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Treatment
effectiveness
Potential
lives saved
1%
10%
25%
50%
PrEP
89%
PEP
100%
Early
100%
Late
63%
All
75%
102 studies (59 peer reviewed)
  COVID deaths:
September 20, 2020
Global HC Q studies. PrEP, PEP, and early treatment studies show efficacy, while late treatment shows mixed results.
9/18
Meta
META
Late
Axfors et al., medRxiv, doi:10.1101/2020.09.16.20194571 (Preprint) (not included in the study count)
Mortality outcomes with hydroxych loroquine and ch loroquine in COVID-19: an international collaborative meta-analysis of randomized trials
Meta analysis assigning 87% weight to the RECOVERY trial, producing the same result. The RECOVERY trial used excessively high non-patient-customized dosage in very sick late stage patients and the result is not generalizable to typical do..
9/14
Positive
POSITIVE
Late
Lauriola et al., Clinical and Translational Science, doi:10.1111/cts.12860 (Peer Reviewed)
Effect of combination therapy of hydroxych loroquine and azithromycin on mortality in COVID‐19 patients
Retrospective 377 patients, 73% reduction in mortality with HC Q+AZ, adjusted hazard ratio HR 0.27 [0.17-0.41]. Mean age 71.8. No serious adverse events. Subject to incomplete adjustment for confounders.
9/13
Positive
POSITIVE
Early
Sulaiman et al., medRxiv, doi:10.1101/2020.09.09.20184143 (Preprint)
The Effect of Early Hydroxych loroquine-based Therapy in COVID-19 Patients in Ambulatory Care Settings: A Nationwide Prospective Cohort Study
Observational prospective 5,541 patients, adjusted HC Q mortality odds ratio OR 0.36, p = 0.012 (~ potential lives saved with global HC Q). Adjusted hospit..
9/9
Positive
POSITIVE
Late
Alamdari et al., Tohoku J. Exp. Med., 2020, 252, 73-84, doi:10.1620/tjem.252.73 (Peer Reviewed)
Mortality Risk Factors among Hospitalized COVID-19 Patients in a Major Referral Center in Iran
Retrospective 396 patients in Iran 93% using HC Q, showing HC Q mortality RR 0.45, p = 0.028. HC Q was the only antiviral that showed a significant difference. Small number..
9/9
Inconc.
INCONC.
Early, Late
Kirenga et al., BMJ Open Respiratory Research, doi:10.1136/bmjresp-2020-000646 (Peer Reviewed)
Characteristics and outcomes of admitted patients infected with SARS-CoV-2 in Uganda
Retrospective 56 patients in Uganda, 29 HC Q and 27 control, showing 25.6% faster recovery with HC Q, 6.4 vs. 8.6 days (p = 0.20). There was no ICU admission, mechanical ventilation, or death. ..
9/9
Negative
NEGATIVE
PrEP
Rentsch et al., medRxiv, doi:10.1101/2020.09.04.20187781 (Preprint)
Hydroxych loroquine for prevention of COVID-19 mortality: a population-based cohort study
Observational database study of RA/SLE patients in the UK, 194,637 RA/SLE patients with 30,569 having >= 2 HC Q prescriptions in the prior 6 months, HC Q HR 1.03 [0.80-1.33] (HR 0.78 before adju..
9/9
Inconc.
INCONC.
PrEP
Laplana et al., medRxiv, doi:10.1101/2020.09.03.20158121 (Preprint)
Lack of protective effect of ch loroquine derivatives on COVID-19 disease in a Spanish sample of chronically treated patients
Survey of 319 autoimmune disease patients taking C Q/HC Q with 5.3% COVID-19 incidence, compared to a control group from the general population (matched on age, sex, and region, but not adjusted..
9/7
Meta
META
Early, Late
Prodromos et al., Preprint, doi:10.13140/RG.2.2.29781.65765 (Preprint) (meta analysis - not included in study count)
Hydroxych loroquine is Effective and Safe for the Treatment of COVID-19, and May be Universally Effective When Used Early Before Hospitalization: A Systematic Review
Meta analysis of 41 studies concluding: "HC Q has been shown to have consistent clinical efficacy for COVID-19 when it is used early in the outpatient setting, and in general would appear to work better the earl..
9/7
Review
REVIEW
Review
IHU, Expert Review of Clinical Immunology (Peer Reviewed) (Review) (not included in the study count)
Natural history and therapeutic options for COVID-19
Review of the current state of knowledge regarding the natural history of and therapeutic options for COVID-19. Treatment with an oral combination of hydroxych loroquine, azithromycin and zinc may represent the best..
9/5
Positive
POSITIVE
Late
Synolaki et al., medRxiv, doi:10.1101/2020.09.05.20184655 (Preprint)
Activin/Follistatin-axis deregulation is independently associated with COVID-19 in-hospital mortality
Retrospective 117 patients, 58 HC Q. HC Q, AZ, and other treatments were found to be independently associated with survival when treatment commenced early.
9/4
Inconc.
INCONC.
Late
Furtado et al., The Lancet, doi:10.1016/S0140-6736(20)31862-6 (Peer Reviewed)
Azithromycin in addition to standard of care versus standard of care alone in the treatment of patients admitted to the hospital with severe COVID-19 in Brazil (COALITION II): a randomised clinical trial
Small RCT comparing the addition of AZ for very late stage patients on ventilation or oxygen. No significant difference was found, OR 1.36, p=0.11. One notable result is that even within this extremely late stage population, results sugge..
9/2
In Vitro
IN VITRO
In Vitro
Wang et al., Phytomedicine, doi:10.1016/j.phymed.2020.153333 (Peer Reviewed) (In Vitro) (not included in the study count)
Ch loroquine and hydroxych loroquine as ACE2 blockers to inhibit viropexis of 2019-nCoV Spike pseudotyped virus
In Vitro study providing novel insights into the molecular mechanism of C Q/HC Q treatment, showing that C Q and HC Q both inhibit the entrance of 201..
9/2
Positive
POSITIVE
Early
Heras et al., Research Square, doi:10.21203/rs.3.rs-70219/v1 (Preprint)
COVID-19 mortality risk factors in older people in a long-term care center
Retrospective 100 elderly nursing home patients, HC Q+AZ mortality 11.4% vs. control 61.9%, RR 0.18, p<0.001 (~ potential lives saved with global HC Q). Me..
9/2
Inconc.
INCONC.
PrEP
de la Iglesia et al., medRxiv, doi:10.1101/2020.08.31.20185314 (Preprint)
Hydroxicloroquine for pre-exposure prophyylaxis for SARS-CoV-2
Analysis of autoimmune disease patients on HC Q, compared to a control group from the general population (matched on age and sex, but not adjusted for autoimmune disease), showing non-significant differences between ..
9/1
Review
REVIEW
Review
Hecel et al., Pharmaceuticals, 13:9, 228, doi:10.3390/ph13090228 (Peer Reviewed) (Review) (not included in the study count)
Zinc(II)—The Overlooked Éminence Grise of Ch loroquine’s Fight against COVID-19?
Review of zinc as an inhibitor of SARS-CoV-2′s RNA-dependent RNA polymerase, and zinc ionophores including C Q/HC Q, showing the latest evidence for zinc and C Q/HC
9/1
Positive
POSITIVE
Early
Elbazidi et al., New Microbes and New Infections, doi:10.1016/j.nmni.2020.100749 (Peer Reviewed)
Pandemic and social changes, political fate
Analysis of US states and countries. Country analysis shows a significant correlation between the dates of decisions to adopt/decline HC Q, and corresponding trend changes in CFR. US state analysis shows a significan..
8/28
Inconc.
INCONC.
Late
Fried et al., Clinical Infectious Disease, doi:10.1093/cid/ciaa1268 (Peer Reviewed)
Patient Characteristics and Outcomes of 11,721 Patients with COVID19 Hospitalized Across the United States
Database analysis of 11,721 hospitalized patients, 4,232 on HC Q. Strong evidence for confounding by indication and compassionate use of HC Q. 24.9% of HC Q patients were o..
