Evidence map›Paper›PMID 33316389›Full record

SynthesisInternational journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases2021

An umbrella review of systematic reviews with meta-analyses evaluating positive and negative outcomes of Hydroxychloroquine and chloroquine therapy.

Stefano Celotto, Nicola Veronese, Mario Barbagallo, Francesca Ometto, Lee Smith, Shahina Pardhan, Yvonne Barnett, Petre Cristian Ilie, Pınar Soysal, Erik Lagolio and 3 more

Open access · goldAbstract readMeta-AnalysisSystematic Review
In one paragraph

Synthesis in International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
1.6field-weighted citation impact, top 15% 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

3 citing papers in PubMed, 12 citations in OpenAlex.

  1. Review
  2. Impact of theInfection and drug resistance · 2022
    Article
  3. Review
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

13 authors at 9 institutions in 3 countries.

Stefano CelottoPrimary Care Department, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy.
Nicola VeroneseGeriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, Palermo, Italy.
Mario BarbagalloGeriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, Palermo, Italy.
Francesca OmettoRheumatological Unit, Local Health Unit 1, 6, Veneto Region, Italy.
Lee SmithThe Cambridge Centre for Sport and Exercise Sciences, Anglia Ruskin University, Cambridge, United Kingdom. Electronic address: lee.smith@anglia.ac.uk.
Shahina PardhanVision and Eye Research Institute, School of Medicine, Anglia Ruskin Univerity, Cambridge, United Kingdom.
Yvonne BarnettSchool of Life Scinces, Anglia Ruskin University, Cambridge, United Kingdom.
Petre Cristian IlieResearch and Innovation Department, The Queen Elizabeth Hospital Foundation Trust, King's Lynn, United Kingdom.
Pınar SoysalDepartment of Geriatric Medicine, Bezmialem Vakif University, Faculty of Medicine, Istanbul, Turkey.
Erik LagolioEmergency Medicine (A&E) - Asl2 - H Santa Corona, Pietra Ligure and First Aid, H Santa Maria Misericordia, Albenga, Italy.
Peter Konstantin KurotschkaDepartment of Medical Sciences and Public Health, University of Cagliari, Italy.
Roberto TonelliClinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, Modena, Italy; Respiratory Intensive Care Unit, University Hospital of Modena, Modena, Italy.
Jacopo DemurtasClinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, Modena, Italy; Primary Care Department, USL Toscana Sud Est-Grosseto, Grosseto, Italy.
Anglia Ruskin University · GBUniversity of Palermo · ITAzienda Usl Toscana Centro · ITBezmiâlem Vakıf Üniversitesi · TROspedale Santa Corona · ITQueen Elizabeth Hospital King's Lynn NHS Foundation Trust · GBRegione del Veneto · ITUniversity of Cagliari · ITUniversity of Modena and Reggio Emilia · IT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND &

aimsHydroxychloroquine (HCQ) and chloroquine (CQ) are anti-malarial drugs frequently used in the rheumatologic field. They were recently identified as potential therapeutic options for Coronavirus Disease (COVID-19). The present study aims to map and grade the diverse health outcomes associated with HCQ/CQ using an umbrella review approach.

methodsUmbrella review of systematic reviews of observational and intervention studies. For observational studies, random-effects summary effect size, 95% confidence interval, and 95% prediction interval were estimated. We also assessed heterogeneity, evidence for small-study effect, and evidence for excess significance bias. The quality of evidence was then graded using validated criteria from highly convincing to weak. The evidence from randomized controlled trials (RCTs) was graded using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) tool.

resultsFrom 313 articles returned in the literature search, six meta-analyses were included (n = 25 outcomes). Among meta-analyses (MAs) of observational studies, HCQ/CQ are weakly associated with a reduced risk for cardiovascular events and diabetes when used for autoimmune diseases and with spontaneous abortion; they are also associated with a higher risk of death in COVID-19 patients. Among MAs of RCTs, HCQ/CQ are associated with an improvement of articular manifestations of rheumatic diseases.

conclusionsThere is high evidence of the efficacy of HCQ/CQ in the rheumatologic field. The lack of evidence for efficacy and the risk of death associated with the use of HCQ/CQ for COVID-19 indicate the inappropriateness of their inclusion in recent COVID-19 therapy guidelines and the urgent need for RCTs to determine eventual appropriateness as a COVID-19 therapy.

Indexed as

COVID-19 Drug TreatmentSARS-CoV-2ChloroquineHumansHydroxychloroquineChloroquineHydroxychloroquineChloroquineCOVID-19Hydroxychloroquineumbrella review

Identifiers

PMID33316389
PMCPMC7833426
OpenAlexW3111466514

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.