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Article ; Online: Lack of efficacy of hydroxychloroquine in covid-19.

Vinetz, Joseph M

2020 Volume 369, Page(s) m2018

MeSH term(s)	Betacoronavirus ; COVID-19 ; Coronavirus Infections ; Humans ; Hydroxychloroquine ; Oxygen ; Pandemics ; Pneumonia, Viral ; SARS-CoV-2 ; Treatment Outcome
Chemical Substances	Hydroxychloroquine (4QWG6N8QKH) ; Oxygen (S88TT14065)
Keywords	covid19
Language	English
Publishing date	2020-05-19
Publishing country	England
Document type	Editorial ; Comment
ZDB-ID	1362901-3
ISSN	1756-1833 ; 0959-8154 ; 0959-8146 ; 0959-8138 ; 0959-535X ; 1759-2151
ISSN (online)	1756-1833
ISSN	0959-8154 ; 0959-8146 ; 0959-8138 ; 0959-535X ; 1759-2151
DOI	10.1136/bmj.m2018
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Lack of efficacy of hydroxychloroquine in covid-19

Vinetz, Joseph M

BMJ

2020 , Page(s) m2018

Keywords	covid19
Language	English
Publisher	BMJ
Publishing country	uk
Document type	Article ; Online
ZDB-ID	1362901-3
ISSN	1756-1833 ; 0959-8154 ; 0959-8146 ; 0959-8138 ; 0959-535X ; 1759-2151
ISSN (online)	1756-1833
ISSN	0959-8154 ; 0959-8146 ; 0959-8138 ; 0959-535X ; 1759-2151
DOI	10.1136/bmj.m2018
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article: Lack of efficacy of hydroxychloroquine in covid-19

Vinetz, Joseph M

BMJ

Keywords	covid19
Publisher	WHO
Document type	Article
Note	WHO #Covidence: #305922
Database	COVID19

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Book ; Online: Lack of efficacy of hydroxychloroquine in covid-19

Vinetz, Joseph M

2020

Keywords	EDITORIALS ; covid19
Language	English
Publishing date	2020-05-19 07:56:19.0
Publisher	BMJ Publishing Group Ltd
Publishing country	us
Document type	Book ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Hydroxychloroquine and COVID-19: Lack of Efficacy and the Social Construction of Plausibility.

Rughiniş, Cosima / Dima, Lorena / Vasile, Sorina

American journal of therapeutics

2021 Volume 27, Issue 6, Page(s) e573–e583

Abstract: ... antimalarial agents came into limelight: chloroquine and its less toxic derivative, hydroxychloroquine (HCQ). Intense ... than 250 RCT registered on ClinicalTrials.gov with HCQ in COVID patients, and more than 150 of them are ... on polymerase chain reactions of COVID patients or for postexposure prophylaxis. The question to be asked is: how many studies ...