8/27
Positive
POSITIVE
PrEP
Ferri at al., Clinical Rheumatology, doi:0.1007/s10067-020-05334-7 (Peer Reviewed)
COVID-19 and rheumatic autoimmune systemic diseases: report of a large Italian patients series
Analysis of 1641 systemic autoimmune disease patients showing csDMARD (HC Q etc.) RR 0.37, p=0.015 (~ potential lives saved with global HC Q). csDMARDs in..
8/26
Meta
META
Early, Late
IHU Marseille (Preprint) (meta analysis - not included in study count)
Meta-analysis on ch loroquine derivatives and COVID-19 mortality
Updated meta analysis of 26 studies showing C Q/HC Q OR 0.60 [0.50 - 0.73], p<0.0001 from clinical studies. For big data studies authors find inconsistent results and OR 0.84 [0.75 - 0.94], p=0..
8/26
Meta
META
Late
Fiolet et al., Clinical Microbiology and Infection (Peer Reviewed) (meta analysis - not included in study count)
Effect of hydroxych loroquine with or without azithromycin on the mortality of COVID-19 patients: a systematic review and meta-analysis
Meta analysis of late stage studies (and one early treatment study with only 2 deaths), showing HC Q RR 0.83 [0.65-1.06], before exclusions RR 0.80 [0.65-1.0]. Authors claim "HC Q alone is..
8/25
Positive
POSITIVE
Early
Ip et al., medRxiv, doi:10.1101/2020.08.20.20178772 (Preprint)
Hydroxych loroquine in the treatment of outpatients with mildly symptomatic COVID-19: A multi-center observational study
Retrospective 1,274 outpatients, 47% reduction in hospitalization with HC Q with propensity matching, HC Q OR 0.53 [0.29-0.95]. Sensitivity analyses revealed similar associations. Adverse event..
8/25
Positive
POSITIVE
Late
Di Castelnuovo et al., European J. Internal Medicine, doi:10.1016/j.ejim.2020.08.019 (Peer Reviewed)
Use of hydroxych loroquine in hospitalised COVID-19 patients is associated with reduced mortality: Findings from the observational multicentre Italian CORIST study
Retrospective 3,451 hospitalized patients, 30% reduction in mortality with HC Q after propensity adjustment, HR 0.70 [0.59 - 0.84].
8/24
Positive
POSITIVE
Late
Catteau et al., Int. J. Antimicrobial Agents, doi:10.1016/j.ijantimicag.2020.106144 (Peer Reviewed)
Low-dose Hydroxych loroquine Therapy and Mortality in Hospitalized Patients with COVID-19: A Nationwide Observational Study of 8075 Participants
Retrospective 8,075 hospitalized patients, 4,542 low-dose HC Q, 3,533 control. 35% lower mortality for HC Q (17.7% vs. 27.1%), adjusted HR 0.68 [0.62–0.76]. Low-dose HC Q m..
8/21
Positive
POSITIVE
Early
Ly et al., Preprint, 2020 (Preprint)
Pattern of SARS-CoV-2 infection among dependant elderly residents living in retirement homes in Marseille, France, March-June 2020
Retrospective analysis of retirement homes, HC Q+AZ >= 3 days mortality OR 0.39, p=0.026. 1690 elderly residents (mean age 83), 226 infected residents, 116 treated with HC Q+AZ >= 3 days. Detec..
8/21
Safety
SAFETY
N/A
Lane et al., The Lancet Rheumatology, doi:10.1016/S2665-9913(20)30276-9 (Peer Reviewed) (not included in the study count)
Risk of hydroxych loroquine alone and in combination with azithromycin in the treatment of rheumatoid arthritis: a multinational, retrospective study
Retrospective study of RA patients using HC Q vs. sulfasalazine (another DMARD). HC Q treatment showed no increased risk in the short term (up to 30 days) among patients with RA. Long term use w..
8/21
Positive
POSITIVE
Late
Gonzalez et al., medRxiv, doi:10.1101/2020.08.18.20172874 (Preprint)
The Prognostic Value of Eosinophil Recovery in COVID-19: A Multicentre, Retrospective Cohort Study on Patients Hospitalised in Spanish Hospitals
Retrospective study focused on eosinophil recovery with 9,644 hospitalized patients in Spain, showing lower mortality for HC Q (14.7% vs 29.2%, p<0.001), and AZ (15.3% vs. 18.4%, p<0.001). With a multivariate model i..
8/20
Positive
POSITIVE
Late
Dubernet et al., J. Global Antimicrobial Resistance, doi:10.1016/j.jgar.2020.08.001 (Peer Reviewed)
A comprehensive strategy for the early treatment of COVID-19 with azithromycin/hydroxych loroquine and/or corticosteroids: results of a retrospective observational study in the French overseas department of Reunion Island
Retrospective analysis of 36 hospitalized patients showing HC Q/AZ associated with lower ICU admission, p=0.008. Median age 66, no mortality. Confounding by indication, however it was patients with hypoxemic pneumoni..
8/20
Safety
SAFETY
Early
Prodromos, C., New Microbes and New Infections, doi:10.1016/j.nmni.2020.100747 (Peer Reviewed) (not included in the study count)
Hydroxych loroquine is protective to the heart, not harmful: A systematic review
Review concluding that HC Q/AZ does not cause Torsade de Pointes or related deaths, HC Q decreases cardiac events, and HC Q should not be restricted in use for COVID-19 pat..
8/18
Positive
POSITIVE
Late
Pinato et al., Cancer Discovery, doi:10.1158/2159-8290.CD-20-0773 (Peer Reviewed)
Clinical portrait of the SARS-CoV-2 epidemic in European cancer patients
Restrospective 890 cancer patients with COVID-19, adjusted mortality HR for HC Q/C Q 0.41, p<0.0001. Confirmed SARS-CoV-2 infection was required, which may help focus on more severe cases. Anal..
8/17
Safety
SAFETY
Early
Mohana et al., medRxiv, doi:10.1101/2020.08.16.20175752 (Preprint) (not included in the study count)
Hydroxych loroquine Safety Outcome within Approved Therapeutic Protocol for COVID-19 Outpatients in Saudi Arabia
Safety study of 2,733 patients in Saudi Arabia showing HC Q in mild to moderate cases in an outpatient setting, within the protocol recommendation and inclusion/exclusion criteria, is safe, highly tolerable, and has ..
8/15
Negative
NEGATIVE
Late
Peters et al., medRxiv, doi:10.1101/2020.08.14.20173369 (Preprint)
Outcomes of Persons With COVID-19 in Hospitals With and Without Standard Treatment With (Hydroxy)ch loroquine
Retrospective study of HC Q use in 9 hospitals in the Netherlands, showing no significant difference in mortality with HC Q/C Q or dexamethasone. Late stage (admitted to ho..
8/14
Inconc.
INCONC.
Late
Abd-Elsalam et al., American Journal of Tropical Medicine and Hygiene, 10.4269/ajtmh.20-0873 (Peer Reviewed)
Hydroxych loroquine in the Treatment of COVID-19: A Multicenter Randomized Controlled Study
Small RCT in Egypt with 97/97 HC Q/control patients, showing 58% more recovery @28days for HC Q (53.6% HC Q, 34% control), p=0.009 (0.06 in the paper refers to the 5 combin..
8/13
Negative
NEGATIVE
Late
Roomi et al., J. Medical Internet Research, doi:10.2196/21758 (Peer Reviewed)
Efficacy of hydroxych loroquine and tocilizumab in patients with COVID-19: A single-center retrospective chart review
Retrospective 176 hospitalized patients (144 HC Q, 32 control) showing no significant differences with HC Q or TCZ. Confounding by indication.
8/11
Safety
SAFETY
Early
Bakhshaliyev et al., J. Electrocardiology, doi:10.1016/j.jelectrocard.2020.08.008 (Peer Reviewed) (not included in the study count)
The effect of 5-day course of hydroxych loroquine and azithromycin combination on QT interval in non-ICU COVID19(+) patient
Safety study of 109 patients showing 5 days of HC Q+AZ did not lead to clinically significant QT prolongation or other conduction delays compared to baseline ECG in non-ICU patients.
