06.19.20136093 (Preprint) Efficacy and safety of ch loroquine or hydroxych loroquine in moderate type of COVID-19: a prospective open-label randomized controlled study Significantly faster clinical recovery and shorter time to RNA negative (from 7.0 days to 2.0 days (HC Q), p=0.01. 67 patients with mild/moderate cases.

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Positive
(news)

PrEP SMSH Sawai Man Singh Hospital, India (News) (not included in the study count) HC Q beneficial as preventive drug: SMS doctors told ICMR PrEP with 4,300 very high risk healthcare workers in a hospital with up to 500+ COVID patients at a time, only 1% cases, all recovered.

Positive
(news)

Pre-Exposure Prophylaxis study (treated before exposed to the virus)

Pre-Exposure Prophylaxis study

SMSH Sawai Man Singh Hospital, India (News) (not included in the study count) HC Q beneficial as preventive drug: SMS doctors told ICMR PrEP with 4,300 very high risk healthcare workers in a hospital with up to 500+ COVID patients at a time, only 1% cases, all recovered. Currently no formal study is available so this is not included in the study count. Source   Study Page   Share   Tweet   Submit Corrections or Comments

Negative
(news)

Late NIH , study not available yet (News) (not included in the study count) NIH halts clinical trial of hydroxych loroquine NIH halts late stage trial reporting no harm and no benefit. 470 patients.

Negative
(news)

Late treatment study (serious condition requiring hospitalization)

Late treatment study

NIH , study not available yet (News) (not included in the study count) NIH halts clinical trial of hydroxych loroquine NIH halts late stage trial reporting no harm and no benefit. 470 patients. Currently no formal study is available so this is not included in the study count. Source   Study Page   Share   Tweet   Submit Corrections or Comments

Positive

Late Sbidian et al. medRxiv, doi:10.1101/2020.06.16.20132597 (Preprint) Hydroxych loroquine with or without azithromycin and in-hospital mortality or discharge in patients hospitalized for COVID-19 infection: a cohort study of 4,642 in-patients in France Retrospective of 4,642 hospitalized patients in France showing significantly faster discharge with HC Q and HC Q+AZ. No significant effect is seen on 28-day mortality, however many more control patients are still in hospital at 28 days suggesting there will be a significant improvement when extending past 28 days. Note that the median age is higher in the group not treated with HC Q or AZ. For other issues with the adjustments see [1]. Also see the analysis here [2]. We received feedback from one person that thinks the trial should be considered negative because the control patients still in hospital should be disregarded. However, based on other studies, it seems very likely that a significant number of deaths in the control group occurred past 28 days whereas no treated patients remained in hospital. This should be simple for the authors to resolve by extending the analysis. Even if we ignore this, it still shows significantly faster discharge for treatment, so we do not see how we can consider it negative. We note that the substantial reduction in hospital time is a very large cost reduction and may lower mortality in general by reducing the chance of exceeding maximum capacity. Additional feedback is welcome.

Positive

Late treatment study (serious condition requiring hospitalization)

Late treatment study

Sbidian et al. medRxiv, doi:10.1101/2020.06.16.20132597 (Preprint) Hydroxych loroquine with or without azithromycin and in-hospital mortality or discharge in patients hospitalized for COVID-19 infection: a cohort study of 4,642 in-patients in France Retrospective of 4,642 hospitalized patients in France showing significantly faster discharge with HC Q and HC Q+AZ. No significant effect is seen on 28-day mortality, however many more control patients are still in hospital at 28 days suggesting there will be a significant improvement when extending past 28 days. Note that the median age is higher in the group not treated with HC Q or AZ. For other issues with the adjustments see [1]. Also see the analysis here [2]. We received feedback from one person that thinks the trial should be considered negative because the control patients still in hospital should be disregarded. However, based on other studies, it seems very likely that a significant number of deaths in the control group occurred past 28 days whereas no treated patients remained in hospital. This should be simple for the authors to resolve by extending the analysis. Even if we ignore this, it still shows significantly faster discharge for treatment, so we do not see how we can consider it negative. We note that the substantial reduction in hospital time is a very large cost reduction and may lower mortality in general by reducing the chance of exceeding maximum capacity. Additional feedback is welcome.

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Inconc.

Late Paccoud et al. Clinical Infectious Diseases, doi:10.1093/cid/ciaa791 (Peer Reviewed) Compassionate use of hydroxych loroquine in clinical practice for patients with mild to severe Covid-19 in a French university hospital Retrospective of 89 hospitalized patients, survival HR 0.89 [0.23-3.47], not statistically significant. Authors note that unmeasured confounders may have persisted and the study may be underpowered.

Inconc.

Late treatment study (serious condition requiring hospitalization)

Late treatment study

Paccoud et al. Clinical Infectious Diseases, doi:10.1093/cid/ciaa791 (Peer Reviewed) Compassionate use of hydroxych loroquine in clinical practice for patients with mild to severe Covid-19 in a French university hospital Retrospective of 89 hospitalized patients, survival HR 0.89 [0.23-3.47], not statistically significant. Authors note that unmeasured confounders may have persisted and the study may be underpowered. Source   Study Page   Share   Tweet   Submit Corrections or Comments

Positive

Late Xue et al. J. Med. Virology (Peer Reviewed) Hydroxych loroquine treatment in COVID-19: a descriptive observational analysis of 30 cases from a single center in Wuhan, China 30 hospitalized patients. Early use of HC Q is more effective, 43% reduction in progression from moderate to severe. "Early" is relative here, within 7 days of hospitalization.

Positive

Late treatment study (serious condition requiring hospitalization)

Late treatment study

Xue et al. J. Med. Virology (Peer Reviewed) Hydroxych loroquine treatment in COVID-19: a descriptive observational analysis of 30 cases from a single center in Wuhan, China 30 hospitalized patients. Early use of HC Q is more effective, 43% reduction in progression from moderate to severe. "Early" is relative here, within 7 days of hospitalization. Source   Study Page   Share   Tweet   Submit Corrections or Comments

Negative
(news)

Late World Health Organization (News) (not included in the study count) “Solidarity” clinical trial for COVID-19 treatments WHO stopped the Solidarity late stage trial of HC Q reporting no benefit. Later news reported "little or no reduction in mortality" [1]. The study has not been released yet and few details are available. This trial used an extremely high dose which may be related to the relatively poor results [2].

Negative
(news)

Late treatment study (serious condition requiring hospitalization)

Late treatment study

World Health Organization (News) (not included in the study count) “Solidarity” clinical trial for COVID-19 treatments WHO stopped the Solidarity late stage trial of HC Q reporting no benefit. Later news reported "little or no reduction in mortality" [1]. The study has not been released yet and few details are available. This trial used an extremely high dose which may be related to the relatively poor results [2]. Currently no formal study is available so this is not included in the study count. Source   Study Page   Share   Tweet   Submit Corrections or Comments

Positive
(news)

PrEP WHIP COVID-19 (News) (not included in the study count) Henry Ford Health System still moving forward with hydroxych loroquine study Ongoing WHIP COVID-19 HC Q PrEP study reports analyzing their data and seeing a significantly improved outcome in a group of COVID-19 patients who received HC Q. For more details on the study see [1].

Positive
(news)

Pre-Exposure Prophylaxis study (treated before exposed to the virus)

Pre-Exposure Prophylaxis study

WHIP COVID-19 (News) (not included in the study count) Henry Ford Health System still moving forward with hydroxych loroquine study Ongoing WHIP COVID-19 HC Q PrEP study reports analyzing their data and seeing a significantly improved outcome in a group of COVID-19 patients who received HC Q. For more details on the study see [1]. Currently no formal study is available so this is not included in the study count.

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Theory

Theory Scherrmann , AAPS J 22, 86 (2020). doi:10.1208/s12248-020-00465-w (Peer Reviewed) (Theory) (not included in the study count) Intracellular ABCB1 as a Possible Mechanism to Explain the Synergistic Effect of Hydroxych loroquine-Azithromycin Combination in COVID-19 Therapy Theory paper, not included in the study count or percentages. Proposes a new mechanism supporting the synergistic interaction between HC Q+AZ.

Theory

Theory

Theory

Scherrmann , AAPS J 22, 86 (2020). doi:10.1208/s12248-020-00465-w (Peer Reviewed) (Theory) (not included in the study count) Intracellular ABCB1 as a Possible Mechanism to Explain the Synergistic Effect of Hydroxych loroquine-Azithromycin Combination in COVID-19 Therapy Theory paper, not included in the study count or percentages. Proposes a new mechanism supporting the synergistic interaction between HC Q+AZ.

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Negative

Late Giacomelli et al., medRxiv, doi:10.1101/2020.06.05.20123299 (Preprint) Early administration of lopinavir/ritonavir plus hydroxych loroquine does not alter the clinical course of SARS-CoV-2 infection: a retrospective cohort study Late stage study of hospitalized patients comparing treatment starting within 5 days versus later. Note that "early" here is only relative - all patients are hospitalized so this is "late" and "very late". The "early" treatment group is significantly older. Severe adverse events attributed by authors to concurrent administration of LPV, making it difficult to make conclusions about HC Q.