Abstract	Background: Severe acute respiratory syndrome coronavirus 2 SARS- Cov2 has taken the world by surprise. Among the first promising repurposing agents proposed for treatment and prophylaxis, 2 antimalarial agents came into limelight: chloroquine and its less toxic derivative, hydroxychloroquine (HCQ). Intense research and public debates have followed. Areas of uncertainty: As HCQ is still used and studied, future research may bring novel evidence, modifying the state-of-the-art. Despite the lack of a single randomized control trial (RCT) with positive results, there are currently (as for the search on 30th of August 2020) more than 250 RCT registered on ClinicalTrials.gov with HCQ in COVID patients, and more than 150 of them are "still recruiting" or "not yet recruiting" patients. Data sources: Our study combines a therapeutic evaluation of RCT data with a sociological analysis of related controversies, examining scientific and public arena discourses. Results: Although any hope of a positive effect was brought exclusively by some and not all of the observational studies, none of the 7 RCT published until now have found any benefit. From a sociological perspective, the HCQ controversy is a useful case study for understanding the construction of plausibility in a cultural context polarized into competing versions of reality, with different epistemologies and ideologies. Conclusions: The results of the first RCTs have been published, and they are disappointing; beneficial effects of HCQ could not be proven either for negative conversion on polymerase chain reactions of COVID patients or for postexposure prophylaxis. The question to be asked is: how many studies do we need until HCQ is abandoned? Argumentative time work, appealing to temporal properties of HCQ including its historical use, accumulation of evidence, alternative therapeutic scenarios, and sensationalist tempo for rhetorical purpose, plays a significant role in its continuing legitimation.
MeSH term(s)	Betacoronavirus/isolation & purification ; Betacoronavirus/pathogenicity ; COVID-19 ; Coronavirus Infections/drug therapy ; Coronavirus Infections/epidemiology ; Coronavirus Infections/virology ; Drug Repositioning ; Humans ; Hydroxychloroquine/therapeutic use ; Pandemics ; Pneumonia, Viral/drug therapy ; Pneumonia, Viral/epidemiology ; Pneumonia, Viral/virology ; Politics ; Randomized Controlled Trials as Topic ; Risk Assessment ; SARS-CoV-2 ; Treatment Outcome
Chemical Substances	Hydroxychloroquine (4QWG6N8QKH)
Keywords	covid19
Language	English
Publishing date	2021-02-02
Publishing country	United States
Document type	Journal Article
ZDB-ID	1280786-2
ISSN	1536-3686 ; 1075-2765
ISSN (online)	1536-3686
ISSN	1075-2765
DOI	10.1097/MJT.0000000000001294
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: "H" is not for hydroxychloroquine-"H" is for heparin: lack of efficacy of hydroxychloroquine and the role of heparin in COVID-19-preliminary data of a prospective and interventional study from Brazil.

de Oliveira Costa, Renata / Nascimento, Joyce Santos / Reichert, Cadiele Oliana / da Costa, Adriana Pedroso Augusto / Dos Santos, Maria Aparecida Pedrosa / Soares, Alberto Macedo / Tomé, Carlos Eduardo Mendonça / Hayden, Ricardo Leite / Dos Santos, Cassiano Waldanski / Barreiro, Bruno / El-Khatib, Amer Abdul Basset / de Pádua Covas Lage, Luís Alberto / Pereira, Juliana / Benetti, Mônica Mazzurana

BMC infectious diseases

2022 Volume 22, Issue 1, Page(s) 120

Abstract: ... Hydroxychloroquine (HCQ) is a drug with immunomodulatory properties that has demonstrated antiviral efficacy ... Background: COVID-19 pandemic is the major public health problem in the world actually. It's ... hospitalized with COVID-19 in a Brazilian public hospital. The study also aims to determine prognostic factors ...

Abstract	Background: COVID-19 pandemic is the major public health problem in the world actually. It's associated with high morbidity and mortality. To date, no therapeutic measure has a curative potential. Hydroxychloroquine (HCQ) is a drug with immunomodulatory properties that has demonstrated antiviral efficacy in in vitro experiments, with conflicting results in in vivo studies. Methods: A single-center, prospective and interventional study, that evaluates the impact on mortality of the HCQ use in 154 patients hospitalized with COVID-19 in a Brazilian public hospital. The study also aims to determine prognostic factors that predict mortality, ICU admission and endotracheal intubation in this population. Results: 154 patients diagnosed with COVID-19 confirmed by RT-PCR and hospitalized were included. There was a male predominance (87/154, 56.5%), median age 60 years and 88% (136/154) had comorbidities. Among these, 76% (117/154) were admitted to the ICU and 29.2% (45/154) experienced EOT. The OMR was 51.3% (79/154). There was no difference in mortality between patients treated with HCQ (N = 95) and non-HCQ (N = 59) (44.1% × 55.8%, p = 0.758). In univariate analysis, age ≥ 60 years (HR 3.62, p < 0.001), need for mechanical ventilation (HR 2.17, p = 0.001), ≥ 2 comorbidities (HR 1.83, p = 0.049), SAH (HR: 1.56, p = 0.054) were predictors of mortality, as well as no use of prophylactic or therapeutic heparin (HR 3.60, p = 0.02). Multivariate analysis identified admission to the ICU (HR 8.98, p = 0.002) and advanced age (HR 3.37, p < 0.01) as independent predictors of mortality, although, use of heparin (HR 0.25, p = 0.001) was independently associated with a favorable outcome. Conclusion: This study confirmed the absence of a benefit associated with the use of HCQ in Brazilian patients hospitalized with COVID-19. However, prophylactic or therapeutic heparin was an independent predictor for reducing mortality in this population.
MeSH term(s)	Antiviral Agents/therapeutic use ; Brazil ; COVID-19/drug therapy ; Heparin/therapeutic use ; Humans ; Hydroxychloroquine/therapeutic use ; Male ; Middle Aged ; Pandemics ; Preliminary Data ; Prospective Studies ; SARS-CoV-2 ; Treatment Outcome
Chemical Substances	Antiviral Agents ; Hydroxychloroquine (4QWG6N8QKH) ; Heparin (9005-49-6)
Language	English
Publishing date	2022-02-04
Publishing country	England
Document type	Journal Article
ZDB-ID	2041550-3
ISSN	1471-2334 ; 1471-2334
ISSN (online)	1471-2334
ISSN	1471-2334
DOI	10.1186/s12879-022-07110-1
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Lack of efficacy of hydroxychloroquine and azithromycin in patients hospitalized for COVID-19 pneumonia

