Efficacy of Hydroxychloroquine for Outpatient COVID-19 Prophylaxis and Treatment A Systematic Review and Meta-Analysis

Main Article Content

Sarah Yang
Ali Eshaghpour
Allen Li
Adrian Salopek
Sofia Ivanisevic
Lawrence Mbuagbaw
Mark Crowther
John Eikelboom

Keywords

randomized controlled trials, hydroxychloroquine, covid-19

Abstract

Early in the coronavirus disease 2019 (COVID-19) pandemic, hydroxychloroquine was suggested as its possible treatment. In order to determine its utility for outpatient prophylaxis and treatment, we performed a review and meta-analysis of randomized controlled trials (RCTs) in the following three groups of outpatients: (a) at high risk of COVID-19, (b) with suspected risk of COVID-19, and (c) with confirmed COVID-19. A comprehensive search of MEDLINE, EMBASE, and medRxiv was performed on July 1, 2021. The initial search yielded 859 studies, 11 of which remained for data extraction. Categories of data extracted included general study characteristics, baseline patient characteristics, intervention details, COVID-19 incidence, number of hospitalizations, and mortality. Cochrane’s risk of bias tool was used to assess bias. All studies were superiority RCTs, utilized varying dosages of hydroxychloroquine, and targeted pre-exposure, post-exposure, and/or confirmed COVID-19 populations. Hydroxychloroquine did not significantly reduce COVID-19 infection, hospitalization, or mortality, overall or in separate outpatient groups.


Résumé
Au début de la pandémie de la maladie à coronavirus  2019 (COVID-19), l’hydroxychloroquine a été suggérée comme traitement possible contre cette maladie. Pour déterminer son utilité en prophylaxie ambulatoire et comme traitement ambulatoire, nous avons effectué une revue et une méta-analyse d’essais cliniques randomisés chez trois groupes de patients ambulatoires : a) cas présentant un risque élevé de contracter la COVID-19; b) cas soupçonnés de COVID-19; c) cas confirmés de COVID-19. Une recherche exhaustive des bases de données MEDLINE, EMBASE et MedRxiv a été effectuée le 1er juillet 2021. La recherche initiale a donné 859 études, dont 11 pour lesquelles les données ne sont pas encore extraites. Les catégories de données extraites sont les caractéristiques générales de l’étude, les caractéristiques initiales des patients, les détails de l’intervention, l’incidence de la COVID-19, le nombre d’hospitalisations et le nombre de décès. L’outil Risque de biais du centre Cochrane a été utilisé pour évaluer les biais. Toutes les études sont des essais cliniques randomisés qui évaluent la supériorité, utilisent différentes posologies d’hydroxychloroquine et ciblent des populations pré-exposées à la COVID-19, post-exposées à la COVID-19 ou atteintes de la COVID-19 (cas confirmés). L’hydroxychloroquine ne diminue pas considérablement l’infection par la COVID-19, ni les hospitalisations et les décès, que ce soit dans l’ensemble des groupes de patients ambulatoires ou dans chacun des groupes.

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