Abstract
Effective therapies are urgently needed for the SARS-CoV-2 pandemic. Chloroquine has been proved to have antiviral effect against coronavirus in vitro. In this study, we aimed to assess the efficacy and safety of chloroquine with different doses in COVID-19. In this multicenter prospective observational study, we enrolled patients older than 18 years old with confirmed SARS-CoV-2 infection excluding critical cases from 12 hospitals in Guangdong and Hubei Provinces. Eligible patients received chloroquine phosphate 500 mg, orally, once (half dose) or twice (full dose) daily. Patients treated with non-chloroquine therapy were included as historical controls. The primary endpoint is the time to undetectable viral RNA. Secondary outcomes include the proportion of patients with undetectable viral RNA by day 10 and 14, hospitalization time, duration of fever, and adverse events. A total of 197 patients completed chloroquine treatment, and 176 patients were included as historical controls. The median time to achieve an undetectable viral RNA was shorter in chloroquine than in non-chloroquine (absolute difference in medians −6.0 days; 95% CI −6.0 to −4.0). The duration of fever is shorter in chloroquine (geometric mean ratio 0.6; 95% CI 0.5 to 0.8). No serious adverse events were observed in the chloroquine group. Patients treated with half dose experienced lower rate of adverse events than with full dose. Although randomized trials are needed for further evaluation, this study provides evidence for safety and efficacy of chloroquine in COVID-19 and suggests that chloroquine can be a cost-effective therapy for combating the COVID-19 pandemic.
Highlights
The coronavirus disease 2019 (COVID-19) emerged in late 2019, originating from Wuhan China[1,2]
We examined the effect of chloroquine on the time to undetectable viral RNA stratified by different doses, types of clinical manifestation, the interaction between province and time from symptom onset to treatment initiation, and a representative center (Figure 3)
The results mainly showed that chloroquine has benefit effect on the time to undetectable viral RNA and the proportion of patients with undetectable viral RNA by day 10 is higher in chloroquine group
Summary
The coronavirus disease 2019 (COVID-19) emerged in late 2019, originating from Wuhan China[1,2]. The responsible virus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), belongs to a distinct clade from the human severe acute respiratory syndrome CoV (SARS-CoV) and Middle East respiratory syndrome CoV (MERS-CoV)[3]. It has become a global pandemic, affecting over 100 countries with more than 240,000 confirmed cases and over 10,000 deaths globally as of March 20, 2020, calling for an urgent demand of effective treatment. All patients achieved undetectable level of viral RNA within 14 days without serious adverse events These results led us to conduct a multicenter prospective observational study in adult patients with COVID-19 to assess the efficacy and safety of chloroquine for COVID-19. We aimed to assess the efficacy and safety of chloroquine with different doses in COVID-19
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