Anis Saib / Walid Amara / Pascal Wang / Simon Cattan / Azeddine Dellal / Kais Regaieg / Stephane Nahon / Olivier Nallet / Lee S Nguyen

PLoS ONE, Vol 16, Iss 6, p e

A retrospective study.

2021 Volume 0252388

Abstract: ... coronavirus disease-2019 (COVID-19). In this retrospective study, we assessed the clinical effects of HCQ/AZI ... with a 28-days follow-up. Methods In a registry-study which included patients hospitalized for COVID-19 ... Background Hydroxychloroquine combined with azithromycin (HCQ/AZI) has initially been used against ...

Abstract	Background Hydroxychloroquine combined with azithromycin (HCQ/AZI) has initially been used against coronavirus disease-2019 (COVID-19). In this retrospective study, we assessed the clinical effects of HCQ/AZI, with a 28-days follow-up. Methods In a registry-study which included patients hospitalized for COVID-19 between March 15 and April 2, 2020, we compared patients who received HCQ/AZI to those who did not, regarding a composite outcome of mortality and mechanical ventilation with a 28-days follow-up. QT was monitored for patients treated with HCQ/AZI. Were excluded patients in intensive care units, palliative care and ventilated within 24 hours of admission. Three analyses were performed to adjust for selection bias: propensity score matching, multivariable survival, and inverse probability score weighting (IPSW) analyses. Results Overall, 203 patients were included: 60 patients treated by HCQ/AZI and 143 control patients. During the 28-days follow-up, 32 (16.3%) patients presented the primary outcome and 23 (12.3%) patients died. Propensity-score matching identified 52 unique pairs of patients with similar characteristics. In the matched cohort (n = 104), HCQ/AZI was not associated with the primary composite outcome (log-rank p-value = 0.16). In the overall cohort (n = 203), survival and IPSW analyses also found no benefit from HCQ/AZI. In the HCQ/AZI group, 11 (18.3%) patients prolonged QT interval duration, requiring treatment cessation. Conclusions HCQ/AZI combination therapy was not associated with lower in-hospital mortality and mechanical ventilation rate, with a 28-days follow-up. In the HCQ/AZI group, 18.3% of patients presented a prolonged QT interval requiring treatment cessation, however, control group was not monitored for this adverse event, making comparison impossible.
Keywords	Medicine ; R ; Science ; Q
Subject code	616
Language	English
Publishing date	2021-01-01T00:00:00Z
Publisher	Public Library of Science (PLoS)
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Lack of efficacy of hydroxychloroquine and azithromycin in patients hospitalized for COVID-19 pneumonia: A retrospective study.