8/11
Negative
NEGATIVE
Late
Saleemi et al., medRxiv, doi:10.1101/2020.08.05.20151027 (Preprint)
Time to negative PCR from symptom onset in COVID-19 patients on Hydroxych loroquine and Azithromycin - A real world experience
Retrospective 65 HC Q+AZ, 20 control patients, showing median time to negative PCR of 23 days for HC Q+AZ vs. 19 days for control. Confounding by indication. 100% of non-HC
8/6
Review
REVIEW
Review
McCullough et al., The American Journal of Medicine, doi:10.1016/j.amjmed.2020.07.003 (Peer Reviewed) (Review) (not included in the study count)
Pathophysiological Basis and Rationale for Early Outpatient Treatment of SARS-CoV-2 (COVID-19) Infection
Review of pathophysiological principles related to early outpatient treatment and therapeutic approaches including reduction of reinoculation, combination antiviral therapy, immunomodulation, antiplatelet/antithrombotic therapy, and admin..
8/6
Meta
META
PEP, Early, Late
Watanabe et al., Open Letter (Letter) (not included in the study count)
Concerns regarding the misinterpretation of statistical hypothesis testing in clinical trials for COVID-19
Open letter signed by 38 professors and doctors regarding misinterpretation of statistics in HC Q RCTs. Authors note [1] that data from RCTs for early treatment in outpatients to date actually show favorable effects..
8/4
Inconc.
INCONC.
Late
Kamran et al., medRxiv, doi:10.1101/2020.07.30.20165365 (Preprint)
Clearing the fog: Is HC Q effective in reducing COVID-19 progression: A randomized controlled trial
Study of 349 low-risk hospitalized patients with 151 non-consenting or ineligible patients used as controls. SOC included zinc, vitamin C and vitamin D. A statistically significant improvement in PCR negativity is shown at day 7 with HC
8/3
Positive
POSITIVE
Late
Yu et al., Science China Life Sciences, 2020 Aug 3, doi:10.1007/s11427-020-1782-1 (Letter)
Beneficial effects exerted by hydroxych loroquine in treating COVID-19 patients via protecting multiple organs
Retrospective 2,882 patients in China, median age 62, 278 receiving HC Q, median 10 days post hospitalization, showing that HC Q treatment can reduce systemic inflammation and inhibit the cytoki..
8/2
Positive
POSITIVE
Late
Davido et al., Int. J. Antimicrobial Agents, 2020, doi:10.1016/j.ijantimicag.2020.106129 (Peer Reviewed)
Impact of medical care including anti-infective agents use on the prognosis of COVID-19 hospitalized patients over time
Retrospective of 132 hospitalized patients. HC Q+AZ significantly reduces death/ICU, HR=0.45, p=0.04. Adjusted for Charlson Comorbidity Index (including age), obesity, O2, lymphocyte count, and treatments. Mean delay..
8/2
In Vitro
IN VITRO
In Vitro
Sheaff, R., bioRxiv, doi:10.1101/2020.08.02.232892 (Preprint) (In Vitro) (not included in the study count)
A New Model of SARS-CoV-2 Infection Based on (Hydroxy)Ch loroquine Activity
In vitro study presenting a new theory on SARS-CoV-2 infection and why HC Q/C Q provides benefits, which potentially explains the observed relationships with smoking, diabetes, obesity, age, and..
7/29
Positive
POSITIVE
Late
D'Arminio Monforte et al., Int. J. Infectious Diseases, doi:10.1016/j.ijid.2020.07.056 (Letter)
Effectiveness of Hydroxych loroquine in COVID-19 disease: A done and dusted situation?
HC Q+AZ adjusted death HR 0.44, p=0.009. Propensity scores include baseline COVID-19 disease severity, age, gender, number of comorbidities, cardio-vascular disease, duration of symptoms, date of admission, baseline ..
7/28
Inconc.
INCONC.
Late
BaŞaran et al., Turk. J. Med. Sci., doi:10.3906/sag-2006-173 (Peer Reviewed)
Outcome of Non-Critical COVID-19 Patients with Early Hospitalization and Early Antiviral Treatment Outside the ICU
Observational study of 174 hospitalized patients in Turkey, median age 45.4, 23 treated with HC Q, 113 with HC Q+AZ, and 32 with regimens including favipiravir. 75% reduction in the median time ..
7/26
Inconc.
INCONC.
PEP
Mitjà et al., medRxiv, doi:10.1101/2020.07.20.20157651 (Preprint)
A Cluster-Randomized Trial of Hydroxych loroquine as Prevention of Covid-19 Transmission and Disease
Death rate reduced from 0.6% to 0.4%, RR 0.68, 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 [0.21 - ..
7/24
Positive
POSITIVE
PrEP
Khurana 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 HC Q 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
NEGATIVE
Late
Cavalcanti et al., NEJM, July 23, 2020, doi:10.1056/NEJMoa201901 (Peer Reviewed)
Hydroxych loroquine 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..
7/22
In Vitro
IN VITRO
In Vitro
Hoffmann et al., Nature, (2020), doi:10.1038/s41586-020-2575-3 (Peer Reviewed) (In Vitro) (not included in the study count)
Ch loroquine does not inhibit infection of human lung cells with SARS-CoV-2
The title of this paper does not appear to match the results. Fig. 1b @100uM shows C Q results in a ~4.5 fold decrease (on a linear scale) in extracellular virus, p=0.05, after 24 hours (we do not see the supplementa..
7/22
Negative
NEGATIVE
Late
Kelly et al., British Journal of Clinical Pharmacology, doi:10.1111/bcp.14482 (Peer Reviewed)
Clinical outcomes and adverse events in patients hospitalised with COVID‐19, treated with off‐label hydroxych loroquine and azithromycin
Retrospective 82 hospitalized patients HC Q/AZ, 52 SOC, not finding statistically significant differences. Confounding by indication. No attempt to adjust for confounders. HC Q/AZ patients were ..
7/21
Positive
POSITIVE
Late
Bernaola 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
HC Q 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)
META
Early
Risch, H., American Journal of Epidemiology, July 20, 2020, doi:10.1093/aje/kwaa152 (Peer Reviewed) (meta analysis - not included in 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)
META
PEP
Watanabe, M., arXiv.org, arXiv:2007.09477 (Preprint) (meta analysis - not included in study count)
Efficacy of Hydroxych loroquine as Prophylaxis for Covid-19
Secondary analysis of Boulware et al.'s PEP trial and treatment delay-response data, confirming that HC Q is effective when used early, p<0.01. The effectiveness found is especially notable considering the limitatio..
7/19
Inconc.
INCONC.
Late
McGrail et al., medRxiv, doi:10.1101/2020.07.17.20156521 (Preprint)
COVID-19 Case Series at UnityPoint Health St. Luke’s Hospital in Cedar Rapids, IA
HC Q+AZ early in the epidemic had a fairly good success rate with few complications, 86% of HC Q patients survived and 92% of HC Q+AZ patients. Patients not receiving eithe..
7/17
Inconc.
INCONC.
Late
Lyngbakken et al., Research Square, doi:10.21203/rs.3.rs-44055/v1 (Preprint)
A pragmatic randomized controlled trial reports the efficacy of hydroxych loroquine on coronavirus disease 2019 viral kinetics
Small RCT of nasopharyngeal viral load not showing significant differences. The rate of reduction for HC Q was 0.24 [0.03-0.46] RNA copies/mL/24h, and 0.14 [-0.10-0.37] for the control group (71% faster with HC
7/16
Positive
POSITIVE
Early
Hong et al., Infect. Chemother., 2020, doi:10.3947/ic.2020.52.e43 (Peer Reviewed)
Early Hydroxych loroquine Administration for Rapid Severe Acute Respiratory Syndrome Coronavirus 2 Eradication
HC Q 1-4 days from diagnosis was the only protective factor against prolonged viral shedding found, OR 0.111, p=0.001. 57.1% viral clearance with 1-4 days delay vs. 22.9% for 5+ days delayed treatment. Authors report..