Negative

Late treatment study (serious condition requiring hospitalization)

Late treatment study

Giacomelli et al., medRxiv, doi:10.1101/2020.06.05.20123299 (Preprint) Early administration of lopinavir/ritonavir plus hydroxych loroquine does not alter the clinical course of SARS-CoV-2 infection: a retrospective cohort study Late stage study of hospitalized patients comparing treatment starting within 5 days versus later. Note that "early" here is only relative - all patients are hospitalized so this is "late" and "very late". The "early" treatment group is significantly older. Severe adverse events attributed by authors to concurrent administration of LPV, making it difficult to make conclusions about HC Q. Source   Study Page   Share   Tweet   Submit Corrections or Comments

Positive

Early Otea et al. medRxiv doi:10.1101/2020.06.10.20101105 (Preprint) A short therapeutic regimen based on hydroxych loroquine plus azithromycin for the treatment of COVID-19 in patients with non-severe disease. A strategy associated with a reduction in hospital admissions and complications. 80 moderate cases, HC Q+AZ appears to reduce serious complications and death. Moderate treated cases resulted in hospitalization at the same rate as mild untreated cases suggesting efficacy.

Positive

Early treatment study (treated soon after symptoms appear)

Early treatment study

Otea et al. medRxiv doi:10.1101/2020.06.10.20101105 (Preprint) A short therapeutic regimen based on hydroxych loroquine plus azithromycin for the treatment of COVID-19 in patients with non-severe disease. A strategy associated with a reduction in hospital admissions and complications. 80 moderate cases, HC Q+AZ appears to reduce serious complications and death. Moderate treated cases resulted in hospitalization at the same rate as mild untreated cases suggesting efficacy. Source   Study Page   Share   Tweet   Submit Corrections or Comments

Positive

Late Pirnay et al. Hosp. Pharm. and Clinician, doi:10.1016/j.phclin.2020.06.001 (Peer Reviewed) Beneficial effect of Hydroxych loroquine-Azithromycin combination in the treatment of elderly patients with Covid-19: results of an observational study 68 very high risk nursing home residents, median age 86, HC Q+AZ early treatment within 2.5 days onset, 2 stopped due to QTc. Only 7 died, significantly less than other nursing homes in France and the same as the median death for the same period in 2019/2018.

Positive

Late treatment study (serious condition requiring hospitalization)

Late treatment study

Pirnay et al. Hosp. Pharm. and Clinician, doi:10.1016/j.phclin.2020.06.001 (Peer Reviewed) Beneficial effect of Hydroxych loroquine-Azithromycin combination in the treatment of elderly patients with Covid-19: results of an observational study 68 very high risk nursing home residents, median age 86, HC Q+AZ early treatment within 2.5 days onset, 2 stopped due to QTc. Only 7 died, significantly less than other nursing homes in France and the same as the median death for the same period in 2019/2018. Source   Study Page   Share   Tweet   Submit Corrections or Comments

Positive

PrEP Bhattacharya et al. medRxix doi:10.1101/2020.06.09.20116806 (Preprint) Pre exposure Hydroxych loroquine use is associated with reduced COVID19 risk in healthcare workers HC Q reduced cases from 38% to 7%. 106 people. No serious adverse effects.

Positive

Pre-Exposure Prophylaxis study (treated before exposed to the virus)

Pre-Exposure Prophylaxis study

Bhattacharya et al. medRxix doi:10.1101/2020.06.09.20116806 (Preprint) Pre exposure Hydroxych loroquine use is associated with reduced COVID19 risk in healthcare workers HC Q reduced cases from 38% to 7%. 106 people. No serious adverse effects.

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Positive
(meta)

Early, Late Million et al. New Microbes and New Infections, doi:10.1016/j.nmni.2020.100709 (Peer Reviewed) (meta analysis - not included in the study count) Clinical Efficacy of Ch loroquine derivatives in COVID-19 Infection: Comparative metaanalysis between the Big data and the real world [H]C Q effective and reduces mortality by a factor 3. Meta analysis of 20 studies.

Positive
(meta)

Early, Late

Early, Late

Million et al. New Microbes and New Infections, doi:10.1016/j.nmni.2020.100709 (Peer Reviewed) (meta analysis - not included in the study count) Clinical Efficacy of Ch loroquine derivatives in COVID-19 Infection: Comparative metaanalysis between the Big data and the real world [H]C Q effective and reduces mortality by a factor 3. Meta analysis of 20 studies. Meta studies are not included in the percentages or study count.

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Negative
(news)

Late RECOVERY , study not available yet (News) (not included in the study count) No clinical benefit from use of hydroxych loroquine in hospitalised patients with COVID-19 RECOVERY trial reports no significant benefit seen for very late stage very sick patients. Extremely high dosage [1, 2]. Extremely sick patients (average of 9 days post symptoms, 60% requiring oxygen and an additional 17% requiring ventilation/ECMO) and unusually high death rate in both arms.

Negative
(news)

Late treatment study (serious condition requiring hospitalization)

Late treatment study

RECOVERY , study not available yet (News) (not included in the study count) No clinical benefit from use of hydroxych loroquine in hospitalised patients with COVID-19 RECOVERY trial reports no significant benefit seen for very late stage very sick patients. Extremely high dosage [1, 2]. Extremely sick patients (average of 9 days post symptoms, 60% requiring oxygen and an additional 17% requiring ventilation/ECMO) and unusually high death rate in both arms. Currently no formal study is available so this is not included in the study count. Source   Study Page   Share   Tweet   Submit Corrections or Comments

Positive
(see notes)

PEP Boulware et al., NEJM, June 3 2020, doi:10.1056/NEJMoa2016638 (Peer Reviewed) A Randomized Trial of Hydroxych loroquine as Postexposure Prophylaxis for Covid-19 COVID reduced by [49%, 29%, 16%] when taken within [2+, 3+, 4+] days of exposure. Very unlikely that the observed benefit and treatment delay-response relationship is due to chance, see [1]. PEP 2+ day delay RCT.

Positive
(see notes)

Post Exposure Prophylaxis study (treated after exposure to the virus)

Post Exposure Prophylaxis study

Boulware et al., NEJM, June 3 2020, doi:10.1056/NEJMoa2016638 (Peer Reviewed) A Randomized Trial of Hydroxych loroquine as Postexposure Prophylaxis for Covid-19 COVID reduced by [49%, 29%, 16%] when taken within [2+, 3+, 4+] days of exposure. Very unlikely that the observed benefit and treatment delay-response relationship is due to chance, see [1]. PEP 2+ day delay RCT. Currently this is the only study where we have evaluated the result as positive while the authors indicate it is negative, however note that author comments also differ from the published conclusion - see detailed analysis.

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Positive

Early Guérin et al. Preprints 2020, 2020050486 doi:10.20944/preprints202005.0486.v1 (Preprint) Azithromycin and Hydroxych loroquine Accelerate Recovery of Outpatients with Mild/Moderate COVID-19 Mean recovery time reduced from 26 days to 9 days (HC Q+AZ) or 13 days (AZ). 88 patients. No cardiac toxicity.

Positive

Early treatment study (treated soon after symptoms appear)

Early treatment study

Guérin et al. Preprints 2020, 2020050486 doi:10.20944/preprints202005.0486.v1 (Preprint) Azithromycin and Hydroxych loroquine Accelerate Recovery of Outpatients with Mild/Moderate COVID-19 Mean recovery time reduced from 26 days to 9 days (HC Q+AZ) or 13 days (AZ). 88 patients. No cardiac toxicity.

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Positive

Late Ayerbe et al. Journal of Thrombosis and Thrombolysis doi: 10.1007/s11239-020-02162-z (Peer Reviewed) The association between treatment with heparin and survival in patients with Covid-19 2075 hospital patients in Spain. HC Q reduces mortality from 30% to 13%. Not adjusted for age and gender. HC Q group 10% more males and 6 years younger. Study primarily interested in Heparin.

Positive

Late treatment study (serious condition requiring hospitalization)

Late treatment study

Ayerbe et al. Journal of Thrombosis and Thrombolysis doi: 10.1007/s11239-020-02162-z (Peer Reviewed) The association between treatment with heparin and survival in patients with Covid-19 2075 hospital patients in Spain. HC Q reduces mortality from 30% to 13%. Not adjusted for age and gender. HC Q group 10% more males and 6 years younger. Study primarily interested in Heparin.

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Positive

Late Chamieh et al., medRxiv 2020.05.28.20114835; doi:10.1101/2020.05.28.20114835 (Preprint) Viral Dynamics Matter in COVID-19 Pneumonia: the success of early treatment with hydroxych loroquine and azithromycin in Lebanon HC Q+AZ potentially explains 94.7% success in treating a fairly complex cohort.

Positive

Late treatment study (serious condition requiring hospitalization)

Late treatment study

Chamieh et al., medRxiv 2020.05.28.20114835; doi:10.1101/2020.05.28.20114835 (Preprint) Viral Dynamics Matter in COVID-19 Pneumonia: the success of early treatment with hydroxych loroquine and azithromycin in Lebanon HC Q+AZ potentially explains 94.7% success in treating a fairly complex cohort. Source   Study Page   Share   Tweet   Submit Corrections or Comments

Positive

PrEP Chatterjee et al. Indian J. Med. Res. (Peer Reviewed) Healthcare workers & SARS-CoV-2 infection in India: A case-control investigation in the time of COVID-19 4+ doses of HC Q associated with a significant decline in the odds of getting infected, dose-response relationship exists.

