Compilation of over 50 studies of Hydroxychloroquine in Covid-19 (+/- zinc, azithro, etc.) @ https://c19study.com/

This entire post is a copy of the website in the title.  I was in a hurry when I posted it and did not make that clear. 
https://c19study.com/

 

 

 

 

PrEP
100%

 

PEP
100%

 

Early
100%

 

Late
61%

 

All
75%

 

  65 studies (39 peer reviewed)
  COVID deaths: 

660,803

Global HCQ studies. PrEP, PEP, and early treatment studies show high effectiveness, while late treatment shows mixed results.
7/26
Inconc.
PEPMitjà et al., medRxiv, doi:10.1101/2020.07.20.20157651 (Preprint)A Cluster-Randomized Trial of Hydroxychloroquine as Prevention of Covid-19 Transmission and Disease
Death rate reduced from 0.6% to 0.4%, RR 0.71, not statistically significant due to low incidence (8 control cases, 5 treatment cases). For positive symptomatic cases, a greater effect is seen for nursing home residents, RR=0.49, vs. ove..
7/24
Positive
PrEPKhurana et al., medRxiv, doi:10.1101/2020.07.21.20159301 (Preprint)Prevalence and clinical correlates of COVID-19 outbreak among healthcare workers in a tertiary level hospital
Study of hospital health care workers showing HCQ prophylaxis reduces COVID-19 significantly, OR 0.30, p=0.02. 94 positive health care workers with a matched sample of 87 testing negative. Full course prophylaxis wa..
7/23
Negative
LateCavalcanti et al., NEJM, July 23, 2020, doi:10.1056/NEJMoa201901 (Peer Reviewed)Hydroxychloroquine with or without Azithromycin in Mild-to-Moderate Covid-19
Late stage RCT of 667 hospitalized patients with up to 14 days of symptoms at enrollment and receiving up to 4 liters per minute supplemental oxygen, not finding a significant effect after 15 days. Authors note: “the trial cannot de..
7/21
Positive
LateBernaola et al., medRxiv, doi:10.1101/2020.07.17.20155960 (Preprint)Observational Study of the Efficiency of Treatments in Patients Hospitalized with Covid-19 in Madrid
HCQ HR 0.83 [0.77-0.89] based on propensity score matched retrospective analysis of 1,645 hospitalized patients. Prednisone HR 0.85 [0.82-0.88], 14 other medications showed either no signicant benefit or a negative ..
7/20
Meta
(positive)
EarlyRisch, H., American Journal of Epidemiology, July 20, 2020, doi:10.1093/aje/kwaa152 (Peer Reviewed) (meta analysis – not included in the study count)Response to: “Early Outpatient Treatment of Symptomatic, High-Risk Covid-19 Patients” and “Re: Early Outpatient Treatment of Symptomatic, High-Risk Covid-19 Patients that Should be Ramped-Up Immediately as Key to the Pandemic Crisis”
Updated meta analysis including 7 new studies of high-risk outpatients, for a total of 12 studies, all showing significant benefit.
7/18
Meta
(positive)
PEPWatanabe, M., arXiv.org, arXiv:2007.09477 (Preprint) (meta analysis – not included in the study count)Efficacy of Hydroxychloroquine as Prophylaxis for Covid-19
Secondary analysis of Boulware et al.’s PEP trial and treatment delay-response data, confirming that HCQ is effective when used early, p<0 .01.="" considering="" effectiveness="" especially="" found="" is="" limitatio..="" notable="" td="" the="">
7/16
Inconc.
EarlySkipper et al., Annals of Internal Medicine, doi:10.7326/M20-4207 (Peer Reviewed)Hydroxychloroquine in Nonhospitalized Adults With Early COVID-19: A Randomized Trial
~70 to 140 hour (inc. shipping) delayed outpatient treatment with HCQ reduced combined hospitalization/death by 50%, p=0.29 (5 HCQ cases, 10 control cases), and reduced hospitalization by 60%,..
7/16
Inconc.
EarlyMitjà et al., Clinical Infectious Diseases, ciaa1009, doi:10.1093/cid/ciaa1009 (Peer Reviewed)Hydroxychloroquine for Early Treatment of Adults with Mild Covid-19: A Randomized-Controlled Trial
This paper has inconsistent data – some of the values reported in Table 2 and the abstract correspond to 12 control hospitalizations, while others correspond to 11 control hospitalizations. There was a 25% reduction in hospitalization an..
7/9
Meta
(positive)
Early, LateRaoult et al., Preprint (Preprint) (meta analysis – not included in the study count)Hydroxychloroquine and Azithromycin as a Treatment of COVID-19: Results of an Open-Label Non-Randomized Clinical Trial: Response to David Spencer (Elsevier)
Updated meta analysis showing significant reductions in mortality and viral shedding. Mortality OR 0.53 [0.4-0.71] for clinical studies, 0.92 big data studies, 18,211 patients. Persistent viral shedding OR 0.47 [0.28-0.79], 4,540 patients.
7/7
Negative
LateAn et al., medRxiv, doi:10.1101/2020.07.04.20146548 (Preprint)Treatment Response to Hydroxychloroquine and Antibiotics for mild to moderate COVID-19: a retrospective cohort study from South Korea
Retrospective of hospitalized patients with 31 HCQ patients and 195 standard treatment patients, not showing a significant difference in terms of viral clearance or recovery. There was no mortality in either group. ..
7/3
Positive
PrEPZhong et al., Lancent Rheumatology, 10.1016/S2665-9913(20)30227-7 (Peer Reviewed)COVID-19 in patients with rheumatic disease in Hubei province, China: a multicentre retrospective observational study
Rheumatic disease patients on HCQ had a lower risk of COVID-19 than those on other disease-modifying anti-rheumatic drugs, OR 0.09 (0.01–0.94), p=0.044 after adjusting for age, sex, smoking, systemic lupus erythemat..
7/3
Positive
EarlyScholz et al., Preprints 2020, 2020070025, doi:10.20944/preprints202007.0025.v1 (Preprint)COVID-19 Outpatients – Early Risk-Stratified Treatment with Zinc Plus Low Dose Hydroxychloroquine and Azithromycin: A Retrospective Case Series Study
Early treatment with HCQ+AZ+Z results in 84% lower hospitalization and 80% lower death – hospitalization OR 0.16 (p<0 .001="" 0.2="" 37..="" 518="" cardiac="" death="" effects.="" no="" or="" p="0.16)." patients="" retrospective="" side="" td="" treated="">
7/1
Positive
LateArshad et al., Int. J. Infect. Dis., July 1 2020, doi:10.1016/j.ijid.2020.06.099 (Peer Reviewed)Treatment with Hydroxychloroquine, Azithromycin, and Combination in Patients Hospitalized with COVID-19
HCQ decreases mortality from 26.4% to 13.5% (HCQ) or 20.1% (HCQ+AZ). Propensity matched HCQ HR 0.487, p=0.009. Michigan 2,541 patients retrospecti..
7/1
Safety
N/ASamuel et al., Heart Rhythm, doi:10.1016/j.hrthm.2020.06.033 (Peer Reviewed) (not included in the study count)Incidence of arrhythmias and electrocardiographic abnormalities in symptomatic pediatric patients with PCR positive SARS-CoV-2 infection including drug induced changes in the corrected QT interval (QTc)
In pediatric patients with PCR positive active COVID-19 infection, significant arrhythmias are infrequent, but occur at an incidence higher than expected in a general pediatric population. Comorbidities are not more common in patients wit..
6/30
Positive
LateMikami et al., J. Gen. Intern. Med., doi:10.1007/s11606-020-05983-z (Peer Reviewed)Risk Factors for Mortality in Patients with COVID-19 in New York City
HCQ decreases mortality, HR 0.53 (CI 0.41–0.67). IPTW adjustment does not significantly change HR 0.53 (0.41-0.68). Retrospective 6,000 patients in New York City.
6/29
Positive
PrEPFerreira et al., J. Medical Virology, July 9, 2020, doi:10.1002/jmv.26286 (preprint 6/29) (Peer Reviewed)Chronic treatment with hydroxychloroquine and SARS-CoV-2 infection
Chronic treatment with HCQ provides protection against COVID, odds ratio 0.51 (0.37-0.70). Note that patients with SLE, RA, and other autoimmune conditions have a significantly increased susceptibility to and incide..
6/29
Safety
N/AMfeukeu-Kuate et al. (Preprint) (not included in the study count)Electrocardiographic safety of daily Hydroxychloroquine 400mg plus Azithromycin 250mg as an ambulatory treatment for COVID-19 patients in Cameroon