7/16
Inconc.
INCONC.
Early
Skipper et al., Annals of Internal Medicine, doi:10.7326/M20-4207 (Peer Reviewed)
Hydroxych loroquine in Nonhospitalized Adults With Early COVID-19: A Randomized Trial
~70 to 140 hour (inc. shipping) delayed outpatient treatment with HC Q reduced combined hospitalization/death by 50%, p=0.29 (5 HC Q cases, 10 control cases), and reduced hospitalization by 60%,..
7/16
Inconc.
INCONC.
Early
Mitjà et al., Clinical Infectious Diseases, ciaa1009, doi:10.1093/cid/ciaa1009 (Peer Reviewed)
Hydroxych loroquine 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..
7/14
Inconc.
INCONC.
Early
Chowdhury et al., Research Square, doi:10.21203/rs.3.rs-38896/v1 (Preprint)
A Randomized Trial of Ivermectin-Doxycycline and Hydroxych loroquine-Azithromycin therapy on COVID19 patients
Small 116 patient RCT comparing Ivermectin-Doxycycline and HC Q+AZ, not showing a significant difference in time to PCR negative or symptom resolution. Time to symptomatic recovery was 5.93 days for Ivermectin-Doxycy..
7/11
Negative
NEGATIVE
Late
Lecronier et al., Critical Care, 24:418, 2020, doi:10.1186/s13054-020-03117-9 (Peer Reviewed)
Comparison of hydroxych loroquine, lopinavir/ritonavir, and standard of care in critically ill patients with SARS-CoV-2 pneumonia: an opportunistic retrospective analysis
Retrospective 80 ICU patients, 22 SOC, 20 lopinavir/ritonavir, 38 HC Q. 28 day mortality 24% (HC Q) versus 41% (SOC), a 41% decrease, but not statistically significant due to very small sample s..
7/9
Meta
META
Early, Late
Raoult et al., Preprint (Preprint) (meta analysis - not included in study count)
Hydroxych loroquine 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
Review
REVIEW
Review
Goldstein, L., Preprint, July 7, 2020 (Preprint) (Review) (not included in the study count)
Hydroxych loroquine-based COVID-19 Treatment, A Systematic Review of Clinical Evidence and Expert Opinion from Physicians’ Surveys
85% of globally surveyed physicians recognized HC Q as at least partially effective in treating COVID-19, according to Sermo W3. More than half of the surveyed US physicians would take the drug or give it to family m..
7/7
Negative
NEGATIVE
Late
An et al., medRxiv, doi:10.1101/2020.07.04.20146548 (Preprint)
Treatment Response to Hydroxych loroquine and Antibiotics for mild to moderate COVID-19: a retrospective cohort study from South Korea
Retrospective of hospitalized patients with 31 HC Q 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
POSITIVE
PrEP
Zhong 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 HC Q 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
POSITIVE
Early
Scholz et al., Preprints 2020, 2020070025, doi:10.20944/preprints202007.0025.v1 (Preprint)
COVID-19 Outpatients – Early Risk-Stratified Treatment with Zinc Plus Low Dose Hydroxych loroquine and Azithromycin: A Retrospective Case Series Study
Early treatment with HC Q+AZ+Z results in 84% lower hospitalization and 80% lower death - hospitalization OR 0.16 (p<0.001), death OR 0.2 (p=0.16). No cardiac side effects. Retrospective 518 patients (141 treated, 37..
7/1
Positive
POSITIVE
Late
Arshad et al., Int. J. Infect. Dis., July 1 2020, doi:10.1016/j.ijid.2020.06.099 (Peer Reviewed)
Treatment with Hydroxych loroquine, Azithromycin, and Combination in Patients Hospitalized with COVID-19
HC Q decreases mortality from 26.4% to 13.5% (HC Q) or 20.1% (HC Q+AZ). Propensity matched HC Q HR 0.487, p=0.009. Michigan 2,541 patients retrospecti..
7/1
Safety
SAFETY
N/A
Samuel 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
POSITIVE
Late
Mikami 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
HC Q 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
POSITIVE
PrEP
Ferreira et al., J. Medical Virology, July 9, 2020, doi:10.1002/jmv.26286 (preprint 6/29) (Peer Reviewed)
Chronic treatment with hydroxych loroquine and SARS-CoV-2 infection
Chronic treatment with HC Q provides protection against COVID, odds ratio 0.51 (0.37-0.70). The actual benefit is likely to be larger becasue research shows that the risk of COVID-19 for systemic autoimmune disease..
6/29
Safety
SAFETY
N/A
Mfeukeu-Kuate et al. (Preprint) (not included in the study count)
Electrocardiographic safety of daily Hydroxych loroquine 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 HC Q+AZ. 51 relatively young patients 39 +/- 11.
6/25
Positive
POSITIVE
Early
Lagier 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 hydroxych loroquine/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
Positive
POSITIVE
Early
Chen et al., medRxiv, doi:10.1101/2020.06.19.20136093 (Preprint)
Efficacy and safety of ch loroquine or hydroxych loroquine 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 (HC Q), p=0.01. 67 patients with mild/moderate cases.
6/19
Positive
(news)
POSITIVE
PrEP
SMSH Sawai Man Singh Hospital, India (News) (not included in the study count)
HC Q 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)
NEGATIVE
Late
NIH, study not available yet (News) (not included in the study count)
NIH halts clinical trial of hydroxych loroquine
NIH halts late stage trial reporting no harm and no benefit. 470 patients.
6/19
Positive
POSITIVE
Late
Sbidian et al., medRxiv, doi:10.1101/2020.06.16.20132597 (Preprint)
Hydroxych loroquine 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 HC Q and HC Q+AZ. No significant effect is seen on 28-day mortality, however many more control ..
6/18
Inconc.
INCONC.
Late
Paccoud et al., Clinical Infectious Diseases, doi:10.1093/cid/ciaa791 (Peer Reviewed)
Compassionate use of hydroxych loroquine 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
POSITIVE
Late
Xue et al., J. Med. Virology, June 17, 2020, doi:10.1002/jmv.26193 (Peer Reviewed)
Hydroxych loroquine treatment in COVID-19: a descriptive observational analysis of 30 cases from a single center in Wuhan, China
30 hospitalized patients. Early use of HC Q is more effective, 43% reduction in progression from moderate to severe. "Early" is relative here, within 7 days of hospitalization.
6/17
Negative
(news)
NEGATIVE
Late
World 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 HC Q 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)
POSITIVE
PrEP
WHIP COVID-19 (News) (not included in the study count)
Henry Ford Health System still moving forward with hydroxych loroquine study
Ongoing WHIP COVID-19 HC Q PrEP study reports analyzing their data and seeing a significantly improved outcome in a group of COVID-19 patients who received HC Q. For more details on the study se..
6/16
Positive
POSITIVE
PrEP
Huang et al., Annals of the Rheumatic Diseases 2020:79, 1163-1169, doi:10.1136/annrheumdis-2020-217425 (Peer Reviewed)
Clinical characteristics of 17 patients with COVID-19 and systemic autoimmune diseases: a retrospective study
Analysis of 1255 COVID-19 patients in Wuhan Tongji Hospital finding 0.61% with systemic autoimmune diseases, much lower than authors expected (3%–10%). Authors hypothesise that protective factors, such as C Q/HC
6/12
Theory
THEORY
Theory
Scherrmann, 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 Hydroxych loroquine-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 HC Q+AZ.