Positive

Pre-Exposure Prophylaxis study (treated before exposed to the virus)

Pre-Exposure Prophylaxis study

Chatterjee et al. Indian J. Med. Res. (Peer Reviewed) Healthcare workers & SARS-CoV-2 infection in India: A case-control investigation in the time of COVID-19 4+ doses of HC Q associated with a significant decline in the odds of getting infected, dose-response relationship exists. Source   Study Page   Share   Tweet   Submit Corrections or Comments

Positive

Early Huang et al. National Science Review, nwaa113, doi:10.1093/nsr/nwaa113 (Peer Reviewed) Preliminary evidence from a multicenter prospective observational study of the safety and efficacy of ch loroquine for the treatment of COVID-19 197 C Q patients, 176 control. Mean time to undetectable viral RNA and duration of fever significantly reduced. No serious adverse events.

Positive

Early treatment study (treated soon after symptoms appear)

Early treatment study

Huang et al. National Science Review, nwaa113, doi:10.1093/nsr/nwaa113 (Peer Reviewed) Preliminary evidence from a multicenter prospective observational study of the safety and efficacy of ch loroquine for the treatment of COVID-19 197 C Q patients, 176 control. Mean time to undetectable viral RNA and duration of fever significantly reduced. No serious adverse events.

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Positive
(meta)

Early Risch , American Journal of Epidemiology, kwaa093, 27 May 2020 doi:10.1093/aje/kwaa093 (Peer Reviewed) (meta analysis - not included in the study count) Early Outpatient Treatment of Symptomatic, High-Risk Covid-19 Patients that Should be Ramped-Up Immediately as Key to the Pandemic Crisis Five studies, including two controlled clinical trials, have demonstrated significant outpatient treatment efficacy.

Positive
(meta)

Early treatment study (treated soon after symptoms appear)

Early treatment study

Risch , American Journal of Epidemiology, kwaa093, 27 May 2020 doi:10.1093/aje/kwaa093 (Peer Reviewed) (meta analysis - not included in the study count) Early Outpatient Treatment of Symptomatic, High-Risk Covid-19 Patients that Should be Ramped-Up Immediately as Key to the Pandemic Crisis Five studies, including two controlled clinical trials, have demonstrated significant outpatient treatment efficacy. Meta studies are not included in the percentages or study count. Source   Study Page   Share   Tweet   Submit Corrections or Comments

Positive
(advisory)

PEP, PrEP ICMR Indian Council of Medical Research (Advisory) (not included in the study count) Revised advisory on the use of Hydroxych loroquine (HC Q) as prophylaxis for SARS-CoV-2 infection Healthcare workers on HC Q prophylaxis less likely to get COVID. Significant dose-response relationship. Extends recommended HC Q prophylaxis to asymptomatic household contacts of cases and frontline workers. Degree of benefit not quantified.

Positive
(advisory)

PEP, PrEP

PEP, PrEP

ICMR Indian Council of Medical Research (Advisory) (not included in the study count) Revised advisory on the use of Hydroxych loroquine (HC Q) as prophylaxis for SARS-CoV-2 infection Healthcare workers on HC Q prophylaxis less likely to get COVID. Significant dose-response relationship. Extends recommended HC Q prophylaxis to asymptomatic household contacts of cases and frontline workers. Degree of benefit not quantified. Currently no formal study is available so this is not included in the study count.

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Retracted

Late Mehra et al. The Lancet, May 22, 2020 doi: 10.1016/S0140-6736(20)31180-6 (Peer Reviewed) Hydroxych loroquine or ch loroquine with or without a macrolide for treatment of COVID-19: a multinational registry analysis Incorrect at first read (implausible death, ventilation, and population numbers). This paper was retracted.

Retracted

Late treatment study (serious condition requiring hospitalization)

Late treatment study

Mehra et al. The Lancet, May 22, 2020 doi: 10.1016/S0140-6736(20)31180-6 (Peer Reviewed) Hydroxych loroquine or ch loroquine with or without a macrolide for treatment of COVID-19: a multinational registry analysis Incorrect at first read (implausible death, ventilation, and population numbers). This paper was retracted. Source   Study Page   Share   Tweet   Submit Corrections or Comments

Negative
(meta)

Late Chacko et al. medRxiv 2020.05.14.20101774; doi:10.1101/2020.05.14.20101774 (Preprint) (meta analysis - not included in the study count) Hydroxych loroquine in COVID-19: A systematic review and meta-analysis Meta analysis of Chen, Tang, Zhaowei, Barbosa, Guatret, Geleris, Magagnoli, Mahevas, Mallat, Rosenberg, Yu et al. studies not seeing a significant effect other than time to resolution of chest CT. Limited by heterogeneous nature of studies, baseline severity varied, most studies have a small sample size, endpoints reported at varying times, dosage varied, and AZ, Zinc are not considered.

Negative
(meta)

Late treatment study (serious condition requiring hospitalization)

Late treatment study

Chacko et al. medRxiv 2020.05.14.20101774; doi:10.1101/2020.05.14.20101774 (Preprint) (meta analysis - not included in the study count) Hydroxych loroquine in COVID-19: A systematic review and meta-analysis Meta analysis of Chen, Tang, Zhaowei, Barbosa, Guatret, Geleris, Magagnoli, Mahevas, Mallat, Rosenberg, Yu et al. studies not seeing a significant effect other than time to resolution of chest CT. Limited by heterogeneous nature of studies, baseline severity varied, most studies have a small sample size, endpoints reported at varying times, dosage varied, and AZ, Zinc are not considered. Meta studies are not included in the percentages or study count. Source   Study Page   Share   Tweet   Submit Corrections or Comments

Positive

Late Kim et al. medRxiv 2020.05.13.20094193; doi:10.1101/2020.05.13.20094193 (Preprint) Treatment Response to Hydroxych loroquine, Lopinavir/Ritonavir, and Antibiotics for Moderate COVID 19: A First Report on the Pharmacological Outcomes from South Korea Retrospective of 97 moderate cases. Time to viral clearance significantly shorter for HC Q+antibiotic. Preprint withdrawn pending peer review.

Positive

Late treatment study (serious condition requiring hospitalization)

Late treatment study

Kim et al. medRxiv 2020.05.13.20094193; doi:10.1101/2020.05.13.20094193 (Preprint) Treatment Response to Hydroxych loroquine, Lopinavir/Ritonavir, and Antibiotics for Moderate COVID 19: A First Report on the Pharmacological Outcomes from South Korea Retrospective of 97 moderate cases. Time to viral clearance significantly shorter for HC Q+antibiotic. Preprint withdrawn pending peer review. Source   Study Page   Share   Tweet   Submit Corrections or Comments

Positive

Early Ahmad et al. doi:10.1101/2020.05.18.20066902 (Preprint) Doxycycline and Hydroxych loroquine as Treatment for High-Risk COVID-19 Patients: Experience from Case Series of 54 Patients in Long-Term Care Facilities 54 patients in long term care facilities. 6% death with HC Q+AZ compared to 22% using a naive indirect comparison.

Positive

Early treatment study (treated soon after symptoms appear)

Early treatment study

Ahmad et al. doi:10.1101/2020.05.18.20066902 (Preprint) Doxycycline and Hydroxych loroquine as Treatment for High-Risk COVID-19 Patients: Experience from Case Series of 54 Patients in Long-Term Care Facilities 54 patients in long term care facilities. 6% death with HC Q+AZ compared to 22% using a naive indirect comparison. Source   Study Page   Share   Tweet   Submit Corrections or Comments

Inconc.

PrEP Macias et al., medRxiv, 10.1101/2020.05.16.20104141 (Preprint) Similar incidence of Coronavirus Disease 2019 (COVID-19) in patients with rheumatic diseases with and without hydroxych loroquine therapy Very small retrospective study of rheumatic disease patients, sample size is too small for statistical significance (HC Q 0.5-4.0%, no-HC Q 0.4-2.7%). Confirmed cases were 1 HC Q and 2 no-HC Q, confimed+likely cases were 1 HC Q and 3 no-HC Q. 1 HC Q and 2 no-HC Q patients were admitted to hospital. We do not think a conclusion can be drawn based on these sample sizes. Further, there are very significant differences between the groups, for example 30% of the HC Q group have SLE vs. 2.5% of the no-HC Q group. SLE patients have a 5.7 times relative risk of pneumonia according to [1], whereas the relative risk with glucocorticoids and TNF-α inhibitors is significantly lower [2]. Two more recent studies with rheumatic disease/autoimmune condition patients provide higher confidence.

Inconc.