No life-threatening modifications of the QT interval was observed in non-severe COVID-19 patients treated ambulatory with HCQ+AZ. 51 relatively young patients 39 +/- 11.
6/25
Positive
EarlyLagier et al., Travel Med. Infect. Dis. 101791, Jun 25, 2020, doi:10.1016/j.tmaid.2020.101791 (Peer Reviewed)Outcomes of 3,737 COVID-19 patients treated with hydroxychloroquine/azithromycin and other regimens in Marseille, France: A retrospective analysis
Early treatment leads to significantly better clinical outcome and faster viral load reduction. Matched sample mortality HR 0.41 p-value 0.048. Retrospective 3,737 patients.
6/22
In Vitro
In VitroWang et al., bioRxiv, doi:10.1101/2020.06.22.164665 (Preprint) (In Vitro) (not included in the study count)Chloroquine and hydroxychloroquine as ACE2 blockers to inhibit viropexis of COVID-19 Spike pseudotype virus
In vitro study, not included in the study count or percentages. CQ and HCQ inhibit the entry of COVID-19 spike pseudotype virus using ACE2 high expressed HEK293T cells.
6/22
Positive
EarlyChen et al., medRxiv, doi:10.1101/2020.06.19.20136093 (Preprint)Efficacy and safety of chloroquine or hydroxychloroquine in moderate type of COVID-19: a prospective open-label randomized controlled study
Significantly faster clinical recovery and shorter time to RNA negative (from 7.0 days to 2.0 days (HCQ), p=0.01. 67 patients with mild/moderate cases.
6/19
Positive
(news)
PrEPSMSH Sawai Man Singh Hospital, India (News) (not included in the study count)HCQ beneficial as preventive drug: SMS doctors told ICMR
PrEP with 4,300 very high risk healthcare workers in a hospital with up to 500+ COVID patients at a time, only 1% cases, all recovered.
6/19
Negative
(news)
LateNIH, study not available yet (News) (not included in the study count)NIH halts clinical trial of hydroxychloroquine
NIH halts late stage trial reporting no harm and no benefit. 470 patients.
6/19
Positive
LateSbidian et al., medRxiv, doi:10.1101/2020.06.16.20132597 (Preprint)Hydroxychloroquine with or without azithromycin and in-hospital mortality or discharge in patients hospitalized for COVID-19 infection: a cohort study of 4,642 in-patients in France
Retrospective of 4,642 hospitalized patients in France showing significantly faster discharge with HCQ and HCQ+AZ. No significant effect is seen on 28-day mortality, however many more control ..
6/18
Inconc.
LatePaccoud et al., Clinical Infectious Diseases, doi:10.1093/cid/ciaa791 (Peer Reviewed)Compassionate use of hydroxychloroquine in clinical practice for patients with mild to severe Covid-19 in a French university hospital
Retrospective of 89 hospitalized patients, survival HR 0.89 [0.23-3.47], not statistically significant. Authors note that unmeasured confounders may have persisted and the study may be underpowered.
6/17
Positive
LateXue et al., J. Med. Virology, June 17, 2020, doi:10.1002/jmv.26193 (Peer Reviewed)Hydroxychloroquine treatment in COVID-19: a descriptive observational analysis of 30 cases from a single center in Wuhan, China
30 hospitalized patients. Early use of HCQ is more effective, 43% reduction in progression from moderate to severe. “Early” is relative here, within 7 days of hospitalization.
6/17
Negative
(news)
LateWorld Health Organization, study not available yet (News) (not included in the study count)“Solidarity” clinical trial for COVID-19 treatments
WHO stopped the Solidarity late stage trial of HCQ reporting no benefit. Later news reported “little or no reduction in mortality” [1]. The study has not been released yet and few details are available. Th..
6/16
Positive
(news)
PrEPWHIP COVID-19 (News) (not included in the study count)Henry Ford Health System still moving forward with hydroxychloroquine study
Ongoing WHIP COVID-19 HCQ PrEP study reports analyzing their data and seeing a significantly improved outcome in a group of COVID-19 patients who received HCQ. For more details on the study se..
6/12
Theory
TheoryScherrmann, AAPS J 22, 86 (2020), doi:10.1208/s12248-020-00465-w (Peer Reviewed) (Theory) (not included in the study count)Intracellular ABCB1 as a Possible Mechanism to Explain the Synergistic Effect of Hydroxychloroquine-Azithromycin Combination in COVID-19 Therapy
Theory paper, not included in the study count or percentages. Proposes a new mechanism supporting the synergistic interaction between HCQ+AZ.
6/12
Negative
LateGiacomelli et al., medRxiv, doi:10.1101/2020.06.05.20123299 (Preprint)Early administration of lopinavir/ritonavir plus hydroxychloroquine does not alter the clinical course of SARS-CoV-2 infection: a retrospective cohort study
Late stage study of hospitalized patients comparing treatment starting within 5 days versus later. Note that “early” here is only relative – all patients are hospitalized so this is “late” and “very late”. Th..
6/10
Positive
EarlyOtea et al., medRxiv, doi:10.1101/2020.06.10.20101105 (Preprint)A short therapeutic regimen based on hydroxychloroquine plus azithromycin for the treatment of COVID-19 in patients with non-severe disease. A strategy associated with a reduction in hospital admissions and complications.
80 moderate cases, HCQ+AZ appears to reduce serious complications and death. Moderate treated cases resulted in hospitalization at the same rate as mild untreated cases suggesting efficacy.
6/9
Positive
LatePirnay et al., Hosp. Pharm. and Clinician, doi:10.1016/j.phclin.2020.06.001 (Peer Reviewed)Beneficial effect of Hydroxychloroquine-Azithromycin combination in the treatment of elderly patients with Covid-19: results of an observational study
68 very high risk nursing home residents, median age 86, HCQ+AZ early treatment within 2.5 days onset, 2 stopped due to QTc. Only 7 died, significantly less than other nursing homes in France and the same as the med..
6/9
Positive
PrEPBhattacharya et al., medRxix, doi:10.1101/2020.06.09.20116806 (Preprint)Pre exposure Hydroxychloroquine use is associated with reduced COVID19 risk in healthcare workers
HCQ reduced cases from 38% to 7%. 106 people. No serious adverse effects.
6/6
Meta
(positive)
Early, LateMillion et al., New Microbes and New Infections, doi:10.1016/j.nmni.2020.100709 (Peer Reviewed) (meta analysis – not included in the study count)Clinical Efficacy of Chloroquine derivatives in COVID-19 Infection: Comparative metaanalysis between the Big data and the real world
[H]CQ effective and reduces mortality by a factor 3. Meta analysis of 20 studies.
6/5
Negative
LateHorby et al., medRxiv, 7/15/2020, doi:10.1101/2020.07.15.20151852 (press release 6/5) (Preprint)Effect of Hydroxychloroquine in Hospitalized Patients with COVID-19: Preliminary results from a multi-centre, randomized, controlled trial
RECOVERY trial reports no significant benefit seen for very late stage very sick patients. Results may be due to the unusually high dosage used [1, 2]. Patients were extremely sick (average of 9 days post symptoms, 60% requiring oxygen an..
6/3
Positive
(see notes)
PEPBoulware et al., NEJM, June 3 2020, doi:10.1056/NEJMoa2016638 (Peer Reviewed)A Randomized Trial of Hydroxychloroquine as Postexposure Prophylaxis for Covid-19
COVID-19 cases are reduced by [49%, 29%, 16%] respectively when taken within ~[70, 94, 118] hours of exposure (including shipping delay). The treatment delay-response relationship is significant at p=0.002. PEP delayed treatment RCT. Cur..
5/31
Positive
EarlyGuérin et al., Asian J. Medicine and Health, July 15, 2020, doi:10.9734/ajmah/2020/v18i730224 (preprint 5/31) (Peer Reviewed)Azithromycin and Hydroxychloroquine Accelerate Recovery of Outpatients with Mild/Moderate COVID-19
Mean clinical recovery time reduced from 26 days (SOC) to 9 days, p<0 .0001="" class="hs" span="" style="display: inline-block; margin: 0px; max-width: 0.01em; padding: 0px; width: 0.01em;">