6/12
Negative
NEGATIVE
Late
Giacomelli et al., Journal of Medical Virology, doi:10.1002/jmv.26407 (preprint 6/12) (Peer Reviewed)
Early administration of lopinavir/ritonavir plus hydroxych loroquine 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
POSITIVE
Early
Otea et al., medRxiv, doi:10.1101/2020.06.10.20101105 (Preprint)
A short therapeutic regimen based on hydroxych loroquine 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, HC Q+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
POSITIVE
Early
Pirnay et al., Hosp. Pharm. and Clinician, doi:10.1016/j.phclin.2020.06.001 (Peer Reviewed)
Beneficial effect of Hydroxych loroquine-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, HC Q+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
POSITIVE
PrEP
Bhattacharya et al., medRxix, doi:10.1101/2020.06.09.20116806 (Preprint)
Pre exposure Hydroxych loroquine use is associated with reduced COVID19 risk in healthcare workers
HC Q reduced cases from 38% to 7%. 106 people. No serious adverse effects.
6/6
Meta
(positive)
META
Early, Late
Million et al., New Microbes and New Infections, doi:10.1016/j.nmni.2020.100709 (Peer Reviewed) (meta analysis - not included in study count)
Clinical Efficacy of Ch loroquine derivatives in COVID-19 Infection: Comparative metaanalysis between the Big data and the real world
[H]C Q effective and reduces mortality by a factor 3. Meta analysis of 20 studies.
6/5
Negative
NEGATIVE
Late
Horby et al., medRxiv, 7/15/2020, doi:10.1101/2020.07.15.20151852 (press release 6/5) (Preprint)
Effect of Hydroxych loroquine 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)
POSITIVE
PEP
Boulware et al., NEJM, June 3 2020, doi:10.1056/NEJMoa2016638 (Peer Reviewed)
A Randomized Trial of Hydroxych loroquine 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
POSITIVE
Early
Guérin et al., Asian J. Medicine and Health, July 15, 2020, doi:10.9734/ajmah/2020/v18i730224 (preprint 5/31) (Peer Reviewed)
Azithromycin and Hydroxych loroquine Accelerate Recovery of Outpatients with Mild/Moderate COVID-19
Mean clinical recovery time reduced from 26 days (SOC) to 9 days, p<0.0001 (HC Q+AZ) or 13 days, p<0.0001 (AZ). No cardiac toxicity. Small retrospective study of 88 patients with case control analysis with matched pa..
5/29
Positive
POSITIVE
Late
Ayerbe 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-19
2075 hospital patients in Spain. HC Q reduces mortality from 30% to 13%. Not adjusted for age and gender. HC Q group 10% more males and 6 years younger. Study primarily interested in Heparin.
5/28
Positive
POSITIVE
Late
Chamieh 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 hydroxych loroquine and azithromycin in Lebanon
HC Q+AZ potentially explains 94.7% success in treating a fairly complex cohort.
5/28
Positive
POSITIVE
PrEP
Chatterjee 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-19
4+ doses of HC Q associated with a significant decline in the odds of getting infected, dose-response relationship exists.
5/28
Positive
POSITIVE
Late
Huang 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 ch loroquine for the treatment of COVID-19
197 C Q patients, 176 control. Mean time to undetectable viral RNA and duration of fever significantly reduced. No serious adverse events.
5/27
Inconc.
INCONC.
Late
Goldman et al., NEJM, doi:10.1056/NEJMoa2015301 (Peer Reviewed)
Remdesivir for 5 or 10 Days in Patients with Severe Covid-19
Study focused on Remdesivir but with results for HC Q in the supplementary appendix, showing 9% death with HC Q versus 12% control, RR 0.78, p = 0.46.
5/27
Meta
META
Early
Risch, American Journal of Epidemiology, kwaa093, 27 May 2020, doi:10.1093/aje/kwaa093 (Peer Reviewed) (meta analysis - not included in study count)
Early Outpatient Treatment of Symptomatic, High-Risk Covid-19 Patients that Should be Ramped-Up Immediately as Key to the Pandemic Crisis
Five studies, including two controlled clinical trials, have demonstrated significant outpatient treatment efficacy.
5/25
Negative
NEGATIVE
Late
Ip et al., medRxiv, doi:10.1101/2020.05.21.20109207 (Preprint)
Hydroxych loroquine and Tocilizumab Therapy in COVID-19 Patients - An Observational Study
Retrospective study of late stage use on 2,512 hospitalized patients showing no significant differences in associated mortality for patients receiving any HC Q during the hospitalization (HR, 0.99 [95% CI, 0.80-1.22]..
5/22
Positive
(advisory)
POSITIVE
PEP, PrEP
ICMR, Indian Council of Medical Research (Advisory) (not included in the study count)
Revised advisory on the use of Hydroxych loroquine (HC Q) as prophylaxis for SARS-CoV-2 infection
Healthcare workers on HC Q prophylaxis less likely to get COVID. Significant dose-response relationship. Extends recommended HC Q prophylaxis to asymptomatic household contacts of cases and fron..
5/22
Retracted
RETRACTED
Late
Mehra et al., The Lancet, May 22, 2020, doi: 10.1016/S0140-6736(20)31180-6 (Peer Reviewed) (not included in the study count)
Hydroxych loroquine or ch loroquine with or without a macrolide for treatment of COVID-19: a multinational registry analysis
Incorrect at first read (implausible death, ventilation, and population numbers). This paper was retracted.
5/20
Meta
(negative)
META
Late
Chacko et al., medRxiv, doi:10.1101/2020.05.14.20101774 (Preprint) (meta analysis - not included in study count)
Hydroxych loroquine in COVID-19: A systematic review and meta-analysis
Meta 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
NEGATIVE
Late
Singh et al., medRxiv, doi:10.1101/2020.05.12.20099028 (Preprint)
Outcomes of Hydroxych loroquine Treatment Among Hospitalized COVID-19 Patients in the United States- Real-World Evidence From a Federated Electronic Medical Record Network
EHR 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
POSITIVE
Late
Kim et al., medRxiv, doi:10.1101/2020.05.13.20094193 (Preprint)
Treatment Response to Hydroxych loroquine, Lopinavir/Ritonavir, and Antibiotics for Moderate COVID 19: A First Report on the Pharmacological Outcomes from South Korea
Retrospective of 97 moderate cases. Time to viral clearance significantly shorter for HC Q+antibiotic. Preprint withdrawn pending peer review.
5/18
Positive
POSITIVE
Early
Ahmad et al., doi:10.1101/2020.05.18.20066902 (Preprint)
Doxycycline and Hydroxych loroquine as Treatment for High-Risk COVID-19 Patients: Experience from Case Series of 54 Patients in Long-Term Care Facilities
54 patients in long term care facilities. 6% death with HC Q+AZ compared to 22% using a naive indirect comparison.
5/16
Inconc.
INCONC.
PrEP
Macias 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 hydroxych loroquine therapy
Very small retrospective study of rheumatic disease patients, sample size is too small for statistical significance (HC Q 0.5-4.0%, no-HC Q 0.4-2.7%). Confirmed cases were 1 HC
5/15
Positive
POSITIVE
Late
Yu et al., Science China Life Sciences, 2020 May 15, 1-7, doi:10.1007/s11427-020-1732-2 (Peer Reviewed)
Low Dose of Hydroxych loroquine Reduces Fatality of Critically Ill Patients With COVID-19
Retrospective, 550 critically ill patients. 19% fatality for HC Q versus 47% for non-HC Q, RR 0.395, p=0.002. The levels of inflammatory cytokine IL-6 were significantly reduced from 22.2 pg/mL..
5/14
Negative
NEGATIVE
Late
Mahévas et al., BMJ 2020, 369, doi: https://doi.org/10.1136/bmj.m1844 (Peer Reviewed)
Clinical efficacy of hydroxych loroquine in patients with covid-19 pneumonia who require oxygen: observational comparative study using routine care data
Observational study of 181 patients with advanced disease requiring oxygen showing no benefit for HC Q. Power of study appears too low to support conclusions [1]. None of the 15 patients receiving HC <..
5/13
Positive
POSITIVE
Late
Okour et al., Journal of Pharmacokinetics and Pharmacodynamics, May 13, 2020, doi:10.1007/s10928-020-09689-x (Peer Reviewed)
Hydroxych loroquine and azithromycin as potential treatments for COVID-19; clinical status impacts the outcome
Odds of PCR-positive decrease by 53% for each unit increase in HC Q log-concentration. Similarly, the odds decrease by 61%, and by 12% for each day increase, and for azithromycin co-treatment, respectively. Computes ..
