Hydroxychloroquine and coronavirus disease 2019: A systematic review of a scientific failure

Stav Rakedzon, Yara Khoury, Gilad Rozenberg, Ami Neuberger

Research output: Contribution to journalReview articlepeer-review

Abstract

Introduction: Hydroxychloroquine (HCQ) emerged early in the course of the coronavirus disease 2019 (COVID-19) pandemic as a possible drug with potential therapeutic and prophylactic benefits. It was quickly adopted in China, Europe, and the USA. We systematically reviewed the existing clinical evidence of HCQ use for the prevention and treatment of COVID-19. Methods: We screened for clinical studies describing HCQ administration to treat or prevent COVID-19 in PubMed. We included randomized controlled trials (RCTs), non-randomized comparative cohorts, and case series studies that had all undergone peer review. Results: A total of 623 studies were screened; 17 studies evaluating HCQ treatment were included. A total of 13 were observational studies, and 4 were RCTs. In terms of effect on mortality rates, observational studies provided conflicting results. As a whole, RCTs, including one large British RCT that has not yet been published, showed no significant effect of HCQ on mortality rates, clinical cure, and virologic response. The use of HCQ as a post-exposure prophylactic agent was found to be ineffective in one RCT. Conclusion: There is no evidence supporting HCQ for prophylaxis or treatment of COVID-19. Many observational trials were methodologically flawed. Scientific efforts have been disappointingly fragmented, and well-conducted trials have only recently been completed, more than 7 months and 600,000 deaths into the pandemic.

Original languageEnglish
Article numbere0025
JournalRambam Maimonides Medical Journal
Volume11
Issue number3
DOIs
StatePublished - 31 Jul 2020
Externally publishedYes

Bibliographical note

Publisher Copyright:
© 2020 Rakedzon et al.

Keywords

  • Chloroquine
  • Coronavirus
  • COVID-19
  • Hydroxychloroquine
  • Pandemic
  • Review

ASJC Scopus subject areas

  • General Medicine

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