Q+AZ) or 13 days, p<0 .0001="" 88="" analysis="" cardiac="" case="" control="" matched="" no="" of="" pa..="" patients="" retrospective="" small="" study="" td="" toxicity.="" with="">

5/29
Positive
LateAyerbe et al., Journal of Thrombosis and Thrombolysis, doi: 10.1007/s11239-020-02162-z (Peer Reviewed)The association between treatment with heparin and survival in patients with Covid-192075 hospital patients in Spain. HCQ reduces mortality from 30% to 13%. Not adjusted for age and gender. HCQ group 10% more males and 6 years younger. Study primarily interested in Heparin.
5/28
Positive
LateChamieh et al., medRxiv 2020.05.28.20114835, doi:10.1101/2020.05.28.20114835 (Preprint)Viral Dynamics Matter in COVID-19 Pneumonia: the success of early treatment with hydroxychloroquine and azithromycin in LebanonHCQ+AZ potentially explains 94.7% success in treating a fairly complex cohort.
5/28
Positive
PrEPChatterjee et al., Indian J. Med. Res., June 20, 2020, doi:10.4103/ijmr.IJMR_2234_20 (Peer Reviewed)Healthcare workers & SARS-CoV-2 infection in India: A case-control investigation in the time of COVID-194+ doses of HCQ associated with a significant decline in the odds of getting infected, dose-response relationship exists.
5/28
Positive
LateHuang et al., National Science Review, nwaa113, doi:10.1093/nsr/nwaa113 (Peer Reviewed)Preliminary evidence from a multicenter prospective observational study of the safety and efficacy of chloroquine for the treatment of COVID-19197 CQ patients, 176 control. Mean time to undetectable viral RNA and duration of fever significantly reduced. No serious adverse events.
5/27
Meta
EarlyRisch, American Journal of Epidemiology, kwaa093, 27 May 2020, doi:10.1093/aje/kwaa093 (Peer Reviewed) (meta analysis – not included in the study count)Early Outpatient Treatment of Symptomatic, High-Risk Covid-19 Patients that Should be Ramped-Up Immediately as Key to the Pandemic CrisisFive studies, including two controlled clinical trials, have demonstrated significant outpatient treatment efficacy.
5/25
Negative
LateIp et al., medRxiv, doi:10.1101/2020.05.21.20109207 (Preprint)Hydroxychloroquine and Tocilizumab Therapy in COVID-19 Patients – An Observational StudyRetrospective study of late stage use on 2,512 hospitalized patients showing no significant differences in associated mortality for patients receiving any HCQ during the hospitalization (HR, 0.99 [95% CI, 0.80-1.22]..
5/22
Positive
(advisory)
PEP, PrEPICMR, Indian Council of Medical Research (Advisory) (not included in the study count)Revised advisory on the use of Hydroxychloroquine (HCQ) as prophylaxis for SARS-CoV-2 infectionHealthcare workers on HCQ prophylaxis less likely to get COVID. Significant dose-response relationship. Extends recommended HCQ prophylaxis to asymptomatic household contacts of cases and fron..
5/22
Retracted
LateMehra et al., The Lancet, May 22, 2020, doi: 10.1016/S0140-6736(20)31180-6 (Peer Reviewed)Hydroxychloroquine or chloroquine with or without a macrolide for treatment of COVID-19: a multinational registry analysisIncorrect at first read (implausible death, ventilation, and population numbers). This paper was retracted.
5/20
Meta
(negative)
LateChacko et al., medRxiv, doi:10.1101/2020.05.14.20101774 (Preprint) (meta analysis – not included in the study count)Hydroxychloroquine in COVID-19: A systematic review and meta-analysisMeta analysis not seeing a significant effect other than time to resolution of chest CT. Limited by heterogeneous nature of studies, baseline severity varied, most studies have a small sample size, endpoints reported at varying times, dos..
5/19
Negative
LateSingh et al., medRxiv, doi:10.1101/2020.05.12.20099028 (Preprint)Outcomes of Hydroxychloroquine Treatment Among Hospitalized COVID-19 Patients in the United States- Real-World Evidence From a Federated Electronic Medical Record NetworkEHR analysis of 3,372 hospitalized COVID-19 patients not showing a significant difference for mortality or the risk of mechanical ventilation. Subject to the limitations of EHR analysis. Misclassification is possible. Confounding by indic..
5/18
Positive
LateKim et al., medRxiv, doi:10.1101/2020.05.13.20094193 (Preprint)Treatment Response to Hydroxychloroquine, Lopinavir/Ritonavir, and Antibiotics for Moderate COVID 19: A First Report on the Pharmacological Outcomes from South KoreaRetrospective of 97 moderate cases. Time to viral clearance significantly shorter for HCQ+antibiotic. Preprint withdrawn pending peer review.
5/18
Positive
EarlyAhmad et al., doi:10.1101/2020.05.18.20066902 (Preprint)Doxycycline and Hydroxychloroquine as Treatment for High-Risk COVID-19 Patients: Experience from Case Series of 54 Patients in Long-Term Care Facilities54 patients in long term care facilities. 6% death with HCQ+AZ compared to 22% using a naive indirect comparison.
5/16
Inconc.
PrEPMacias et al., medRxiv, 10.1101/2020.05.16.20104141 (Preprint)Similar incidence of Coronavirus Disease 2019 (COVID-19) in patients with rheumatic diseases with and without hydroxychloroquine therapyVery small retrospective study of rheumatic disease patients, sample size is too small for statistical significance (HCQ 0.5-4.0%, no-HCQ 0.4-2.7%). Confirmed cases were 1 HC
5/15
Positive
LateYu et al., Sci China Life Sci., 2020 May 15, 1-7, doi:10.1007/s11427-020-1732-2 (Peer Reviewed)Low Dose of Hydroxychloroquine Reduces Fatality of Critically Ill Patients With COVID-19Retrospective, 550 critically ill patients. 19% fatality for HCQ versus 47% for non-HCQ.
5/14
Negative