5/11
Negative
NEGATIVE
Late
Rosenberg et al., JAMA, May 11, 2020, doi:10.1001/jama.2020.8630 (Peer Reviewed)
Association of Treatment With Hydroxych loroquine or Azithromycin With In-Hospital Mortality in Patients With COVID-19 in New York State
Restrospective observational late stage study showing no significant differences but calling for clinical trials. Zervos et al. [1] point out serious limitations that they say should be corrected on the record: patients receiving HC
5/10
Positive
POSITIVE
Late
Alberici 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 infection
Analysis of 94 hemodialysis COVID-19 positive patients. Reduction in death seen with HC Q but p=0.12, OR 0.44 [0.16–1.24].
5/8
Ex Vivo
EX VIVO
Ex Vivo
Grassin-Delyle et al., Clinical Infectious Diseases, doi:10.1093/cid/ciaa546 (Peer Reviewed) (Ex Vivo) (not included in the study count)
Ch loroquine Inhibits the Release of Inflammatory Cytokines by Human Lung Explants
On human lung parenchymal explants, C Q concentration clinically achievable in the lung (100 µM) inhibited the lipopolysaccharide-induced release of TNF-ɑ (by 76%), IL-6 (by 68%), CCL2 (by 72%), and CCL3 (by 67%). In..
5/8
Positive
POSITIVE
Late
Carlucci et al., J. Med. Microbiol., Sep 15, 2020, doi: 10.1099/jmm.0.001250 (preprint 5/8) (Peer Reviewed)
Zinc sulfate in combination with a zinc ionophore may improve outcomes in hospitalized COVID-19 patients
Retrospective 932 patients. Addition of Zinc to HC Q+AZ reduces mortality / transfer to hospice, ICU admission, and the need for ventilation. Reduction in mortality or transfer to hospice adjusted odds ratio OR 0.56..
5/7
Theory
THEORY
Theory
Derendorf, 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 hydroxych loroquine and azithromycin
Discusses pharmacokinetic properties of HC Q+AZ as a potential underlying mechanism of the observed antiviral effects.
5/7
Inconc.
INCONC.
Late
Geleris et al., NEJM, May 7, 2020, doi:10.1056/NEJMoa2012410 (Peer Reviewed)
Observational Study of Hydroxych loroquine in Hospitalized Patients with Covid-19
There 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)
POSITIVE
N/A
Sermo (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 therapies
HC Q used by 55% of physicians worldwide for COVID. Survey of 6,150 physicians.
5/6
Animal
ANIMAL
N/A
Maisonnasse et al., Nature, 2020, doi:10.1038/s41586-020-2558-4 (preprint 5/6) (Peer Reviewed) (not included in the study count)
Hydroxych loroquine use against SARS-CoV-2 infection in non-human primates
Monkey study which reports no effect of HC Q or HC Q+AZ. However, there are several signs of effectiveness despite the very small sample sizes and 100% recovery of all treated and control monkey..
5/5
Positive
POSITIVE
Late
Membrillo de Novales et al., Preprints 2020, 2020050057, doi:10.20944/preprints202005.0057.v1 (Preprint)
Early Hydroxych loroquine Is Associated with an Increase of Survival in COVID-19 Patients: An Observational Study
166 patients hospitalised with COVID-19, HC Q 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
POSITIVE
Early, Late
Million 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 Hydroxych loroquine and Azithromycin: A Retrospective Analysis of 1061 Cases in Marseille, France
Retrospective 1061 patients. HC Q+AZ safe and results in a low fatality rate.
5/5
Inconc.
INCONC.
PrEP
Gendelman et al., Autoimmunity Reviews, 19:7, July 2020, doi:10.1016/j.autrev.2020.102566 (Peer Reviewed)
Continuous Hydroxych loroquine or Colchicine Therapy Does Not Prevent Infection With SARS-CoV-2: Insights From a Large Healthcare Database Analysis
Very small study of rheumatic disease/autoimmune disorder patients showing no significant difference but with only 3 chronic HC Q patient cases. Only considers people tested at a time when primarily symptomatic cases..
5/5
Positive
POSITIVE
PrEP
Mitchell et al., SSRN, doi:10.2139/ssrn.3586954 (Preprint)
Markedly Lower Rates of Coronavirus Infection and Fatality in Malaria-Endemic Regions – A Clue As to Treatment?
Analysis of COVID-19 amongst 2.4B people shows a wide counterintuitive disparity between well-developed and less-developed countries, with more affluent countries about one hundred times more likely to be infected and die due to COVID-19...
5/4
Inconc.
INCONC.
PrEP
Huh et al., medRxiv, doi:10.1101/2020.05.04.20089904 (Preprint)
Association of previous medications with the risk of COVID-19: a nationwide claims-based study from South Korea
Database analysis of many drugs and COVID-19 cases, with 23 cases taking HC Q, and 251 control patients not taking HC Q, showing OR 1.07, p=0.77, and in multivariable analysis OR 1.48, p=0.086. ..
5/1
Safety
SAFETY
N/A
Mercuro 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 Hydroxych loroquine With or Without Concomitant Azithromycin Among Hospitalized Patients Testing Positive for Coronavirus Disease 2019 (COVID-19)
Study of 90 hospitalized patients given HC Q, 53 also receiving AZ, 53% hypertension, 29% diabetes mellitus, baseline median QTc 473ms for HC Q, and 442ms for HC Q+AZ. Medi..
5/1
Safety
SAFETY
N/A
Bessière 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 Hydroxych loroquine Alone or in Combination With Azithromycin in an Intensive Care Unit
Study of 40 very serious condition ICU patients, 75% required invasive mechanical ventilation, 63% received vasoactive drugs, 50% received other treatments favoring QT prolongation. HC Q with or w/o AZ was given to 4..
5/2
Positive
(news)
POSITIVE
Late
Seydi (News) (not included in the study count)
Coronavirus: a study in Senegal confirms the effectiveness of hydroxych loroquine
Preliminary results of Senegal trial with 181 patients showing faster recovery with HC Q, and even faster recovery with HC Q+AZ.
4/30
Positive
POSITIVE
Early
Meo et al., Eur. Rev. Med. Pharmacol. Sci. 2020, 24 (8), 4539-4547, doi:10.26355/eurrev_202004_21038 (Peer Reviewed)
Efficacy of ch loroquine and hydroxych loroquine in the treatment of COVID-19
Analysis of COVID-19 and malaria, finding that COVID-19 is highly pandemic in countries where malaria is least pandemic, and vice versa, suggesting that C Q/HC Q (widely used for malaria) are pr..
4/27
Positive
POSITIVE
Late
Sánchez-Álvarez et al., Nefrología, doi:10.1016/j.nefroe.2020.04.002 (Peer Reviewed)
Status of SARS-CoV-2 infection in patients on renal replacement therapy. Report of the COVID-19 Registry of the Spanish Society of Nephrology (SEN)
Analysis of 868 patients on renal replacement therapy. Statistically significant reduction in mortality with HC Q for patients on dialysis (OR 0.47, p=0.005). No statistically significant change was found for transp..
4/29
Safety
SAFETY
N/A
Saleh et al., Circulation: Arrhythmia and Electrophysiology, doi:10.1161/CIRCEP.120.008662 (Peer Reviewed)
The Effect of Ch loroquine, Hydroxych loroquine and Azithromycin on the Corrected QT Interval in Patients with SARS-CoV-2 Infection
201 hospitalized patients. No serious side effects of HC Q. 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 VITRO
In Vitro
Andreani 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 hydroxych loroquine and azithromycin on SARS-CoV-2 shows synergistic effect
HC Q and AZ has a synergistic effect in vitro on SARS-CoV-2 at concentrations compatible with that obtained in human lung.
4/24
Inconc.
INCONC.
