Current best evidence for clinical care (more info)
OBJECTIVE: The pandemic coronavirus disease-19 (COVID-19) has pushed the global healthcare system to a crisis and amounted to a huge economic burden. Different drugs for prophylaxis against COVID-19 including chloroquine (CQ) or hydroxychloroquine (HCQ) have been tried. This study was performed to systematically review the role of CQ and HCQ in preventing the spread of COVID-19.
METHODS: PubMed, EMBASE, ClinicalTrials.gov, International Clinical Trials Registry Platform and Cochrane Library databases were searched for studies that evaluated the prophylactic role of CQ or HCQ on SARS-CoV-2 (pre-clinical studies) or COVID-19 (clinical studies) until 30 March 2020. The available literature was critically appraised.
RESULTS: A total of 45 articles were screened and 5 (3 in vitro pre-clinical studies and 2 clinical opinions) were included. The pre-clinical studies showed the prophylactic effects of CQ and HCQ against SARS-CoV-2. On the other hand, the clinical opinions advocated the prophylactic use of CQ and HCQ against COVID-19. However, no original clinical studies on the prophylactic role of CQ or HCQ on COVID-19 were available.
CONCLUSION: Although pre-clinical results are promising, to date there is a dearth of evidence to support the efficacy of CQ or HCQ in preventing COVID-19. Considering potential safety issues and the likelihood of imparting a false sense of security, prophylaxis with CQ or HCQ against COVID-19 needs to be thoroughly evaluated in observational studies or high-quality randomized controlled studies.
| Discipline / Specialty Area | Score |
|---|---|
| Pediatrics (General) | |
| Public Health | |
| Family Medicine (FM)/General Practice (GP) | |
| General Internal Medicine-Primary Care(US) | |
| Hospital Doctor/Hospitalists | |
| Internal Medicine | |
| Infectious Disease | |
THis is an interesting review that doesn't shed much light...
This article outlines the sparse data for chloroquine and hydroxychloroquine use for COVID-19. Certainly, this information is extremely timely but there is not much of it here, and I think most physicians (and knowledgeable lay people, for that matter) already understand we need much more information about these drugs before they are used generally.
This meta-analysis shows how easily a promising drug can be accepted and prescribed, despite no serious clinical evidence (a classical halo effect!).