LateMahévas et al., BMJ 2020, 369, doi: https://doi.org/10.1136/bmj.m1844 (Peer Reviewed)Clinical efficacy of hydroxychloroquine in patients with covid-19 pneumonia who require oxygen: observational comparative study using routine care dataObservational study of 181 patients with advanced disease requiring oxygen showing no benefit for HCQ. Power of study appears too low to support conclusions [1]. None of the 15 patients receiving HC<..
5/11
Positive
LateDavido et al., medRxiv, doi:10.1101/2020.05.05.2008875 (Preprint)Hydroxychloroquine plus azithromycin: a potential interest in reducing in hospital morbidity due to COVID-19 pneumonia (HI-ZY-COVID)?Retrospective of 132 hospitalized patients. HCQ+AZ significantly reduces death. Note that due to the controversy, authors withdrew this paper from medRxiv pending peer review.
5/11
Negative
LateRosenberg et al., JAMA, May 11, 2020, doi:10.1001/jama.2020.8630 (Peer Reviewed)Association of Treatment With Hydroxychloroquine or Azithromycin With In-Hospital Mortality in Patients With COVID-19 in New York StateRestrospective observational late stage study showing no significant differences but calling for clinical trials.
5/10
Positive
LateAlberici et al., Kidney Int., 98:1, 20-26, July 1, 2020, doi:10.1016/j.kint.2020.04.030 (preprint 5/10) (Peer Reviewed)A report from the Brescia Renal COVID Task Force on the clinical characteristics and short-term outcome of hemodialysis patients with SARS-CoV-2 infectionAnalysis of 94 hemodialysis COVID-19 positive patients. Reduction in death seen with HCQ but p=0.12, OR 0.44 (0.16–1.24).
5/8
Positive
LateCarlucci et al., doi:10.1101/2020.05.02.20080036 (Preprint)Hydroxychloroquine and azithromycin plus zinc vs hydroxychloroquine and azithromycin alone: outcomes in hospitalized COVID-19 patientsObservational retrospective. Addition of Zinc to HCQ+AZ reduces mortality.
5/7
Theory
TheoryDerendorf, H., Int. J. Antimicrobial Agents, 7 May 2020, doi:10.1016/j.ijantimicag.2020.106007 (Peer Reviewed) (Theory) (not included in the study count)Excessive lysosomal ion-trapping of hydroxychloroquine and azithromycinDiscusses pharmacokinetic properties of HCQ+AZ as a potential underlying mechanism of the observed antiviral effects.
5/7
Inconc.
LateGeleris et al., NEJM, May 7, 2020, doi:10.1056/NEJMoa2012410 (Peer Reviewed)Observational Study of Hydroxychloroquine in Hospitalized Patients with Covid-19There appears to be a major error in this paper. Before propensity matching, 38 control patients had hypertension. After propensity matching, 146 patients had hypertension (Table 1). This is not possible. Even if all propensity matched co..
5/7
Positive
(news)
N/ASermo (News) (not included in the study count)Sermo reports: COVID-19 treatment trends over 6 weeks and 33,700 interviews: Usage, efficacy and safety perceptions of most-used therapiesHCQ used by 55% of physicians worldwide for COVID. Survey of 6,150 physicians.
5/6
Animal
AnimalMaisonnasse et al., Nature, 2020, doi:10.1038/s41586-020-2558-4 (preprint 5/6) (Peer Reviewed) (not included in the study count)Hydroxychloroquine use against SARSCoV-2 infection in non-human primatesMonkey study which reports no effect of HCQ or HCQ+AZ. However, there are actually several signs of effectiveness despite the very small sample sizes and 100% recovery of all treated and contr..
5/5
Positive
LateMembrillo de Novales et al., Preprints 2020, 2020050057, doi:10.20944/preprints202005.0057.v1 (Preprint)Early Hydroxychloroquine Is Associated with an Increase of Survival in COVID-19 Patients: An Observational Study166 patients hospitalised with COVID-19, HCQ increased survival 1.4 – 1.8 times when patients admitted in early stages. Early is relative to hospital admission here – all patients relatively serious condition.
5/5
Positive
Early, LateMillion et al., Travel Med Infect Dis., 2020 May 5, doi:10.1016/j.tmaid.2020.101738 (Peer Reviewed)Early Treatment of COVID-19 Patients With Hydroxychloroquine and Azithromycin: A Retrospective Analysis of 1061 Cases in Marseille, FranceRetrospective 1061 patients. HCQ+AZ safe and results in a low fatality rate.
5/5
Inconc.
PrEPGendelman et al., Autoimmunity Reviews, 19:7, July 2020, doi:10.1016/j.autrev.2020.102566 (Peer Reviewed)Continuous Hydroxychloroquine or Colchicine Therapy Does Not Prevent Infection With SARS-CoV-2: Insights From a Large Healthcare Database AnalysisVery small study of rheumatic disease/autoimmune disorder patients showing no significant difference but with only 3 chronic HCQ patient cases. Only considers people tested at a time when primarily symptomatic cases..
5/1
Safety
N/AMercuro et al., JAMA Cardiol., May 1, 2020, doi:10.1001/jamacardio.2020.1834 (Peer Reviewed) (not included in the study count)Risk of QT Interval Prolongation Associated With Use of Hydroxychloroquine With or Without Concomitant Azithromycin Among Hospitalized Patients Testing Positive for Coronavirus Disease 2019 (COVID-19)Study of 90 hospitalized patients given HCQ, 53 also receiving AZ, 53% hypertension, 29% diabetes mellitus, baseline median QTc 473ms for HCQ, and 442ms for HCQ+AZ. Medi..
5/1
Safety
N/ABessière et al., JAMA Cardiol., May 1, 2020, doi:10.1001/jamacardio.2020.1787 (Peer Reviewed) (not included in the study count)Assessment of QT Intervals in a Case Series of Patients With Coronavirus Disease 2019 (COVID-19) Infection Treated With Hydroxychloroquine Alone or in Combination With Azithromycin in an Intensive Care UnitStudy of 40 very serious condition ICU patients, 75% required invasive mechanical ventilation, 63% received vasoactive drugs, 50% received other treatments favoring QT prolongation. HCQ with or w/o AZ was given to 4..
5/2
Positive
(news)
LateSeydi (News) (not included in the study count)Coronavirus: a study in Senegal confirms the effectiveness of hydroxychloroquinePreliminary results of Senegal trial with 181 patients showing faster recovery with HCQ, and even faster recovery with HCQ+AZ.