Pre-Exposure Prophylaxis study (treated before exposed to the virus)

Pre-Exposure Prophylaxis study

Macias et al., medRxiv, 10.1101/2020.05.16.20104141 (Preprint) Similar incidence of Coronavirus Disease 2019 (COVID-19) in patients with rheumatic diseases with and without hydroxych loroquine therapy Very small retrospective study of rheumatic disease patients, sample size is too small for statistical significance (HC Q 0.5-4.0%, no-HC Q 0.4-2.7%). Confirmed cases were 1 HC Q and 2 no-HC Q, confimed+likely cases were 1 HC Q and 3 no-HC Q. 1 HC Q and 2 no-HC Q patients were admitted to hospital. We do not think a conclusion can be drawn based on these sample sizes. Further, there are very significant differences between the groups, for example 30% of the HC Q group have SLE vs. 2.5% of the no-HC Q group. SLE patients have a 5.7 times relative risk of pneumonia according to [1], whereas the relative risk with glucocorticoids and TNF-α inhibitors is significantly lower [2]. Two more recent studies with rheumatic disease/autoimmune condition patients provide higher confidence. Source   Study Page   Share   Tweet   Submit Corrections or Comments

Positive

Late Yu et al. Sci China Life Sci. 2020 May 15;1-7. doi: 10.1007/s11427-020-1732-2 (Peer Reviewed) Low Dose of Hydroxych loroquine Reduces Fatality of Critically Ill Patients With COVID-19 Retrospective, 550 critically ill patients. 19% fatality for HC Q versus 47% for non-HC Q.

Positive

Late treatment study (serious condition requiring hospitalization)

Late treatment study

Yu et al. Sci China Life Sci. 2020 May 15;1-7. doi: 10.1007/s11427-020-1732-2 (Peer Reviewed) Low Dose of Hydroxych loroquine Reduces Fatality of Critically Ill Patients With COVID-19 Retrospective, 550 critically ill patients. 19% fatality for HC Q versus 47% for non-HC Q. Source   Study Page   Share   Tweet   Submit Corrections or Comments

Negative

Late Mahévas et al., BMJ 2020 369 doi: https://doi.org/10.1136/bmj.m1844 (Peer Reviewed) Clinical efficacy of hydroxych loroquine in patients with covid-19 pneumonia who require oxygen: observational comparative study using routine care data Observational study of 181 patients with advanced disease requiring oxygen showing no benefit for HC Q. Power of study appears too low to support conclusions [1]. None of the 15 patients receiving HC Q+AZ were transferred to intensive care or died compared to 23% overall.

Negative

Late treatment study (serious condition requiring hospitalization)

Late treatment study

Mahévas et al., BMJ 2020 369 doi: https://doi.org/10.1136/bmj.m1844 (Peer Reviewed) Clinical efficacy of hydroxych loroquine in patients with covid-19 pneumonia who require oxygen: observational comparative study using routine care data Observational study of 181 patients with advanced disease requiring oxygen showing no benefit for HC Q. Power of study appears too low to support conclusions [1]. None of the 15 patients receiving HC Q+AZ were transferred to intensive care or died compared to 23% overall. Source   Study Page   Share   Tweet   Submit Corrections or Comments

Positive

Late Davido et al. medRxiv preprint doi:10.1101/2020.05.05.2008875 (Preprint) Hydroxych loroquine plus azithromycin: a potential interest in reducing in2 hospital morbidity due to COVID-19 pneumonia (HI-ZY-COVID)? Retrospective of 132 hospitalized patients. HC Q+AZ significantly reduces death. Note that due to the controversy, authors withdrew this paper from medRxiv pending peer review.

Positive

Late treatment study (serious condition requiring hospitalization)

Late treatment study

Davido et al. medRxiv preprint doi:10.1101/2020.05.05.2008875 (Preprint) Hydroxych loroquine plus azithromycin: a potential interest in reducing in2 hospital morbidity due to COVID-19 pneumonia (HI-ZY-COVID)? Retrospective of 132 hospitalized patients. HC Q+AZ significantly reduces death. Note that due to the controversy, authors withdrew this paper from medRxiv pending peer review. Source   Study Page   Share   Tweet   Submit Corrections or Comments

Negative

Late Rosenberg et al. JAMA, May 11, 2020, doi:10.1001/jama.2020.8630 (Peer Reviewed) Association of Treatment With Hydroxych loroquine or Azithromycin With In-Hospital Mortality in Patients With COVID-19 in New York State Restrospective observational late stage study showing no significant differences but calling for clinical trials.

Negative

Late treatment study (serious condition requiring hospitalization)

Late treatment study

Rosenberg et al. JAMA, May 11, 2020, doi:10.1001/jama.2020.8630 (Peer Reviewed) Association of Treatment With Hydroxych loroquine or Azithromycin With In-Hospital Mortality in Patients With COVID-19 in New York State Restrospective observational late stage study showing no significant differences but calling for clinical trials. Source   Study Page   Share   Tweet   Submit Corrections or Comments

Positive

Late Carlucci et al. doi: 10.1101/2020.05.02.20080036 (Preprint) Hydroxych loroquine and azithromycin plus zinc vs hydroxych loroquine and azithromycin alone: outcomes in hospitalized COVID-19 patients Observational retrospective. Addition of Zinc to HC Q+AZ reduces mortality.

Positive

Late treatment study (serious condition requiring hospitalization)

Late treatment study

Carlucci et al. doi: 10.1101/2020.05.02.20080036 (Preprint) Hydroxych loroquine and azithromycin plus zinc vs hydroxych loroquine and azithromycin alone: outcomes in hospitalized COVID-19 patients Observational retrospective. Addition of Zinc to HC Q+AZ reduces mortality. Source   Study Page   Share   Tweet   Submit Corrections or Comments

Theory

Theory Derendorf , Int. J. Antimicrobial Agents, 7 May 2020, doi:10.1016/j.ijantimicag.2020.106007 (Peer Reviewed) (Theory) (not included in the study count) Excessive lysosomal ion-trapping of hydroxych loroquine and azithromycin Discusses pharmacokinetic properties of HC Q+AZ as a potential underlying mechanism of the observed antiviral effects.

Theory

Theory

Theory

Derendorf , Int. J. Antimicrobial Agents, 7 May 2020, doi:10.1016/j.ijantimicag.2020.106007 (Peer Reviewed) (Theory) (not included in the study count) Excessive lysosomal ion-trapping of hydroxych loroquine and azithromycin Discusses pharmacokinetic properties of HC Q+AZ as a potential underlying mechanism of the observed antiviral effects. Source   Study Page   Share   Tweet   Submit Corrections or Comments

Negative

Late Geleris et al. NEJM, May 7, 2020. doi: 10.1056/NEJMoa2012410 (Peer Reviewed) Observational Study of Hydroxych loroquine in Hospitalized Patients with Covid-19 Observational study of 1446 hospitalized patients. No significant effect on a combined intubation/death outcome for late treatment. RCT recommended. No AZ or Zinc. HC Q group much sicker - patients already in mild/moderate ARDS, most of the control group not in ARDS. However, secondary analysis shows the success of HC Q was hidden by combining intubation and death - death / (combined death/intubation) for HC Q was 157 / 262 (60%) vs. control 75 / 84 (89%), for details see: [1]. Control cases received other therapeutics.

Negative

Late treatment study (serious condition requiring hospitalization)

Late treatment study

Geleris et al. NEJM, May 7, 2020. doi: 10.1056/NEJMoa2012410 (Peer Reviewed) Observational Study of Hydroxych loroquine in Hospitalized Patients with Covid-19 Observational study of 1446 hospitalized patients. No significant effect on a combined intubation/death outcome for late treatment. RCT recommended. No AZ or Zinc. HC Q group much sicker - patients already in mild/moderate ARDS, most of the control group not in ARDS. However, secondary analysis shows the success of HC Q was hidden by combining intubation and death - death / (combined death/intubation) for HC Q was 157 / 262 (60%) vs. control 75 / 84 (89%), for details see: [1]. Control cases received other therapeutics. Source   Study Page   Share   Tweet   Submit Corrections or Comments

Positive
(news)

N/A Sermo (News) (not included in the study count) Sermo reports: COVID-19 treatment trends over 6 weeks and 33,700 interviews: Usage, efficacy and safety perceptions of most-used therapies HC Q used by 55% of physicians worldwide for COVID. Survey of 6,150 physicians.

Positive
(news)

N/A

N/A

Sermo (News) (not included in the study count) Sermo reports: COVID-19 treatment trends over 6 weeks and 33,700 interviews: Usage, efficacy and safety perceptions of most-used therapies HC Q used by 55% of physicians worldwide for COVID. Survey of 6,150 physicians. Currently no formal study is available so this is not included in the study count. Source   Study Page   Share   Tweet   Submit Corrections or Comments

Positive

Late Membrillo de Novales et al. Preprints 2020, 2020050057 doi:10.20944/preprints202005.0057.v1 (Preprint) Early Hydroxych loroquine Is Associated with an Increase of Survival in COVID-19 Patients: An Observational Study 166 patients hospitalised with COVID, HC Q increased survival 1.4 - 1.8 times when patients admitted in early stages. Early is relative to hospital admission here - all patients relatively serious condition.

Positive

Late treatment study (serious condition requiring hospitalization)

Late treatment study

Membrillo de Novales et al. Preprints 2020, 2020050057 doi:10.20944/preprints202005.0057.v1 (Preprint) Early Hydroxych loroquine Is Associated with an Increase of Survival in COVID-19 Patients: An Observational Study 166 patients hospitalised with COVID, HC Q increased survival 1.4 - 1.8 times when patients admitted in early stages. Early is relative to hospital admission here - all patients relatively serious condition. Source   Study Page   Share   Tweet   Submit Corrections or Comments

Positive

Early Million et al. Travel Med Infect Dis. 2020 May 5;101738. doi:10.1016/j.tmaid.2020.101738 (Peer Reviewed) Early Treatment of COVID-19 Patients With Hydroxych loroquine and Azithromycin: A Retrospective Analysis of 1061 Cases in Marseille, France Retrospective 1061 patients. HC Q+AZ safe and results in a low fatality rate.