Early
Ashraf et al., medRxiv doi:10.1101/2020.04.20.20072421.t (Preprint)
COVID-19 in Iran, a comprehensive investigation from exposure to treatment outcomes
Small limited trial with 100 patients concluding that HC Q improved clinical outcome, OR 0.016 [0.002-0.11] in regression analysis.
4/21
Positive
POSITIVE
Early
Izoulet M., SSRN, doi:10.2139/ssrn.3575899 (Preprint)
Countries which Primarily Use Antimalarial Drugs As COVID-19 Treatment See Slower Dynamic of Daily Deaths
Compares the dynamics of daily deaths in the 10 days following the 3rd death in countries using and not using [H]C Q, showing dramatically lower death in [H]C Q countries. This paper does not at..
4/21
Negative
NEGATIVE
Late
Magagnoli et al., Med (2020), doi:10.1016/j.medj.2020.06.001 (preprint 4/21) (Peer Reviewed)
Outcomes of hydroxych loroquine usage in United States veterans hospitalized with Covid-19
Retrospective 368 hospitalized patients, no statistically significant reduction in mortality or the need for mechanical ventilation with HC Q or HC Q+AZ, or for death with HC
4/17
Positive
POSITIVE
PEP
Lee 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
NEGATIVE
Late
Borba et al., JAMA Network Open, doi:10.1001/jamanetworkopen.2020.8857 (Peer Reviewed)
Ch loroquine 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)
Comparison of typical C Q dosage with high dosage C Q (600mg C Q twice daily for 10 days), showing higher mortality with high dosage, OR 2.8 [0.9 - 8.5] when controlled by ..
4/15
Positive
POSITIVE
Early, Late
Esper et al., Prevent Senior Institute, São Paulo, Brazil (Preprint)
Empirical treatment with hydroxych loroquine and azithromycin for suspected cases of COVID-19 followed-up by telemedicine
636 patients. HC Q+AZ reduced hospitalization 79% when used within 7 days (65% overall). Non-randomized.
4/15
Theory
THEORY
Theory
Brufsky, A., J. Medical Virology, doi:10.1002/jmv.25887 (Peer Reviewed) (Theory) (not included in the study count)
Hyperglycemia, hydroxych loroquine, and the COVID‐19 pandemic
Theory on the effectiveness of HC Q. HC Q has been shown to block the polarization of macrophages to an M1 inflammatory subtype and is predicted to interfere with glycosylation of a number of pr..
4/14
Negative
NEGATIVE
Late
Tang et al., BMJ 2020, 369, doi:10.1136/bmj.m1849 (Peer Reviewed)
Hydroxych loroquine in patients with COVID-19: an open-label, randomized, controlled trial
150 patients very late stage RCT. No significant difference. More symptomatic relief with HC Q. Treatment very late, average 16.6 days after symptom onset. Data favorable to HC Q was deleted in..
4/13
Review
REVIEW
Late
Gao et al., Biosci Trends, May 21, 2020, 14:2, 156-158, doi:10.5582/bst.2020.03072, Epub Apr 13, 2020 (Peer Reviewed) (not included in the study count)
Update on Use of Ch loroquine/Hydroxych loroquine to Treat Coronavirus Disease 2019 (COVID-19)
Increasing evidence from completed clinical studies shows C Q and HC Q effective (HC Q more effective).
4/12
Negative
NEGATIVE
Late
Barbosa et al., Preprint (Preprint)
Clinical outcomes of hydroxych loroquine in hospitalized patients with COVID-19: a quasi-randomized comparative study
Small retrospective study with 63 patients (32 treated with HC Q), 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
POSITIVE
Early
Gautret et al., Travel Medicine and Infectious Disease, doi:10.1016/j.tmaid.2020.101663 (Peer Reviewed)
Clinical and microbiological effect of a combination of hydroxych loroquine and azithromycin in 80 COVID-19 patients with at least a six-day follow up: A pilot observational study
Pilot study suggesting improvement with HC Q+AZ and recommending further study. 80 patients with relatively mild cases, no control group, and no attempt to analyze confounding factors.
4/10
Meta
(negative)
META
Late
Lover, medRxiv, doi:10.1101/2020.03.22.20040949 (Preprint) (meta analysis - not included in study count)
Quantifying treatment effects of hydroxych loroquine 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 HC Q treatment, with more significant effects from [HC Q+AZ]".
4/3
Theory
THEORY
Theory
Fantini et al., Int J Antimicrob Agents, 55:5, doi:10.1016/j.ijantimicag.2020.105960 (Peer Reviewed) (Theory) (not included in the study count)
Structural and molecular modelling studies reveal a new mechanism of action of ch loroquine and hydroxych loroquine against SARS-CoV-2 infection
In-silico analysis confirming the antiviral properties of C Q, showing a new mechanism of action of C Q, and showing that HC Q is more potent than C Q.
4/1
Positive
POSITIVE
Early
Huang 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 Ch loroquine
22 patients. All C Q patients discharged by day 14 versus 50% of Lopinavir/Rotinavir patients. Symptom onset to treatment 2.5 days for C Q vs. 6.5 days for Lopinavir/Rotinavir.
3/31
Positive
POSITIVE
Late
Chen et al., medRxiv doi:10.1101/2020.03.22.20040758 (Preprint)
Efficacy of hydroxych loroquine in patients with COVID-19: results of a randomized clinical trial
62 patients. RCT showing significantly faster recovery with HC Q. 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 VITRO
In Vitro
Clementi 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 Hydroxych loroquine Anti-SARS-CoV-2 Effects in vitro
In 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
NEGATIVE
Late
Molina et al., Médecine et Maladies Infectieuses, 50:4, June 2020, 10.1016/j.medmal.2020.03.006 (preprint 3/28) (Letter)
No evidence of rapid antiviral clearance or clinical benefit with the combination of hydroxych loroquine and azithromycin in patients with severe COVID-19 infection
11 patients with severe cases. No evidence of benefit for HC Q.
3/26
Positive
(news)
POSITIVE
Late
Zhong Nanshan (钟南山) (News) (not included in the study count)
Efficacy and safety of ch loroquine for treatment of COVID-19. An open-label, multi-center, non-randomized trial
197 patients. C Q effective. Day 10 viral RNA negative 91.4% HC Q versus 57.4% control. Median time to negative test 3 days versus 9 days for control.
3/24
Theory
THEORY
Theory
Pagliano et al., Clin. Infect. Dis., 2020 Mar 24, doi:10.1093/cid/ciaa320 (Peer Reviewed) (Theory) (not included in the study count)
Is Hydroxych loroquine a Possible Post-Exposure Prophylaxis Drug to Limit the Transmission to Health Care Workers Exposed to COVID19?
C Q and HC Q 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
THEORY
Theory
Hu 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 ch loroquine efficacy against COVID-19
C Q 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)
POSITIVE
PrEP
ICMR, Indian Council of Medical Research (Advisory) (not included in the study count)
Advisory on the use of hydroxy-ch loroquine as prophylaxis for SARS-CoV-2 infection
Recommends HC Q for prophylaxis in asymptomatic healthcare workers as found effective in-vitro and in-vivo.
3/20
Positive
(news)
POSITIVE
Late
Hu et al., Shanghai Combined Task Force on COVID-19 (News) (not included in the study count)
Shanghai Experience of COVID-19 Management
Clinical studies of HC Q with 184 cases and 21 hospitals show HC Q is effective.
3/18
In Vitro
IN VITRO
In Vitro
Liu et al., Cell Discovery 6, 16 (2020), doi:10.1038/s41421-020-0156-0 (Peer Reviewed) (In Vitro) (not included in the study count)
Hydroxych loroquine, a less toxic derivative of ch loroquine, is effective in inhibiting SARS-CoV-2 infection in vitro
HC Q effective in vitro and less toxic than C Q. In addition to direct antiviral activity, HC Q is a safe and successful anti-inflammatory agent that has been used extensiv..
3/17
Inconc.
INCONC.