4/30
Positive
EarlyMeo et al., Eur. Rev. Med. Pharmacol. Sci. 2020, 24 (8), 4539-4547, doi:10.26355/eurrev_202004_21038 (Peer Reviewed)Efficacy of chloroquine and hydroxychloroquine in the treatment of COVID-19Analysis of COVID-19 and malaria, finding that COVID-19 is highly pandemic in countries where malaria is least pandemic, and vice versa, suggesting that CQ/HCQ (widely used for malaria) are pr..
4/29
Safety
N/ASaleh et al., Circulation: Arrhythmia and Electrophysiology, doi:10.1161/CIRCEP.120.008662 (Peer Reviewed)The Effect of Chloroquine, Hydroxychloroquine and Azithromycin on the Corrected QT Interval in Patients with SARS-CoV-2 Infection201 hospitalized patients. No serious side effects of HCQ. No instances of Torsade de pointes, or arrhythmogenic death were reported. They report that although use of these medications resulted in QT prolongation, c..
4/25
In Vitro
In VitroAndreani et al., Microbial Pathogenesis, doi:/10.1016/j.micpath.2020.104228 (Peer Reviewed) (In Vitro) (not included in the study count)In vitro testing of combined hydroxychloroquine and azithromycin on SARS-CoV-2 shows synergistic effectHCQ and AZ has a synergistic effect in vitro on SARS-CoV-2 at concentrations compatible with that obtained in human lung.
4/24
Positive
EarlyAshraf et al., medRxiv doi:10.1101/2020.04.20.20072421.t (Preprint)COVID-19 in Iran, a comprehensive investigation from exposure to treatment outcomes100 patients. HCQ improved clinical outcome.
4/21
Positive
EarlyIzoulet M., SSRN, doi:10.2139/ssrn.3575899 (Preprint)Countries which Primarily Use Antimalarial Drugs As COVID-19 Treatment See Slower Dynamic of Daily DeathsCompares the dynamics of daily deaths in the 10 days following the 3rd death in countries using and not using [H]CQ, showing dramatically lower death in [H]CQ countries. This paper does not at..
4/21
Negative
LateMagagnoli et al., Med (2020), doi:10.1016/j.medj.2020.06.001 (preprint 4/21) (Peer Reviewed)Outcomes of hydroxychloroquine usage in United States veterans hospitalized with Covid-19Retrospective 368 hospitalized patients, no significant reduction in mortality or the need for mechanical ventilation with HCQ or HCQ+AZ. Study notes HCQ was more likely..
4/17
Positive
PEPLee at al., Int. J. Antimicrob. Agents, 2020, Apr 17, doi:10.1016/j.ijantimicag.2020.105988 (Peer Reviewed)Can Post-Exposure Prophylaxis for COVID-19 Be Considered as an Outbreak Response Strategy in Long-Term Care Hospitals?Post exposure prophylaxis of 211 high-risk people after major exposure event in a long term care hospital, showing no positive cases after 14 days.
4/16
Negative
LateBorba et al., JAMA Network Open, doi:10.1001/jamanetworkopen.2020.8857 (Peer Reviewed)Chloroquine diphosphate in two different dosages as adjunctive therapy of hospitalized patients with severe respiratory syndrome in the context of coronavirus (SARS-CoV-2) infection: Preliminary safety results of a randomized, double-blinded, phase IIb clinical trial (CloroCovid-19 Study)Increased incidence of prolonged QT and death in high dose treatment arm. Patients >75 only enrolled in high dose arm, age of high dose arm significantly higher than low dose arm (p=0.02). Very sick at baseline, 43% in ICU, 88.9% on respi..
4/15
Positive
EarlyEsper et al., Prevent Senior Institute, São Paulo, Brazil (Preprint)Empirical treatment with hydroxychloroquine and azithromycin for suspected cases of COVID-19 followed-up by telemedicine636 patients. HCQ+AZ reduced hospitalization 79% when used within 7 days (65% overall). Non-randomized.
4/14
Negative
LateTang et al., BMJ 2020, 369, doi:10.1136/bmj.m1849 (Peer Reviewed)Hydroxychloroquine in patients with COVID-19: an open-label, randomized, controlled trial150 patients very late stage RCT. No significant difference. More symptomatic relief with HCQ. No safety concerns of HCQ. Treatment very late, average 16.6 days after symptom onset. Data favor..
4/13
Positive
LateGao et al., Biosci Trends, May 21, 2020, 14:2, 156-158, doi:10.5582/bst.2020.03072, Epub Apr 13, 2020 (Peer Reviewed)Update on Use of Chloroquine/Hydroxychloroquine to Treat Coronavirus Disease 2019 (COVID-19)Increasing evidence from completed clinical studies shows CQ and HCQ effective (HCQ more effective).
4/12
Negative
LateBarbosa et al., Preprint (Preprint)Clinical outcomes of hydroxychloroquine in hospitalized patients with COVID-19 : a quasi-randomized comparative studySmall retrospective study with 63 patients (32 treated with HCQ), showing no effectiveness, however the baseline state of each arm significantly differs. This preprint was submitted to NEJM but has not been publishe..
4/11
Positive
EarlyGautret et al., Travel Medicine and Infectious Disease, doi:10.1016/j.tmaid.2020.101663 (Peer Reviewed)Clinical and microbiological effect of a combination of hydroxychloroquine and azithromycin in 80 COVID-19 patients with at least a six-day follow up: A pilot observational studyPilot study suggesting improvement with HCQ+AZ and recommending further study.
4/10
Meta
(negative)
LateLover, medRxiv, doi:10.1101/2020.03.22.20040949 (Preprint) (meta analysis – not included in the study count)Quantifying treatment effects of hydroxychloroquine and azithromycin for COVID-19: a secondary analysis of an open label non-randomized clinical trial (Gautret et al, 2020)Secondary analysis of Gautret et al. showing “modest to no impact of HCQ treatment, with more significant effects from [HCQ+AZ]”.
4/1
Positive
LateHuang et al., Journal of Molecular Cell Biology, Volume 12, Issue 4, April 2020, 322–325, doi:10.1093/jmcb/mjaa014 (Peer Reviewed)Treating COVID-19 with Chloroquine22 patients. All CQ patients discharged by day 14 versus 50% of Lopinavir/Rotinavir patients. Symptom onset to treatment 2.5 days for CQ vs. 6.5 days for Lopinavir/Rotinavir.