Positive

Early treatment study (treated soon after symptoms appear)

Early treatment study

Million et al. Travel Med Infect Dis. 2020 May 5;101738. doi:10.1016/j.tmaid.2020.101738 (Peer Reviewed) Early Treatment of COVID-19 Patients With Hydroxych loroquine and Azithromycin: A Retrospective Analysis of 1061 Cases in Marseille, France Retrospective 1061 patients. HC Q+AZ safe and results in a low fatality rate. Source   Study Page   Share   Tweet   Submit Corrections or Comments

Inconc.

PrEP Gendelman et al. Autoimmunity Reviews, 19:7, July 2020, doi:10.1016/j.autrev.2020.102566 (Peer Reviewed) Continuous Hydroxych loroquine or Colchicine Therapy Does Not Prevent Infection With SARS-CoV-2: Insights From a Large Healthcare Database Analysis Very small study of rheumatic disease/autoimmune disorder patients showing no significant difference but with only 3 chronic HC Q patient cases. Only considers people tested at a time when primarily symptomatic cases were tested. Note that patients with SLE, RA, and other autoimmune conditions have a significantly increased susceptibility to and incidence of infections [1, 2, 3, 4, 5, 6, 7], with this context the results suggest HC Q is effective, but this is still inconclusive with the small sample size. Two more recent studies with rheumatic disease/autoimmune condition patients provide higher confidence.

Inconc.

Pre-Exposure Prophylaxis study (treated before exposed to the virus)

Pre-Exposure Prophylaxis study

Gendelman et al. Autoimmunity Reviews, 19:7, July 2020, doi:10.1016/j.autrev.2020.102566 (Peer Reviewed) Continuous Hydroxych loroquine or Colchicine Therapy Does Not Prevent Infection With SARS-CoV-2: Insights From a Large Healthcare Database Analysis Very small study of rheumatic disease/autoimmune disorder patients showing no significant difference but with only 3 chronic HC Q patient cases. Only considers people tested at a time when primarily symptomatic cases were tested. Note that patients with SLE, RA, and other autoimmune conditions have a significantly increased susceptibility to and incidence of infections [1, 2, 3, 4, 5, 6, 7], with this context the results suggest HC Q is effective, but this is still inconclusive with the small sample size. Two more recent studies with rheumatic disease/autoimmune condition patients provide higher confidence. Source   Study Page   Share   Tweet   Submit Corrections or Comments

Positive
(news)

Late Seydi (News) (not included in the study count) Coronavirus: a study in Senegal confirms the effectiveness of hydroxych loroquine Preliminary results of Senegal trial with 181 patients showing faster recovery with HC Q, and even faster recovery with HC Q+AZ.

Positive
(news)

Late treatment study (serious condition requiring hospitalization)

Late treatment study

Seydi (News) (not included in the study count) Coronavirus: a study in Senegal confirms the effectiveness of hydroxych loroquine Preliminary results of Senegal trial with 181 patients showing faster recovery with HC Q, and even faster recovery with HC Q+AZ. Currently no formal study is available so this is not included in the study count. Source   Study Page   Share   Tweet   Submit Corrections or Comments

Positive
(meta)

Early Meo et al. Eur Rev Med Pharmacol Sci 2020; 24 (8): 4539-4547, doi:10.26355/eurrev_202004_21038 (Peer Reviewed) (meta analysis - not included in the study count) Efficacy of ch loroquine and hydroxych loroquine in the treatment of COVID-19 Review of 9 articles supporting the efficacy of HC Q and C Q.

Positive
(meta)

Early treatment study (treated soon after symptoms appear)

Early treatment study

Meo et al. Eur Rev Med Pharmacol Sci 2020; 24 (8): 4539-4547, doi:10.26355/eurrev_202004_21038 (Peer Reviewed) (meta analysis - not included in the study count) Efficacy of ch loroquine and hydroxych loroquine in the treatment of COVID-19 Review of 9 articles supporting the efficacy of HC Q and C Q. Meta studies are not included in the percentages or study count. Source   Study Page   Share   Tweet   Submit Corrections or Comments

Positive

N/A Saleh et al. Circulation: Arrhythmia and Electrophysiology, doi:10.1161/CIRCEP.120.008662 (Peer Reviewed) The Effect of Ch loroquine, Hydroxych loroquine and Azithromycin on the Corrected QT Interval in Patients with SARS-CoV-2 Infection 201 hospitalized patients. No serious side effects of HC Q.

Positive

N/A

N/A

Saleh et al. Circulation: Arrhythmia and Electrophysiology, doi:10.1161/CIRCEP.120.008662 (Peer Reviewed) The Effect of Ch loroquine, Hydroxych loroquine and Azithromycin on the Corrected QT Interval in Patients with SARS-CoV-2 Infection 201 hospitalized patients. No serious side effects of HC Q. Source   Study Page   Share   Tweet   Submit Corrections or Comments

In Vitro

In Vitro Andreani et al. Microbial Pathogenesis, doi:/10.1016/j.micpath.2020.104228 (Peer Reviewed) (In Vitro) (not included in the study count) In vitro testing of combined hydroxych loroquine and azithromycin on SARS-CoV-2 shows synergistic effect HC Q and AZ has a synergistic effect in vitro on SARS-CoV-2 at concentrations compatible with that obtained in human lung.

In Vitro

In Vitro

In Vitro

Andreani et al. Microbial Pathogenesis, doi:/10.1016/j.micpath.2020.104228 (Peer Reviewed) (In Vitro) (not included in the study count) In vitro testing of combined hydroxych loroquine and azithromycin on SARS-CoV-2 shows synergistic effect HC Q and AZ has a synergistic effect in vitro on SARS-CoV-2 at concentrations compatible with that obtained in human lung. Source   Study Page   Share   Tweet   Submit Corrections or Comments

Positive

Early Ashraf et al. medRxiv doi:10.1101/2020.04.20.20072421.t (Preprint) COVID-19 in Iran, a comprehensive investigation from exposure to treatment outcomes 100 patients. HC Q improved clinical outcome.

Positive

Early treatment study (treated soon after symptoms appear)

Early treatment study

Ashraf et al. medRxiv doi:10.1101/2020.04.20.20072421.t (Preprint) COVID-19 in Iran, a comprehensive investigation from exposure to treatment outcomes 100 patients. HC Q improved clinical outcome. Source   Study Page   Share   Tweet   Submit Corrections or Comments

Negative

Late Magagnoli et al., Med (2020), doi:10.1016/j.medj.2020.06.001 (preprint 4/21) (Peer Reviewed) Outcomes of hydroxych loroquine usage in United States veterans hospitalized with Covid-19 Retrospective 368 hospitalized patients, no significant reduction in mortality or the need for mechanical ventilation with HC Q or HC Q+AZ. Study notes HC Q was more likely to be prescribed to patients with more severe disease.

Negative

Late treatment study (serious condition requiring hospitalization)

Late treatment study

Magagnoli et al., Med (2020), doi:10.1016/j.medj.2020.06.001 (preprint 4/21) (Peer Reviewed) Outcomes of hydroxych loroquine usage in United States veterans hospitalized with Covid-19 Retrospective 368 hospitalized patients, no significant reduction in mortality or the need for mechanical ventilation with HC Q or HC Q+AZ. Study notes HC Q was more likely to be prescribed to patients with more severe disease. Source   Study Page   Share   Tweet   Submit Corrections or Comments

Positive

PEP Lee at al. Int J. Antimicrob. Agents. 2020 Apr 17;105988. doi: 10.1016/j.ijantimicag.2020.105988 (Peer Reviewed) Can Post-Exposure Prophylaxis for COVID-19 Be Considered as an Outbreak Response Strategy in Long-Term Care Hospitals? Post exposure prophylaxis of 211 people after major exposure event in LTCH, 0 positive for COVID after 14 days.

Positive

Post Exposure Prophylaxis study (treated after exposure to the virus)

Post Exposure Prophylaxis study

Lee at al. Int J. Antimicrob. Agents. 2020 Apr 17;105988. doi: 10.1016/j.ijantimicag.2020.105988 (Peer Reviewed) Can Post-Exposure Prophylaxis for COVID-19 Be Considered as an Outbreak Response Strategy in Long-Term Care Hospitals? Post exposure prophylaxis of 211 people after major exposure event in LTCH, 0 positive for COVID after 14 days. Source   Study Page   Share   Tweet   Submit Corrections or Comments

Negative

Late Borba et al. JAMA Network Open doi: 10.1001/jamanetworkopen.2020.8857 (Peer Reviewed) Ch loroquine diphosphate in two different dosages as adjunctive therapy of hospitalized patients with severe respiratory syndrome in the context of coronavirus (SARS-CoV-2) infection: Preliminary safety results of a randomized, double-blinded, phase IIb clinical trial (CloroCovid-19 Study) Increased incidence of prolonged QT and death in high dose treatment arm. Patients >75 only enrolled in high dose arm, age of high dose arm significantly higher than low dose arm (p=0.02). Very sick at baseline, 43% in ICU, 88.9% on respiratory therapy prior to treatment.