Saib, Anis / Amara, Walid / Wang, Pascal / Cattan, Simon / Dellal, Azeddine / Regaieg, Kais / Nahon, Stephane / Nallet, Olivier / Nguyen, Lee S

PloS one

2021 Volume 16, Issue 6, Page(s) e0252388

Abstract: ... against coronavirus disease-2019 (COVID-19). In this retrospective study, we assessed the clinical effects ... hospitalized for COVID-19 between March 15 and April 2, 2020, we compared patients who received HCQ/AZI ... Background: Hydroxychloroquine combined with azithromycin (HCQ/AZI) has initially been used ...

Abstract	Background: Hydroxychloroquine combined with azithromycin (HCQ/AZI) has initially been used against coronavirus disease-2019 (COVID-19). In this retrospective study, we assessed the clinical effects of HCQ/AZI, with a 28-days follow-up. Methods: In a registry-study which included patients hospitalized for COVID-19 between March 15 and April 2, 2020, we compared patients who received HCQ/AZI to those who did not, regarding a composite outcome of mortality and mechanical ventilation with a 28-days follow-up. QT was monitored for patients treated with HCQ/AZI. Were excluded patients in intensive care units, palliative care and ventilated within 24 hours of admission. Three analyses were performed to adjust for selection bias: propensity score matching, multivariable survival, and inverse probability score weighting (IPSW) analyses. Results: Overall, 203 patients were included: 60 patients treated by HCQ/AZI and 143 control patients. During the 28-days follow-up, 32 (16.3%) patients presented the primary outcome and 23 (12.3%) patients died. Propensity-score matching identified 52 unique pairs of patients with similar characteristics. In the matched cohort (n = 104), HCQ/AZI was not associated with the primary composite outcome (log-rank p-value = 0.16). In the overall cohort (n = 203), survival and IPSW analyses also found no benefit from HCQ/AZI. In the HCQ/AZI group, 11 (18.3%) patients prolonged QT interval duration, requiring treatment cessation. Conclusions: HCQ/AZI combination therapy was not associated with lower in-hospital mortality and mechanical ventilation rate, with a 28-days follow-up. In the HCQ/AZI group, 18.3% of patients presented a prolonged QT interval requiring treatment cessation, however, control group was not monitored for this adverse event, making comparison impossible.
MeSH term(s)	Anti-Bacterial Agents/therapeutic use ; Antimalarials/therapeutic use ; Azithromycin/therapeutic use ; COVID-19/drug therapy ; COVID-19/mortality ; COVID-19/pathology ; COVID-19/virology ; Female ; Follow-Up Studies ; Humans ; Hydroxychloroquine/therapeutic use ; Intensive Care Units ; Male ; Middle Aged ; Respiration, Artificial ; Retrospective Studies ; SARS-CoV-2/drug effects ; SARS-CoV-2/isolation & purification ; Survival Rate ; Treatment Outcome
Chemical Substances	Anti-Bacterial Agents ; Antimalarials ; Hydroxychloroquine (4QWG6N8QKH) ; Azithromycin (83905-01-5)
Language	English
Publishing date	2021-06-09
Publishing country	United States
Document type	Journal Article ; Observational Study
ISSN	1932-6203
ISSN (online)	1932-6203
DOI	10.1371/journal.pone.0252388
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Hydroxychloroquine and COVID-19: Lack of Efficacy and the Social Construction of Plausibility