3/31
Positive
LateChen et al., medRxiv doi:10.1101/2020.03.22.20040758 (Preprint)Efficacy of hydroxychloroquine in patients with COVID-19: results of a randomized clinical trial62 patients. RCT showing significantly faster recovery with HCQ. 13% progressed to severe cases in the control group, versus 0% for the treatment group. Significant improvement seen in pneumonia on chest CT for 61% ..
3/31
In Vitro
In VitroClementi et al., Front. Microbiol., 10 July 2020, doi:10.3389/fmicb.2020.01704 (preprint 3/31) (Peer Reviewed) (In Vitro) (not included in the study count)Combined Prophylactic and Therapeutic Use Maximizes Hydroxychloroquine Anti-SARS-CoV-2 Effects in vitroIn vitro study, not included in the study count or percentages, showing greater inhibition for combined pre and post-exposure treatment for Vero E6 and Caco-2 cells.
3/28
Negative
(letter)
LateMolina et al., Médecine et Maladies Infectieuses, 50:4, June 2020, 10.1016/j.medmal.2020.03.006 (preprint 3/28) (Letter to the editor)No evidence of rapid antiviral clearance or clinical benefit with the combination of hydroxychloroquine and azithromycin in patients with severe COVID-19 infection11 patients with severe cases. No evidence of benefit for HCQ.
3/26
Positive
(news)
LateZhong Nanshan (钟南山) (News) (not included in the study count)Efficacy and safety of chloroquine for treatment of COVID-19. An open-label, multi-center, non-randomized trial197 patients. HCQ effective. Viral RNA negative in 95.9% versus 79.6% control. Median time to negative tests 3 days versus 9 days for control.
3/24
Theory
TheoryPagliano et al., Clin. Infect. Dis., 2020 Mar 24, doi:10.1093/cid/ciaa320 (Peer Reviewed) (Theory)Is Hydroxychloroquine a Possible Post-Exposure Prophylaxis Drug to Limit the Transmission to Health Care Workers Exposed to COVID19?CQ and HCQ inhibit replication at early stages of infection, no similar effect reported for other drugs which are only able to interfere after cell infection. Large volume of existing data on ..
3/23
Theory
TheoryHu et al., Nature Nanotechnology, 15, 247–249, 2020, doi:10.1038/s41565-020-0674-9 (Peer Reviewed) (Theory) (not included in the study count)Insights from nanomedicine into chloroquine efficacy against COVID-19CQ is known in nanomedicine research for the investigation of nanoparticle uptake in cells, and may have potential for the treatment of COVID-19.
3/21
Positive
(advisory)
PrEPICMR, Indian Council of Medical Research (Advisory) (not included in the study count)Advisory on the use of hydroxy-chloroquine as prophylaxis for SARS-CoV-2 infectionRecommends HCQ for prophylaxis in asymptomatic healthcare workers as found effective in-vitro and in-vivo.
3/20
Positive
(news)
LateHu et al., Shanghai Combined Task Force on COVID-19 (News) (not included in the study count)Shanghai Experience of COVID-19 ManagementClinical studies of HCQ with 184 cases and 21 hospitals show HCQ is effective.
3/18
In Vitro
In VitroLiu et al., Cell Discovery 6, 16 (2020), doi:10.1038/s41421-020-0156-0 (Peer Reviewed) (In Vitro) (not included in the study count)Hydroxychloroquine, a less toxic derivative of chloroquine, is effective in inhibiting SARS-CoV-2 infection in vitroHCQ effective in vitro and less toxic than CQ. In addition to direct antiviral activity, HCQ is a safe and successful anti-inflammatory agent that has been used extensiv..
3/17
Positive
EarlyGautret et al., Int. J. of Antimicrobial Agents, 17 March 2020, doi:10.1016/j.ijantimicag.2020.105949 (Peer Reviewed)Hydroxychloroquine and azithromycin as a treatment of COVID-19: results of an openlabel non-randomized clinical trialHCQ significantly associated with viral load reduction / elimination, enhanced with AZ.
3/17
Review
N/ASahraei et al., Int. J. Antimicrobial Agents, April 2020, 55:4, doi:10.1016/j.ijantimicag.2020.105945 (Peer Reviewed) (not included in the study count)Aminoquinolines against coronavirus disease 2019 (COVID-19): chloroquine or hydroxychloroquineDiscussion of mechanisms of action, CQ vs. HCQ, early studies, safety.
3/13
Review
N/ATodaro and Rigano (Preprint) (not included in the study count)An Effective Treatment for Coronavirus (COVID-19)Discussion of existing research, treatment guidelines, and mechanisms of action for CQ and HCQ, recommending use.
3/12
Theory
TheoryDevaux et al., International Journal of Antimicrobial Agents, doi:10.1016/j.ijantimicag.2020.105938 (Peer Reviewed) (Theory) (not included in the study count)New insights on the antiviral effects of chloroquine against coronavirus: what to expect for COVID-19?Discusses mechanisms of CQ interference with the SARS-CoV-2 replication cycle.
3/10
Meta
(positive)
N/ACortegiani et al., J. Crit. Care, June 2020, 57:279-283, doi:10.1016/j.jcrc.2020.03.005, Epub Mar 10, 2020 (Peer Reviewed) (meta analysis – not included in the study count)A Systematic Review on the Efficacy and Safety of Chloroquine for the Treatment of COVID-19Review of six articles and 23 ongoing clinical trials in China recommending research and clinical use adhering to MEURI.
3/9
In Vitro
N/AYao et al., Clin. Infect. Dis., 2020 Mar 9, doi:10.1093/cid/ciaa237 (Peer Reviewed) (not included in the study count)In Vitro Antiviral Activity and Projection of Optimized Dosing Design of Hydroxychloroquine for the Treatment of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2)HCQ is more potent than CQ in vitro for inhibiting SARS-CoV-2. Simulates HCQ concentration in lung fluid and provides dosing recommendations.
3/6
Negative