Negative

Late treatment study (serious condition requiring hospitalization)

Late treatment study

Borba et al. JAMA Network Open doi: 10.1001/jamanetworkopen.2020.8857 (Peer Reviewed) Ch loroquine diphosphate in two different dosages as adjunctive therapy of hospitalized patients with severe respiratory syndrome in the context of coronavirus (SARS-CoV-2) infection: Preliminary safety results of a randomized, double-blinded, phase IIb clinical trial (CloroCovid-19 Study) Increased incidence of prolonged QT and death in high dose treatment arm. Patients >75 only enrolled in high dose arm, age of high dose arm significantly higher than low dose arm (p=0.02). Very sick at baseline, 43% in ICU, 88.9% on respiratory therapy prior to treatment. Source   Study Page   Share   Tweet   Submit Corrections or Comments

Positive

Early Esper et al. Prevent Senior Institute, São Paulo, Brazil (Preprint) Empirical treatment with hydroxych loroquine and azithromycin for suspected cases of COVID-19 followed-up by telemedicine 636 patients. HC Q+AZ reduced hospitalization 79% when used within 7 days (65% overall). Non-randomized.

Positive

Early treatment study (treated soon after symptoms appear)

Early treatment study

Esper et al. Prevent Senior Institute, São Paulo, Brazil (Preprint) Empirical treatment with hydroxych loroquine and azithromycin for suspected cases of COVID-19 followed-up by telemedicine 636 patients. HC Q+AZ reduced hospitalization 79% when used within 7 days (65% overall). Non-randomized. Source   Study Page   Share   Tweet   Submit Corrections or Comments

Negative

Late Tang et al. BMJ 2020, 369 doi:10.1136/bmj.m1849 (Peer Reviewed) Hydroxych loroquine in patients with COVID-19: an open-label, randomized, controlled trial 150 patients very late stage RCT. No significant difference. More symptomatic relief with HC Q. No safety concerns of HC Q. Treatment very late, average 16.6 days after symptom onset. Data favorable to HC Q was deleted in the second version, see analysis [1].

Negative

Late treatment study (serious condition requiring hospitalization)

Late treatment study

Tang et al. BMJ 2020, 369 doi:10.1136/bmj.m1849 (Peer Reviewed) Hydroxych loroquine in patients with COVID-19: an open-label, randomized, controlled trial 150 patients very late stage RCT. No significant difference. More symptomatic relief with HC Q. No safety concerns of HC Q. Treatment very late, average 16.6 days after symptom onset. Data favorable to HC Q was deleted in the second version, see analysis [1]. Source   Study Page   Share   Tweet   Submit Corrections or Comments

Positive

N/A Gao et al. Biosci Trends, 2020 May 21;14(2):156-158. doi: 10.5582/bst.2020.03072. Epub 2020 Apr 13 (Peer Reviewed) Update on Use of Ch loroquine/Hydroxych loroquine to Treat Coronavirus Disease 2019 (COVID-19) Increasing evidence from completed clinical studies shows C Q and HC Q effective (HC Q more effective).

Positive

N/A

N/A

Gao et al. Biosci Trends, 2020 May 21;14(2):156-158. doi: 10.5582/bst.2020.03072. Epub 2020 Apr 13 (Peer Reviewed) Update on Use of Ch loroquine/Hydroxych loroquine to Treat Coronavirus Disease 2019 (COVID-19) Increasing evidence from completed clinical studies shows C Q and HC Q effective (HC Q more effective). Source   Study Page   Share   Tweet   Submit Corrections or Comments

Positive

Early Gautret et al. Travel Medicine and Infectious Disease, doi:10.1016/j.tmaid.2020.101663 (Peer Reviewed) Clinical and microbiological effect of a combination of hydroxych loroquine and azithromycin in 80 COVID-19 patients with at least a six-day follow up: A pilot observational study Pilot study suggesting improvement with HC Q+AZ and recommending further study.

Positive

Early treatment study (treated soon after symptoms appear)

Early treatment study

Gautret et al. Travel Medicine and Infectious Disease, doi:10.1016/j.tmaid.2020.101663 (Peer Reviewed) Clinical and microbiological effect of a combination of hydroxych loroquine and azithromycin in 80 COVID-19 patients with at least a six-day follow up: A pilot observational study Pilot study suggesting improvement with HC Q+AZ and recommending further study. Source   Study Page   Share   Tweet   Submit Corrections or Comments

Positive

Late Huang et al. Journal of Molecular Cell Biology, Volume 12, Issue 4, April 2020, Pages 322–325, doi:10.1093/jmcb/mjaa014 (Peer Reviewed) Treating COVID-19 with Ch loroquine 22 patients. All C Q patients discharged by day 14 versus 50% of Lopinavir/Rotinavir patients. Symptom onset to treatment 2.5 days for C Q vs. 6.5 days for Lopinavir/Rotinavir.

Positive

Late treatment study (serious condition requiring hospitalization)

Late treatment study

Huang et al. Journal of Molecular Cell Biology, Volume 12, Issue 4, April 2020, Pages 322–325, doi:10.1093/jmcb/mjaa014 (Peer Reviewed) Treating COVID-19 with Ch loroquine 22 patients. All C Q patients discharged by day 14 versus 50% of Lopinavir/Rotinavir patients. Symptom onset to treatment 2.5 days for C Q vs. 6.5 days for Lopinavir/Rotinavir. Source   Study Page   Share   Tweet   Submit Corrections or Comments

Positive

Late Chen et al. medRxiv doi:10.1101/2020.03.22.20040758 (Preprint) Efficacy of hydroxych loroquine in patients with COVID-19: results of a randomized clinical trial 62 patients. RCT showing significantly faster recovery with HC Q. 13% progressed to severe cases in the control group, versus 0% for the treatment group. Significant improvement seen in pneumonia on chest CT for 61% of treated patients and 16% of control patients.

Positive

Late treatment study (serious condition requiring hospitalization)

Late treatment study

Chen et al. medRxiv doi:10.1101/2020.03.22.20040758 (Preprint) Efficacy of hydroxych loroquine in patients with COVID-19: results of a randomized clinical trial 62 patients. RCT showing significantly faster recovery with HC Q. 13% progressed to severe cases in the control group, versus 0% for the treatment group. Significant improvement seen in pneumonia on chest CT for 61% of treated patients and 16% of control patients. Source   Study Page   Share   Tweet   Submit Corrections or Comments

In Vitro

In Vitro Clementi et al., Front. Microbiol., 10 July 2020, doi:10.3389/fmicb.2020.01704 (preprint 3/31) (Peer Reviewed) (In Vitro) (not included in the study count) Combined Prophylactic and Therapeutic Use Maximizes Hydroxych loroquine Anti-SARS-CoV-2 Effects in vitro In vitro study, not included in the study count or percentages, showing greater inhibition for combined pre and post-exposure treatment for Vero E6 and Caco-2 cells.

In Vitro

In Vitro

In Vitro

Clementi et al., Front. Microbiol., 10 July 2020, doi:10.3389/fmicb.2020.01704 (preprint 3/31) (Peer Reviewed) (In Vitro) (not included in the study count) Combined Prophylactic and Therapeutic Use Maximizes Hydroxych loroquine Anti-SARS-CoV-2 Effects in vitro In vitro study, not included in the study count or percentages, showing greater inhibition for combined pre and post-exposure treatment for Vero E6 and Caco-2 cells. Source   Study Page   Share   Tweet   Submit Corrections or Comments

Negative
(letter)

Late Molina et al. Médecine et Maladies Infectieuses, 50:4, June 2020, 10.1016/j.medmal.2020.03.006 (preprint 3/28) (Letter to the editor) No evidence of rapid antiviral clearance or clinical benefit with the combination of hydroxych loroquine and azithromycin in patients with severe COVID-19 infection 11 patients with severe cases. No evidence of benefit for HC Q.

Negative
(letter)

Late treatment study (serious condition requiring hospitalization)

Late treatment study

Molina et al. Médecine et Maladies Infectieuses, 50:4, June 2020, 10.1016/j.medmal.2020.03.006 (preprint 3/28) (Letter to the editor) No evidence of rapid antiviral clearance or clinical benefit with the combination of hydroxych loroquine and azithromycin in patients with severe COVID-19 infection 11 patients with severe cases. No evidence of benefit for HC Q. Source   Study Page   Share   Tweet   Submit Corrections or Comments

Positive
(news)

Late Zhong Nanshan (News) (not included in the study count) Efficacy and safety of ch loroquine for treatment of COVID-19. An open-label, multi-center, non-randomized trial 197 patients. HC Q effective. Viral RNA negative in 95.9% versus 79.6% control. Median time to negative tests 3 days versus 9 days for control.