Rughinis, Cosima / Dima, Lorena / Vasile, Sorina

Am J Ther

Abstract	BACKGROUND: Severe acute respiratory syndrome coronavirus 2 SARS- Cov2 has taken the world by surprise. Among the first promising repurposing agents proposed for treatment and prophylaxis, 2 antimalarial agents came into limelight: chloroquine and its less toxic derivative, hydroxychloroquine (HCQ). Intense research and public debates have followed. AREAS OF UNCERTAINTY: As HCQ is still used and studied, future research may bring novel evidence, modifying the state-of-the-art. Despite the lack of a single randomized control trial (RCT) with positive results, there are currently (as for the search on 30th of August 2020) more than 250 RCT registered on ClinicalTrials.gov with HCQ in COVID patients, and more than 150 of them are "still recruiting" or "not yet recruiting" patients. DATA SOURCES: Our study combines a therapeutic evaluation of RCT data with a sociological analysis of related controversies, examining scientific and public arena discourses. RESULTS: Although any hope of a positive effect was brought exclusively by some and not all of the observational studies, none of the 7 RCT published until now have found any benefit. From a sociological perspective, the HCQ controversy is a useful case study for understanding the construction of plausibility in a cultural context polarized into competing versions of reality, with different epistemologies and ideologies. CONCLUSIONS: The results of the first RCTs have been published, and they are disappointing; beneficial effects of HCQ could not be proven either for negative conversion on polymerase chain reactions of COVID patients or for postexposure prophylaxis. The question to be asked is: how many studies do we need until HCQ is abandoned? Argumentative time work, appealing to temporal properties of HCQ including its historical use, accumulation of evidence, alternative therapeutic scenarios, and sensationalist tempo for rhetorical purpose, plays a significant role in its continuing legitimation.
Keywords	covid19
Publisher	WHO
Document type	Article
Note	WHO #Covidence: #900652
Database	COVID19

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Article ; Online: Treatment Considerations for COVID-19: A Critical Review of the Evidence (or Lack Thereof).

Vijayvargiya, Prakhar / Esquer Garrigos, Zerelda / Castillo Almeida, Natalia E / Gurram, Pooja R / Stevens, Ryan W / Razonable, Raymund R

Mayo Clinic proceedings

2020 Volume 95, Issue 7, Page(s) 1454–1466

Abstract: ... hydroxychloroquine, and lopinavir/ritonavir, which are being repurposed for the treatment of COVID-19. Novel ... that may lead to a highly morbid and potentially fatal coronavirus disease 2019 (COVID-19). There is currently ... no drug that has been proven as an effective therapy for COVID-19. Several candidate drugs are being ...

Abstract	The novel severe acute respiratory syndrome coronavirus 2 is causing a worldwide pandemic that may lead to a highly morbid and potentially fatal coronavirus disease 2019 (COVID-19). There is currently no drug that has been proven as an effective therapy for COVID-19. Several candidate drugs are being considered and evaluated for treatment. This includes clinically available drugs, such as chloroquine, hydroxychloroquine, and lopinavir/ritonavir, which are being repurposed for the treatment of COVID-19. Novel experimental therapies, such as remdesivir and favipiravir, are also actively being investigated for antiviral efficacy. Clinically available and investigational immunomodulators, such as the interleukin 6 inhibitors tocilizumab and sarilumab and the anti-granulocyte-macrophage colony-stimulating factor lenzilumab, are being tested for their anticipated effect in counteracting the pro-inflammatory cytokine environment that characterizes severe and critical COVID-19. This review article examines the evidence behind the potential use of these leading drug candidates for the treatment of COVID-19. The authors conclude, based on this review, that there is still no high-quality evidence to support any of these proposed drug therapies. The authors, therefore, encourage the enrollment of eligible patients to multiple ongoing clinical trials that assess the efficacy and safety of these candidate therapies. Until the results of controlled trials are available, none of the suggested therapeutics is clinically proven as an effective therapy for COVID-19.
MeSH term(s)	Antiviral Agents/therapeutic use ; Betacoronavirus ; COVID-19 ; Coronavirus Infections/complications ; Coronavirus Infections/drug therapy ; Coronavirus Infections/therapy ; Humans ; Immunization, Passive ; Immunologic Factors/therapeutic use ; Pandemics ; Pneumonia, Viral/complications ; Pneumonia, Viral/therapy ; SARS-CoV-2 ; COVID-19 Drug Treatment ; COVID-19 Serotherapy
Chemical Substances	Antiviral Agents ; Immunologic Factors
Keywords	covid19
Language	English
Publishing date	2020-04-30
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	124027-4
ISSN	1942-5546 ; 0025-6196
ISSN (online)	1942-5546
ISSN	0025-6196
DOI	10.1016/j.mayocp.2020.04.027
Database	MEDical Literature Analysis and Retrieval System OnLINE

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