LateChen et al., J. Zhejiang University (Med Sci), doi:10.3785/j.issn.1008-9292.2020.03.03 (Peer Reviewed)A pilot study of hydroxychloroquine in treatment of patients with common coronavirus disease-19 (COVID-19)30 moderate hospitalized cases, all recovered. Time to RNA negative comparable. Less frequent radiological progression with HCQ but not statistically significant. One HCQ patient developed to ..
3/4
Positive
LateColson et al., Int J. Antimicrob Agents, doi: 10.1016/j.ijantimicag.2020.105932. Epub 2020 Mar 4. (Peer Reviewed)Chloroquine and Hydroxychloroquine as Available Weapons to Fight COVID-19Recommending CQ and HCQ for COVID-19 based on 20 clinical studies in China and a strong rationale for use.
2/20
Positive
LateJiang et al., Chin. J. Tuberc. Respir. Dis., 2020, 43, doi:10.3760/cma.j.issn.1001-0939.2020.0019 (Peer Reviewed)Expert Consensus on Chloroquine Phosphate for the Treatment of Novel Coronavirus PneumoniaEarly trials in China show CQ results in shorter hospital stays and improved patient outcomes.
2/19
Positive
LateGao et al., BioScience Trends, 2020, doi:10.5582/bst.2020.01047 (Peer Reviewed)Breakthrough: Chloroquine phosphate has shown apparent efficacy in treatment of COVID-19 associated pneumonia in clinical studiesResults from 15 clinical trials in China showing CQ is effective.
2/17
Positive
(news)
LateSun Yanrong, deputy head of the China National Center for Biotechnology Development (News) (not included in the study count)Antimalarial drug confirmed effective on COVID-19HCQ under clinical trials in >10 hospitals in China and has shown fairly good efficacy.
2/4
In Vitro
In VitroWang et al., Cell Res. 30, 269–271, doi:L10.1038/s41422-020-0282-0 (Peer Reviewed) (In Vitro) (not included in the study count)Remdesivir and chloroquine effectively inhibit the recently emerged novel coronavirus (2019-nCoV) in vitroIn vitro study, not included in the study count or percentages. Remdesivir and CQ potently blocked virus infection in vitro.
2014
In Vitro
In Vitrode Wilde et al., Antimicrobial Agents and Chemotherapy, Jul 2014, 58:8, 4875-4884, doi:10.1128/AAC.03011-14 (Peer Reviewed) (In Vitro) (not included in the study count)Screening of an FDA-Approved Compound Library Identifies Four Small-Molecule Inhibitors of Middle East Respiratory Syndrome Coronavirus Replication in Cell CultureCQ inhibits SARS-CoV, MERS-CoV, and HCoV-229E-GFP replication in the low-micromolar range.
2012
Animal
AnimalYan et al., Cell Research, 23, 300–302, doi:10.1038/cr.2012.165 (Peer Reviewed) (not included in the study count)Anti-malaria drug chloroquine is highly effective in treating avian influenza A H5N1 virus infection in an animal modelCQ, a known autophagy inhibitor that is in clinical use, can efficiently ameliorate acute lung injury and dramatically improve the survival rate in mice infected with live avian influenza A H5N1 virus.
2009
Animal
AnimalKeyaerts et al., Antimicrob. Agents Chemother, August 2009, 53(8), doi:0.1128/AAC.01509-08 (Peer Reviewed) (not included in the study count)Antiviral Activity of Chloroquine against Human Coronavirus OC43 Infection in Newborn MiceCQ inhibits HCoV-OC43 replication in HRT-18 cells. A lethal HCoV-OC43 infection in newborn C57BL/6 mice can be treated with CQ acquired transplacentally or via maternal milk. The highest survi..
2008
In Vitro
In VitroKono et al., Antiviral Research, 77:2, February 2008, 150-152, 10.1016/j.antiviral.2007.10.011 (Peer Reviewed) (In Vitro) (not included in the study count)Inhibition of human coronavirus 229E infection in human epithelial lung cells (L132) by chloroquine: Involvement of p38 MAPK and ERKCQ significantly decreased viral replication of HCoV-229E at concentrations lower than in clinical usage. CQ affects the activation of p38 mitogen-activated protein kinase (MAPK) and extracell..
2006
In Vitro
In VitroSavarino et al., Lancet Infect. Dis., doi:10.1016/S1473-3099(06)70361-9 (Peer Reviewed) (In Vitro) (not included in the study count)New insights into the antiviral effects of chloroquineUpdate to 2003 paper, not included in the study count or percentages. Hypothesis of CQ inhibiting SARS replication has been confirmed in two in-vitro studies. CQ affected an early stage of SAR..
2005
In Vitro
In VitroVincent et al., Virol. J. 2:69, 2005, doi:10.1186/1743-422X-2-69 (Peer Reviewed) (In Vitro) (not included in the study count)Chloroquine is a potent inhibitor of SARS coronavirus infection and spreadIn vitro study, SARS-CoV-1, not included in the study count or percentages. CQ has strong antiviral effects on SARS CoV infection when cells treated either before or after exposure, suggesting prophylactic and treat..
2004
In Vitro
In VitroKeyaerts et al., Biochem. Biophys. Res. Comm., 323:1, 8 October 2004, doi:10.1016/j.bbrc.2004.08.085 (Peer Reviewed) (In Vitro) (not included in the study count)In vitro inhibition of severe acute respiratory syndrome coronavirus by chloroquineIn vitro study, SARS-CoV-1, not included in the study count or percentages. IC50 of CQ for antiviral activity (8.8) is significantly lower than cytostatic activity CC50 (261.3), selectivity index of 30. IC50 for inh..
2003
Theory
TheorySavarino et al., Lancet Infect. Dis., doi:10.1016/S1473-3099(03)00806-5 (Peer Reviewed) (Theory) (not included in the study count)Effects of chloroquine on viral infections: an old drug against today’s diseasesNot included in the study count or percentages. Discussion/review noting that CQ exerts antiviral effects, inhibiting the replication of several viruses including members of the flaviviruses, retroviruses, and coron..
1896
Inconc.
(news)
N/AEdwin Wiley Grove (News) (not included in the study count)Laxative Bromo QuinineQuinine has been used for respiratory infections since 1896. Not included in the study count or percentages, just as an interesting observation.