Positive
(news)

Late treatment study (serious condition requiring hospitalization)

Late treatment study

Zhong Nanshan (News) (not included in the study count) Efficacy and safety of ch loroquine for treatment of COVID-19. An open-label, multi-center, non-randomized trial 197 patients. HC Q effective. Viral RNA negative in 95.9% versus 79.6% control. Median time to negative tests 3 days versus 9 days for control. Currently no formal study is available so this is not included in the study count. Source   Study Page   Share   Tweet   Submit Corrections or Comments

Theory

Theory Pagliano et al. Clin Infect Dis, 2020 Mar 24; ciaa320. doi:10.1093/cid/ciaa320 (Peer Reviewed) (Theory) Is Hydroxych loroquine a Possible Post-Exposure Prophylaxis Drug to Limit the Transmission to Health Care Workers Exposed to COVID19? C Q and HC Q inhibit replication at early stages of infection, no similar effect reported for other drugs which are only able to interfere after cell infection. Large volume of existing data on safety.

Theory

Theory

Theory

Pagliano et al. Clin Infect Dis, 2020 Mar 24; ciaa320. doi:10.1093/cid/ciaa320 (Peer Reviewed) (Theory) Is Hydroxych loroquine a Possible Post-Exposure Prophylaxis Drug to Limit the Transmission to Health Care Workers Exposed to COVID19? C Q and HC Q inhibit replication at early stages of infection, no similar effect reported for other drugs which are only able to interfere after cell infection. Large volume of existing data on safety. Source   Study Page   Share   Tweet   Submit Corrections or Comments

Theory

Theory Hu et al., Nature Nanotechnology, 15, 247–249, 2020, doi:10.1038/s41565-020-0674-9 (Peer Reviewed) (Theory) (not included in the study count) Insights from nanomedicine into ch loroquine efficacy against COVID-19 C Q is known in nanomedicine research for the investigation of nanoparticle uptake in cells, and may have potential for the treatment of COVID-19.

Theory

Theory

Theory

Hu et al., Nature Nanotechnology, 15, 247–249, 2020, doi:10.1038/s41565-020-0674-9 (Peer Reviewed) (Theory) (not included in the study count) Insights from nanomedicine into ch loroquine efficacy against COVID-19 C Q is known in nanomedicine research for the investigation of nanoparticle uptake in cells, and may have potential for the treatment of COVID-19. Source   Study Page   Share   Tweet   Submit Corrections or Comments

Positive
(advisory)

PrEP ICMR Indian Council of Medical Research (Advisory) (not included in the study count) Advisory on the use of hydroxy-ch loroquine as prophylaxis for SARS-CoV-2 infection Recommends HC Q for prophylaxis in asymptomatic healthcare workers as found effective in-vitro and in-vivo.

Positive
(advisory)

Pre-Exposure Prophylaxis study (treated before exposed to the virus)

Pre-Exposure Prophylaxis study

ICMR Indian Council of Medical Research (Advisory) (not included in the study count) Advisory on the use of hydroxy-ch loroquine as prophylaxis for SARS-CoV-2 infection Recommends HC Q for prophylaxis in asymptomatic healthcare workers as found effective in-vitro and in-vivo. Currently no formal study is available so this is not included in the study count. Source   Study Page   Share   Tweet   Submit Corrections or Comments

Positive
(news)

Late Hu et al., Shanghai Combined Task Force on COVID-19 (News) (not included in the study count) Shanghai Experience of COVID-19 Management Clinical studies of HC Q with 184 cases and 21 hospitals show HC Q is effective.

Positive
(news)

Late treatment study (serious condition requiring hospitalization)

Late treatment study

Hu et al., Shanghai Combined Task Force on COVID-19 (News) (not included in the study count) Shanghai Experience of COVID-19 Management Clinical studies of HC Q with 184 cases and 21 hospitals show HC Q is effective. Currently no formal study is available so this is not included in the study count. Source   Study Page   Share   Tweet   Submit Corrections or Comments

In Vitro

In Vitro Liu et al. Cell Discovery 6, 16 (2020). doi:10.1038/s41421-020-0156-0 (Peer Reviewed) (In Vitro) (not included in the study count) Hydroxych loroquine, a less toxic derivative of ch loroquine, is effective in inhibiting SARS-CoV-2 infection in vitro HC Q effective in vitro and less toxic than C Q.

In Vitro

In Vitro

In Vitro

Liu et al. Cell Discovery 6, 16 (2020). doi:10.1038/s41421-020-0156-0 (Peer Reviewed) (In Vitro) (not included in the study count) Hydroxych loroquine, a less toxic derivative of ch loroquine, is effective in inhibiting SARS-CoV-2 infection in vitro HC Q effective in vitro and less toxic than C Q. Source   Study Page   Share   Tweet   Submit Corrections or Comments

Positive

Early Gautret et al. Int. J. of Antimicrobial Agents, 17 March 2020, doi:10.1016/j.ijantimicag.2020.105949 (Peer Reviewed) Hydroxych loroquine and azithromycin as a treatment of COVID-19: results of an openlabel non-randomized clinical trial HC Q significantly associated with viral load reduction / elimination, enhanced with AZ.

Positive

Early treatment study (treated soon after symptoms appear)

Early treatment study

Gautret et al. Int. J. of Antimicrobial Agents, 17 March 2020, doi:10.1016/j.ijantimicag.2020.105949 (Peer Reviewed) Hydroxych loroquine and azithromycin as a treatment of COVID-19: results of an openlabel non-randomized clinical trial HC Q significantly associated with viral load reduction / elimination, enhanced with AZ. Source   Study Page   Share   Tweet   Submit Corrections or Comments

Positive

N/A Todaro and Rigano (Preprint) An Effective Treatment for Coronavirus (COVID-19) Discussion of existing research, treatment guidelines, and mechanims of action for C Q and HC Q, recommending use.

Positive

N/A

N/A

Todaro and Rigano (Preprint) An Effective Treatment for Coronavirus (COVID-19) Discussion of existing research, treatment guidelines, and mechanims of action for C Q and HC Q, recommending use. Source   Study Page   Share   Tweet   Submit Corrections or Comments

Theory

Theory Devaux et al., International Journal of Antimicrobial Agents, doi:10.1016/j.ijantimicag.2020.105938 (Peer Reviewed) (Theory) (not included in the study count) New insights on the antiviral effects of ch loroquine against coronavirus: what to expect for COVID-19? Discusses mechanisms of C Q interference with SARS-CoV-2 replication cycle.

Theory

Theory

Theory

Devaux et al., International Journal of Antimicrobial Agents, doi:10.1016/j.ijantimicag.2020.105938 (Peer Reviewed) (Theory) (not included in the study count) New insights on the antiviral effects of ch loroquine against coronavirus: what to expect for COVID-19? Discusses mechanisms of C Q interference with SARS-CoV-2 replication cycle. Source   Study Page   Share   Tweet   Submit Corrections or Comments

Positive
(meta)

N/A Cortegiani et al. J Crit Care, 2020 Jun;57:279-283. doi:10.1016/j.jcrc.2020.03.005 Epub 2020 Mar 10 (Peer Reviewed) (meta analysis - not included in the study count) A Systematic Review on the Efficacy and Safety of Ch loroquine for the Treatment of COVID-19 Review of six articles and 23 ongoing clinical trials in China recommending research and clinical use adhering to MEURI.

Positive
(meta)

N/A

N/A

Cortegiani et al. J Crit Care, 2020 Jun;57:279-283. doi:10.1016/j.jcrc.2020.03.005 Epub 2020 Mar 10 (Peer Reviewed) (meta analysis - not included in the study count) A Systematic Review on the Efficacy and Safety of Ch loroquine for the Treatment of COVID-19 Review of six articles and 23 ongoing clinical trials in China recommending research and clinical use adhering to MEURI. Meta studies are not included in the percentages or study count. Source   Study Page   Share   Tweet   Submit Corrections or Comments

In Vitro

N/A Yao et al., Clin. Infect. Dis. 2020 Mar 9, doi:10.1093/cid/ciaa237 (Peer Reviewed) (not included in the study count) In Vitro Antiviral Activity and Projection of Optimized Dosing Design of Hydroxych loroquine for the Treatment of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) HC Q more potent than C Q in vitro.

In Vitro

N/A

N/A

Yao et al., Clin. Infect. Dis. 2020 Mar 9, doi:10.1093/cid/ciaa237 (Peer Reviewed) (not included in the study count) In Vitro Antiviral Activity and Projection of Optimized Dosing Design of Hydroxych loroquine for the Treatment of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) HC Q more potent than C Q in vitro. Source   Study Page   Share   Tweet   Submit Corrections or Comments

Negative

Late Chen et al., J. Zhejiang University (Med Sci), doi:10.3785/j.issn.1008-9292.2020.03.03 (Peer Reviewed) A pilot study of hydroxych loroquine in treatment of patients with common coronavirus disease-19 (COVID-19) 30 moderate hospitalized cases, all recovered. Time to RNA negative comparable. Less frequent radiological progression with HC Q but not statistically significant. One HC Q patient developed to a severe case. Treatment group 4 years older and with higher incidence of hypertension.

Negative

Late treatment study (serious condition requiring hospitalization)

Late treatment study

Chen et al., J. Zhejiang University (Med Sci), doi:10.3785/j.issn.1008-9292.2020.03.03 (Peer Reviewed) A pilot study of hydroxych loroquine in treatment of patients with common coronavirus disease-19 (COVID-19) 30 moderate hospitalized cases, all recovered. Time to RNA negative comparable. Less frequent radiological progression with HC Q but not statistically significant. One HC Q patient developed to a severe case. Treatment group 4 years older and with higher incidence of hypertension.

