Safety and Efficacy of Hydroxychloroquine and Chloroquine in Treatment of COVID-19: A Rapid Review of Evidence

Abstract

Context: The coronavirus (named COVID-19) 2019 pandemic has caused significant morbidity and mortality around the world and has created serious challenges for health systems. To date, no medical treatment is developed for COVID-19 with proven effectiveness. This study is a rapid review aimed to identify and summarize evidence on the efficacy and safety of Hydroxychloroquine (HCQ) and Chloroquine (CQ) for COVID-19 infection. Methods: This study is a rapid review that systematically searched electronic databases, including PubMed, EMBASE, ClinicalTrials.gov, and Cochrane Library, until May 22, 2020. Peer-reviewed randomized clinical trials, reviews, and observational studies on the efficacy and safety of HCQ and CQ for the prevention and treatment of COVID-19 infection were included. Results: There were seven review articles, five clinical trial studies, and eight observational studies focusing on CQ or HCQ to treat COVID-19 patients. Of five clinical trials, three reported favorable outcomes among patients who received CQ or HCQ. Of eight observational studies, four reported no difference between the use of HCQ alone or combined administration of HCQ and Azithromycin with other medications. Three studies showed that the combined administration of HCQ and Azithromycin or HCQ alone is associated with improved clinical outcomes. Conclusions: The included studies reported conflicting results on the efficacy and safety of HCQ and CQ in treating COVID-19. Therefore, it seems that there is not sufficient evidence about the effectiveness and safety of HCQ and CQ to treat patients with COVID-19 and more studies, which also report long-term follow up results, are needed.