Note: In Vitro, Meta, Theory, Safety, Review, and News items are not included in the percentages and study count. There is a total of 110 items. Positive/negative effects vary in degree and certainty, please read the papers or descriptions thereof for more details.
Please send us corrections, updates, comments. Please send us any missing papers but check first – almost all submissions to date were already posted.
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John F. McGowan, Ph.D.
John F. McGowan, Ph.D.
1 year ago

Please clarify the graph. Does "demographic adjusted deaths per million" refer to death rates reported in the 50 studies somehow or to official national death statistics? Can you give references to the sources for the national curves, e.g. where does the curve for the USA come from? Does the graph itself have a reference — review paper etc. — or did you create it yourself? Does "Early HCQ use" refer to nationwide early HCQ use or something else? Does early refer to early use during the illness or early adoption of HCQ as a treatment?

What does demographic adjusted refer to? Is it adjustment for age? Can you provide a reference for the demographic adjustment? How close is it to the "raw" death rate?

John McGowan

Meryl Nass, M.D.
Meryl Nass, M.D.
1 year ago

Apologies. This entire post is a copy of the material on the website named at the top, and I posted it because of many queries about my June 29 post on the hydroxychloroquine narrative. People said that I had proven that the suppression of hydroxychloroquine was corrupt, but I had not provided any evidence that the drug worked against Covid. So I felt a compilation of evidence was needed.

In much earlier posts I have discussed the relative risks and benefits of hydroxychloroquine.

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