22 patients. All CQ patients discharged by day 14 versus 50% of lopinavir/ritonavir patients. Symptom onset was very different - 2.5 days for CQ vs. 6.5 days for lopinavir/ritonavir.
This study is excluded in meta
analysis:
excessive unadjusted differences between groups.
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risk of no recovery at day 14, 91.7% lower, RR 0.08, p = 0.02, treatment 0 of 10 (0.0%), control 6 of 12 (50.0%), NNT 2.0, relative risk is not 0 because of continuity correction due to zero events (with reciprocal of the contrasting arm).
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risk of no improvement in pneumonia at day 14, 83.0% lower, RR 0.17, p = 0.22, treatment 10, control 12.
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Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
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Huang et al., 1 Apr 2020, Randomized Controlled Trial, China, peer-reviewed, 18 authors, study period 27 January, 2020 - 15 February, 2020, average treatment delay 2.5 days, dosage chloroquine 500mg bid days 1-10, this trial compares with another treatment - results may be better when compared to placebo.
Treating COVID-19 with Chloroquine
Mingxing Huang, Tiantian Tang, Pengfei Pang, Man Li, Ruolan Ma, Jiahui Lu, Jingxian Shu, Yingying You, Binghui Chen, Jiabi Liang, Zhongsi Hong, Huili Chen, Ling Kong, Dajiang Qin, Duanqing Pei, Jinyu Xia, Shanping Jiang, Hong Shan
Journal of Molecular Cell Biology, doi:10.1093/jmcb/mjaa014
Treating COVID-19 with Chloroquine A novel coronavirus disease 2019 (COVID-19) emerged around December 2019 in Wuhan, China and has spread rapidly worldwide (Lu et al., 2020). Until March 27, 2020, the Chinese health authorities had reported 82082 confirmed COVID-19 cases in China with 3298 deaths and 381443 confirmed cases with 20787 deaths outside China. The World Health Organization (WHO) named the virus SARS-CoV-2, which belongs to a distinct clade from the human severe acute respiratory syndrome CoV (SARS-CoV) and Middle East respiratory syndrome CoV (MERS-CoV) (Zhu et al., 2020). At present, there is no effective therapy against this new virus. Identifying effective antiviral agents to treat the COVID-19 is of most urgency. Coronavirus relies on cellular machinery to replicate itself, thus providing a rationale to search for effective therapies among agents that may impact pathways required for the viral life cycle. The vesicular trafficking system plays a critical role in viral entry, unpacking, assembly, and packaging. Among agents that can interfere with normal vesicular trafficking are several drugs approved for human therapies. A well-known antimalaria drug, Chloroquine, stands out as one of the earliest reagents that can block vesicular trafficking and also interfere with the life cycle of parasites and viruses (Savarino
References
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Kono, Tatsumi, Imai, Inhibition of human coronavirus 229E infection in human epithelial lung cells (L132) by chloroquine: involvement of p38 MAPK and ERK, Antivir. Res
Lu, Stratton, Tang, Outbreak of pneumonia of unknown etiology in Wuhan, China: the mystery and the miracle, J. Med. Virol
Savarino, Di Trani, Donatelli, New insights into the antiviral effects of chloroquine, Lancet Infect. Dis
Wang, Cao, Zhang, Remdesivir and chloroquine effectively inhibit the recently emerged novel coronavirus (2019-nCoV) in vitro, Cell Res
Zhang, Yi, Li, Chloroquine inhibits endosomal viral RNA release and autophagy-dependent viral replication and effectively prevents maternal to fetal transmission of Zika virus, Antivir. Res
Zhou, Yang, Wang, A pneumonia outbreak associated with a new coronavirus of probable bat origin, Nature
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