Evidence map›Paper›PMID 33031488›Full record

SynthesisThe Journal of antimicrobial chemotherapy2021

Efficacy of chloroquine or hydroxychloroquine in COVID-19 patients: a systematic review and meta-analysis.

Zakariya Kashour, Muhammad Riaz, Musa A Garbati, Oweida AlDosary, Haytham Tlayjeh, Dana Gerberi, M Hassan Murad, M Rizwan Sohail, Tarek Kashour, Imad M Tleyjeh

Open access · hybridAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in The Journal of antimicrobial chemotherapy, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 78 papers, 9 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
78citing papers in PubMed, 9 pooled it
3.2field-weighted citation impact, top 5% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

78 citing papers in PubMed, 9 syntheses or guidelines pooled it, 131 citations in OpenAlex.

  1. Pooled it
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  4. Effectiveness of favipiravir in COVID-19: a live systematic review.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2021
    Pooled it
  5. Efficacy and safety of hydroxychloroquine/chloroquine against SARS-CoV-2 infection: A systematic review and meta-analysis.Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy · 2021
    Pooled it
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  20. COVID-19-Associated Liver Injury.Hepatic medicine : evidence and research · 2023
    Review

18 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 7 institutions in 5 countries.

Zakariya KashourDepartment of Medicine, University of Alberta, Edmonton, AB, Canada.
Muhammad RiazDepartment of Statistics, Quaid-i-Azam University Islamabad, Islamabad, Pakistan.
Musa A GarbatiInfectious Diseases Unit, Department of Medicine, University of Maiduguri, Maiduguri, Nigeria.
Oweida AlDosaryInfectious Diseases Section, Department of Medical Specialties, King Fahad Medical City, Riyadh, Saudi Arabia.
Haytham TlayjehDepartment of Intensive Care, King Abdulaziz Medical City, King Saud bin Abdulaziz for Health Sciences and King Abdullah International Medical Research Center, Riyadh, Saudi Arabia.
Dana GerberiMayo Clinic Libraries, Mayo Clinic, Rochester, MN, USA.
M Hassan MuradDivision of Health Care Policy & Research, Department of Health Sciences Research, Mayo Clinic College of Medicine and Science, Rochester, MN, USA.
M Rizwan SohailDivision of Infectious Diseases, Mayo Clinic College of Medicine and Science, Rochester, MN, USA.
Tarek KashourDepartment of Cardiac Sciences, King Fahad Cardiac Center, King Saud University Medical City, Riyadh, Saudi Arabia.
Imad M TleyjehInfectious Diseases Section, Department of Medical Specialties, King Fahad Medical City, Riyadh, Saudi Arabia.
Mayo Clinic · USKing Fahd Medical City · SAKing Saud bin Abdulaziz University for Health Sciences · SAKing Saud Medical City · SAQuaid-i-Azam University · PKUniversity of Alberta · CAUniversity of Maiduguri · NG

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesClinical studies of chloroquine (CQ) and hydroxychloroquine (HCQ) in COVID-19 disease reported conflicting results. We sought to systematically evaluate the effect of CQ and HCQ with or without azithromycin on outcomes of COVID-19 patients.

methodsWe searched multiple databases, preprints and grey literature up to 17 July 2020. We pooled only adjusted-effect estimates of mortality using a random-effect model. We summarized the effect of CQ or HCQ on viral clearance, ICU admission/mechanical ventilation and hospitalization.

resultsSeven randomized clinical trials (RCTs) and 14 cohort studies were included (20 979 patients). Thirteen studies (1 RCT and 12 cohort studies) with 15 938 hospitalized patients examined the effect of HCQ on short-term mortality. The pooled adjusted OR was 1.05 (95% CI 0.96-1.15, I2 = 0%). Six cohort studies examined the effect of the HCQ+azithromycin combination with a pooled adjusted OR of 1.32 (95% CI 1.00-1.75, I2 = 68.1%). Two cohort studies and four RCTs found no effect of HCQ on viral clearance. One small RCT demonstrated improved viral clearance with CQ and HCQ. Three cohort studies found that HCQ had no significant effect on mechanical ventilation/ICU admission. Two RCTs found no effect for HCQ on hospitalization risk in outpatients with COVID-19.

conclusionsModerate certainty evidence suggests that HCQ, with or without azithromycin, lacks efficacy in reducing short-term mortality in patients hospitalized with COVID-19 or risk of hospitalization in outpatients with COVID-19.

Indexed as

COVID-19 Drug TreatmentAntiviral AgentsAzithromycinChloroquineCOVID-19HospitalizationHumansHydroxychloroquineRandomized Controlled Trials as TopicTreatment OutcomeAntiviral AgentsAzithromycinChloroquineHydroxychloroquine

Identifiers

PMID33031488
PMCPMC7665543
OpenAlexW3092382993

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.