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Positive

N/A Colson et al., Int J Antimicrob Agents, doi: 10.1016/j.ijantimicag.2020.105932. Epub 2020 Mar 4. (Peer Reviewed) Ch loroquine and Hydroxych loroquine as Available Weapons to Fight COVID-19 Recommending C Q and HC Q for COVID based on 20 clinical studies in China and strong rationale for use.

Positive

N/A

N/A

Colson et al., Int J Antimicrob Agents, doi: 10.1016/j.ijantimicag.2020.105932. Epub 2020 Mar 4. (Peer Reviewed) Ch loroquine and Hydroxych loroquine as Available Weapons to Fight COVID-19 Recommending C Q and HC Q for COVID based on 20 clinical studies in China and strong rationale for use. Source   Study Page   Share   Tweet   Submit Corrections or Comments

Positive

N/A Jiang et al., Chin J Tuberc Respir Dis, 2020,43 doi:10.3760/cma.j.issn.1001-0939.2020.0019 (Peer Reviewed) Expert Consensus on Ch loroquine Phosphate for the Treatment of Novel Coronavirus Pneumonia C Q is an effective treatment for COVID.

Positive

N/A

N/A

Jiang et al., Chin J Tuberc Respir Dis, 2020,43 doi:10.3760/cma.j.issn.1001-0939.2020.0019 (Peer Reviewed) Expert Consensus on Ch loroquine Phosphate for the Treatment of Novel Coronavirus Pneumonia C Q is an effective treatment for COVID. Source   Study Page   Share   Tweet   Submit Corrections or Comments

Positive

Late Gao et al. BioScience Trends, 2020, doi:10.5582/bst.2020.01047 (Peer Reviewed) Breakthrough: Ch loroquine phosphate has shown apparent efficacy in treatment of COVID-19 associated pneumonia in clinical studies Results from 15 clinical trials in China show C Q is effective.

Positive

Late treatment study (serious condition requiring hospitalization)

Late treatment study

Gao et al. BioScience Trends, 2020, doi:10.5582/bst.2020.01047 (Peer Reviewed) Breakthrough: Ch loroquine phosphate has shown apparent efficacy in treatment of COVID-19 associated pneumonia in clinical studies Results from 15 clinical trials in China show C Q is effective. Source   Study Page   Share   Tweet   Submit Corrections or Comments

Positive
(news)

Late Sun Yanrong, deputy head of the China National Center for Biotechnology Development (News) (not included in the study count) Antimalarial drug confirmed effective on COVID-19 HC Q under clinical trials in >10 hospitals in China and has shown fairly good efficacy.

Positive
(news)

Late treatment study (serious condition requiring hospitalization)

Late treatment study

Sun Yanrong, deputy head of the China National Center for Biotechnology Development (News) (not included in the study count) Antimalarial drug confirmed effective on COVID-19 HC Q under clinical trials in >10 hospitals in China and has shown fairly good efficacy. Currently no formal study is available so this is not included in the study count. Source   Study Page   Share   Tweet   Submit Corrections or Comments

In Vitro

In Vitro Wang et al. Cell Res 30, 269–271. doi:L10.1038/s41422-020-0282-0 (Peer Reviewed) (In Vitro) (not included in the study count) Remdesivir and ch loroquine effectively inhibit the recently emerged novel coronavirus (2019-nCoV) in vitro In vitro study, not included in the study count or percentages. Remdesivir and C Q potently blocked virus infection in vitro.

In Vitro

In Vitro

In Vitro

Wang et al. Cell Res 30, 269–271. doi:L10.1038/s41422-020-0282-0 (Peer Reviewed) (In Vitro) (not included in the study count) Remdesivir and ch loroquine effectively inhibit the recently emerged novel coronavirus (2019-nCoV) in vitro In vitro study, not included in the study count or percentages. Remdesivir and C Q potently blocked virus infection in vitro. Source   Study Page   Share   Tweet   Submit Corrections or Comments

In Vitro

In Vitro Savarino et al., Lancet Infect. Dis. doi:10.1016/S1473-3099(06)70361-9 (Peer Reviewed) (In Vitro) (not included in the study count) New insights into the antiviral effects of ch loroquine Update to 2003 paper, not included in the study count or percentages. Hypothesis of C Q inhibiting SARS replication has been confirmed in two in-vitro studies. C Q affected an early stage of SARS replication.

In Vitro

In Vitro

In Vitro

Savarino et al., Lancet Infect. Dis. doi:10.1016/S1473-3099(06)70361-9 (Peer Reviewed) (In Vitro) (not included in the study count) New insights into the antiviral effects of ch loroquine Update to 2003 paper, not included in the study count or percentages. Hypothesis of C Q inhibiting SARS replication has been confirmed in two in-vitro studies. C Q affected an early stage of SARS replication. Source   Study Page   Share   Tweet   Submit Corrections or Comments

In Vitro

In Vitro Vincent et al. Virol J 2, 69 (2005). doi:10.1186/1743-422X-2-69 (Peer Reviewed) (In Vitro) (not included in the study count) Ch loroquine is a potent inhibitor of SARS coronavirus infection and spread In vitro study, SARS-CoV-1, not included in the study count or percentages. C Q has strong antiviral effects on SARS CoV infection when cells treated either before or after exposure, suggesting prophylactic and treatment use. Describes three mechanisms by which the drug might work and suggests it may have both a prophylactic and therapeutic role in Coronavirus infections.

In Vitro

In Vitro

In Vitro

Vincent et al. Virol J 2, 69 (2005). doi:10.1186/1743-422X-2-69 (Peer Reviewed) (In Vitro) (not included in the study count) Ch loroquine is a potent inhibitor of SARS coronavirus infection and spread In vitro study, SARS-CoV-1, not included in the study count or percentages. C Q has strong antiviral effects on SARS CoV infection when cells treated either before or after exposure, suggesting prophylactic and treatment use. Describes three mechanisms by which the drug might work and suggests it may have both a prophylactic and therapeutic role in Coronavirus infections. Source   Study Page   Share   Tweet   Submit Corrections or Comments

In Vitro

In Vitro Keyaerts et al. Biochem. Biophys. Res. Comm. 323:1, 8 October 2004, doi:10.1016/j.bbrc.2004.08.085 (Peer Reviewed) (In Vitro) (not included in the study count) In vitro inhibition of severe acute respiratory syndrome coronavirus by ch loroquine In vitro study, SARS-CoV-1, not included in the study count or percentages. IC50 of C Q for antiviral activity (8.8) significantly lower than cytostatic activity CC50 (261.3), selectivity index of 30. IC50 for inhibition of SARS-CoV in vitro approximates plasma concentrations of C Q reached during treatment of acute malaria. C Q may be considered for immediate use in the prevention and treatment of SARS-CoV infections.

In Vitro

In Vitro

In Vitro

Keyaerts et al. Biochem. Biophys. Res. Comm. 323:1, 8 October 2004, doi:10.1016/j.bbrc.2004.08.085 (Peer Reviewed) (In Vitro) (not included in the study count) In vitro inhibition of severe acute respiratory syndrome coronavirus by ch loroquine In vitro study, SARS-CoV-1, not included in the study count or percentages. IC50 of C Q for antiviral activity (8.8) significantly lower than cytostatic activity CC50 (261.3), selectivity index of 30. IC50 for inhibition of SARS-CoV in vitro approximates plasma concentrations of C Q reached during treatment of acute malaria. C Q may be considered for immediate use in the prevention and treatment of SARS-CoV infections.

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Theory

Theory Savarino et al., Lancet Infect. Dis. doi:10.1016/S1473-3099(03)00806-5 (Peer Reviewed) (Theory) (not included in the study count) Effects of ch loroquine on viral infections: an old drug against today's diseases Not included in the study count or percentages. Discussion/review noting that C Q exerts antiviral effects, inhibiting the replication of several viruses including members of the flaviviruses, retroviruses, and coronaviruses. Notes that C Q has immunomodulatory effects, suppressing the production/release of tumour necrosis factor α and interleukin 6, which mediate the inflammatory complications of several viral diseases.

Theory

Theory

Theory

Savarino et al., Lancet Infect. Dis. doi:10.1016/S1473-3099(03)00806-5 (Peer Reviewed) (Theory) (not included in the study count) Effects of ch loroquine on viral infections: an old drug against today's diseases Not included in the study count or percentages. Discussion/review noting that C Q exerts antiviral effects, inhibiting the replication of several viruses including members of the flaviviruses, retroviruses, and coronaviruses. Notes that C Q has immunomodulatory effects, suppressing the production/release of tumour necrosis factor α and interleukin 6, which mediate the inflammatory complications of several viral diseases. Source   Study Page   Share   Tweet   Submit Corrections or Comments

Positive
(news)

N/A Edwin Wiley Grove (News) (not included in the study count) Laxative Bromo Quinine Quinine has been used for respiratory infections since 1896. Not included in the study count or percentages, just as an interesting observation.

Positive
(news)

N/A

N/A

Edwin Wiley Grove (News) (not included in the study count) Laxative Bromo Quinine Quinine has been used for respiratory infections since 1896. Not included in the study count or percentages, just as an interesting observation.

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