Early
Gautret et al., Int. J. of Antimicrobial Agents, 17 March 2020, doi:10.1016/j.ijantimicag.2020.105949 (Peer Reviewed)
Hydroxych loroquine and azithromycin as a treatment of COVID-19: results of an openlabel non-randomized clinical trial
HC Q was significantly associated with reduction / elimination of viral load, which was enhanced with AZ. Updated 8/13: responses to this paper have raised methodological issues [1, 2, 3]. Despite the limitations, t..
3/17
Review
REVIEW
N/A
Sahraei 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): ch loroquine or hydroxych loroquine
Discussion of mechanisms of action, C Q vs. HC Q, early studies, safety.
3/13
Review
REVIEW
N/A
Todaro 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 C Q and HC Q, recommending use.
3/12
Theory
THEORY
Theory
Devaux 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 ch loroquine against coronavirus: what to expect for COVID-19?
Discusses mechanisms of C Q interference with the SARS-CoV-2 replication cycle.
3/10
Meta
(positive)
META
N/A
Cortegiani 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 study count)
A Systematic Review on the Efficacy and Safety of Ch loroquine for the Treatment of COVID-19
Review of six articles and 23 ongoing clinical trials in China recommending research and clinical use adhering to MEURI.
3/9
In Vitro
IN VITRO
N/A
Yao 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 Hydroxych loroquine for the Treatment of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2)
HC Q is more potent than C Q in vitro for inhibiting SARS-CoV-2. Simulates HC Q concentration in lung fluid and provides dosing recommendations.
3/6
Negative
NEGATIVE
Late
Chen et al., J. Zhejiang University (Med Sci), doi:10.3785/j.issn.1008-9292.2020.03.03 (Peer Reviewed)
A pilot study of hydroxych loroquine 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 HC Q but not statistically significant. One HC Q patient developed to ..
3/4
Review
REVIEW
Late
Colson et al., Int J. Antimicrob Agents, doi: 10.1016/j.ijantimicag.2020.105932. Epub 2020 Mar 4. (Peer Reviewed) (not included in the study count)
Ch loroquine and Hydroxych loroquine as Available Weapons to Fight COVID-19
Recommending C Q and HC Q for COVID-19 based on 20 clinical studies in China and a strong rationale for use.
2/20
Positive
POSITIVE
Late
Jiang et al., Chin. J. Tuberc. Respir. Dis., 2020, 43, doi:10.3760/cma.j.issn.1001-0939.2020.0019 (Peer Reviewed)
Expert Consensus on Ch loroquine Phosphate for the Treatment of Novel Coronavirus Pneumonia
Early trials in China show C Q results in shorter hospital stays and improved patient outcomes.
2/19
Positive
POSITIVE
Late
Gao et al., BioScience Trends, 2020, doi:10.5582/bst.2020.01047 (Peer Reviewed)
Breakthrough: Ch loroquine phosphate has shown apparent efficacy in treatment of COVID-19 associated pneumonia in clinical studies
Results from 15 clinical trials in China showing C Q is effective.
2/17
Positive
(news)
POSITIVE
Late
Sun Yanrong, deputy head of the China National Center for Biotechnology Development (News) (not included in the study count)
Antimalarial drug confirmed effective on COVID-19
HC Q under clinical trials in >10 hospitals in China and has shown fairly good efficacy.
2/11
Positive
POSITIVE
Late
Xia et al., ChiCTR2000029741 (Preprint)
Efficacy of Ch loroquine and Lopinavir/ Ritonavir in mild/general novel coronavirus (CoVID-19) infections: a prospective, open-label, multicenter randomized controlled clinical study
Early results from a very small trial, reported within the application for a later trial. Very minimal details are provided, but we include this as the earliest published results. For COVID-19 patients with pneumonia the viral negative co..
2/4
In Vitro
IN VITRO
In Vitro
Wang 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 ch loroquine effectively inhibit the recently emerged novel coronavirus (2019-nCoV) in vitro
In vitro study, not included in the study count or percentages. Remdesivir and C Q potently blocked virus infection in vitro.
2014
In Vitro
IN VITRO
In Vitro
de 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 Culture
C Q inhibits SARS-CoV, MERS-CoV, and HCoV-229E-GFP replication in the low-micromolar range.
2012
Animal
ANIMAL
Animal
Yan et al., Cell Research, 23, 300–302, doi:10.1038/cr.2012.165 (Peer Reviewed) (not included in the study count)
Anti-malaria drug ch loroquine is highly effective in treating avian influenza A H5N1 virus infection in an animal model
C Q, 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
ANIMAL
Animal
Keyaerts 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 Ch loroquine against Human Coronavirus OC43 Infection in Newborn Mice
C Q inhibits HCoV-OC43 replication in HRT-18 cells. A lethal HCoV-OC43 infection in newborn C57BL/6 mice can be treated with C Q acquired transplacentally or via maternal milk. The highest survi..
2008
In Vitro
IN VITRO
In Vitro
Kono 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 ch loroquine: Involvement of p38 MAPK and ERK
C Q significantly decreased viral replication of HCoV-229E at concentrations lower than in clinical usage. C Q affects the activation of p38 mitogen-activated protein kinase (MAPK) and extracell..
2006
In Vitro
IN VITRO
In Vitro
Savarino 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 ch loroquine
Update to 2003 paper, not included in the study count or percentages. Hypothesis of C Q inhibiting SARS replication has been confirmed in two in-vitro studies. C Q affected an early stage of SAR..
2005
In Vitro
IN VITRO
In Vitro
Vincent et al., Virol. J. 2:69, 2005, doi:10.1186/1743-422X-2-69 (Peer Reviewed) (In Vitro) (not included in the study count)
Ch loroquine is a potent inhibitor of SARS coronavirus infection and spread
In vitro study, SARS-CoV-1, not included in the study count or percentages. C Q has strong antiviral effects on SARS CoV infection when cells treated either before or after exposure, suggesting prophylactic and treat..
2004
In Vitro
IN VITRO
In Vitro
Keyaerts 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 ch loroquine
In vitro study, SARS-CoV-1, not included in the study count or percentages. IC50 of C Q for antiviral activity (8.8) is significantly lower than cytostatic activity CC50 (261.3), selectivity index of 30. IC50 for inh..
2003
Theory
THEORY
Theory
Savarino et al., Lancet Infect. Dis., doi:10.1016/S1473-3099(03)00806-5 (Peer Reviewed) (Theory) (not included in the study count)
Effects of ch loroquine on viral infections: an old drug against today's diseases
Not included in the study count or percentages. Discussion/review noting that C Q exerts antiviral effects, inhibiting the replication of several viruses including members of the flaviviruses, retroviruses, and coron..
1918
Inconc.
INCONC.
N/A
Burrows, E., Medical Record, 97:6, 235, Feb 7, 1920 (Peer Reviewed) (not included in the study count)
A confirmatory report upon the abortive action of quinine dihydrochloride
Quinine was found to be effective for the Spanish Flu in 1918.
1890
Inconc.
(news)
INCONC.
N/A
Le Grelot (News) (not included in the study count)
Quinine use for the Russian influenze pandemic if 1889-1890
Quinine and antipyrine, a bitherapy for defying death during the Russian influenza pandemic of 1889-1890 (around 40,000 deaths in France at the beginning of 1890).
1889
Inconc.
(news)
INCONC.
N/A
Edwin Wiley Grove (News) (not included in the study count)
Laxative Bromo Quinine
Quinine has been used for respiratory infections since 1889. Not included in the study count or percentages, just as an interesting observation.

Note: In Vitro, Ex Vivo, Meta, Theory, Safety, Review, News, and Retracted items are not included in the percentages and study count. There is a total of 171 items. Recently added studies - 9/19: Axfors et al., Lyngbakken et al., Fantini et al., 9/18: Xia et al. Positive/negative effects vary in degree and certainty, please read the papers or descriptions thereof for more details. Every study has some limitations when considered in isolation (for example confounding factors; sub-optimal treatment regimens; dosing regimens that may be too low, too high, or insufficiently account for the long half-life of HCQ; large treatment delays; small sample sizes; lack of focus on severity; reliance on Internet surveys; and patient characteristics very different from the most at-risk population).


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