Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2021 Jun 5;10(11):2503.
doi: 10.3390/jcm10112503.

Efficacy and Safety of Hydroxychloroquine for Hospitalized COVID-19 Patients: A Systematic Review and Meta-Analysis

Adrian V Hernandez  1   2 , Mi T Phan  1 , Jonathon Rocco  1 , Vinay Pasupuleti  3 , Joshuan J Barboza  2 , Alejandro Piscoya  2 , Yuani M Roman  1   4 , Charles M White  1   4
Affiliations
Review

Efficacy and Safety of Hydroxychloroquine for Hospitalized COVID-19 Patients: A Systematic Review and Meta-Analysis

Adrian V Hernandez et al. J Clin Med. .

Abstract

We systematically reviewed the efficacy and safety of hydroxychloroquine as treatment for hospitalized COVID-19. Randomized controlled trials (RCTs) evaluating hydroxychloroquine as treatment for hospitalized COVID-19 patients were searched until 2nd of December 2020. Primary outcomes were all-cause mortality, need of mechanical ventilation, need of non-invasive ventilation, ICU admission and oxygen support at 14 and 30 days. Secondary outcomes were clinical recovery and worsening, discharge, radiological progression of pneumonia, virologic clearance, serious adverse events (SAE) and adverse events. Inverse variance random effects meta-analyses were performed. Thirteen RCTs (n=18,540) were included. Hydroxychloroquine total doses ranged between 2000 and 12,400 mg; treatment durations were from 5 to 16 days and follow up times between 5 and 30 days. Compared to controls, hydroxychloroquine non-significantly increased mortality at 14 days (RR 1.07, 95%CI 0.92-1.25) or 30 days (RR 1.08, 95%CI 1.00-1.16). Hydroxychloroquine did not affect other primary or secondary outcomes, except SAEs that were significantly higher than the control (RR 1.24, 95%CI 1.05-1.46). Eleven RCTs had high or some concerns of bias. Subgroup analyses were consistent with main analyses. Hydroxychloroquine was not efficacious for treating hospitalized COVID-19 patients and caused more severe adverse events. Hydroxychloroquine should not be recommended as treatment for hospitalized COVID-19 patients.

Keywords: COVID-19; hospitalization; hydroxychloroquine; mechanical ventilation; mortality.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Flow chart of study selection.
Figure 2
Figure 2
Risk of bias of included randomized controlled trials.
Figure 3
Figure 3
Effect of hydroxychloroquine on all-cause mortality at 14 days in hospitalized COVID-19 patients.
Figure 4
Figure 4
Effect of hydroxychloroquine on all-cause mortality at 30 days in hospitalized COVID-19 patients.
Figure 5
Figure 5
Effect of hydroxychloroquine on adverse events in hospitalized COVID-19 patients.
Figure 6
Figure 6
Effect of hydroxychloroquine on serious adverse events (SAEs) in hospitalized COVID-19 patients.
See this image and copyright information in PMC

References

    1. Worldometer COVID-19 Coronavirus Pandemic. [(accessed on 22 February 2021)]; Available online: https://www.worldometers.info/coronavirus/
    1. National Institutes of Health . COVID-19 Treatment Guidelines Panel Coronavirus Disease 2019 (COVID-19) Treatment Guidelines. National Institutes of Health; Bethesda, MD, USA: 2020. [(accessed on 22 February 2021)]. Available online: https://www.covid19treatmentguidelines.nih.gov/ - PubMed
    1. Satarker S., Ahuja T., Banerjee M., Dogra S., Agarwal T., Nampoothiri M. Hydroxychloroquine in COVID-19: Potential Mechanism of Action Against SARS-CoV-2. Curr. Pharmacol. Rep. 2020;6:203–211. doi: 10.1007/s40495-020-00231-8. - DOI - PMC - PubMed
    1. Colson P., Rolain J.-M., Lagier J.-C., Brouqui P., Raoult D. Chloroquine and hydroxychloroquine as available weapons to fight COVID-19. Int. J. Antimicrob. Agents. 2020;55:105932. doi: 10.1016/j.ijantimicag.2020.105932. - DOI - PMC - PubMed
    1. Wang M., Cao R., Zhang L., Yang X., Liu J., Xu M., Shi Z., Hu Z., Zhong W., Xiao G. Remdesivir and chloroquine effectively inhibit the recently emerged novel coronavirus (2019-nCoV) in vitro. Cell Res. 2020;30:269–271. doi: 10.1038/s41422-020-0282-0. - DOI - PMC - PubMed

LinkOut - more resources