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dc.creatorFiolet, Thibault
dc.creatorGuihur, Anthony
dc.creatorRebeaud, Mathieu
dc.creatorMulot, Matthieu
dc.creatorPeifferSmadja, Nathan
dc.creatorMahamat-Saleh, Yahya
dc.date.accessioned2020-09-07T14:35:23Z
dc.date.available2020-09-07T14:35:23Z
dc.date.created2020
dc.identifier.issn1198-743Xspa
dc.identifier.otherhttps://doi.org/10.1016/j.cmi.2020.08.022spa
dc.identifier.urihttp://hdl.handle.net/20.500.12010/12807
dc.description.abstractBackground Hydroxychloroquine or chloroquine with or without azithromycin have been widely promoted to treat COVID-19 following early in vitro antiviral effects against SARS-CoV-2 Objective The aim of this systematic review and meta-analysis was to assess whether chloroquine or hydroxychloroquine with or without azithromycin decreased COVID-19 mortality compared to the standard of care. Data sources Pubmed, Web of Science, Embase Cochrane Library, Google Scholar and MedRxiv were searched until 25 July 2020. Study eligibility criteria We included published and unpublished studies comparing the mortality rate between patients treated with chloroquine or hydroxychloroquine with or without azithromycin and patients managed with standard of care. Participants Patients ≥18 years old with confirmed COVID-19. Interventions Chloroquine or hydroxychloroquine with or without azithromycin. Methods Effect sizes were pooled using a random-effects model. Multiple subgroup analyses were conducted to assess the drug safety. Results The initial search yielded 839 articles, of which 29 articles met our inclusion criteria. All studies except one were conducted on hospitalized patients and evaluated the effects of hydroxychloroquine with or without azithromycin. Among the 29 articles, 3 were randomized controlled trials (RCT), one was a non-randomized trial and 25 were observational studies, including 10 with a critical risk of bias and 15 with a serious or moderate risk of bias. After excluding studies with critical risk of bias, the meta-analysis included 11,932 participants for the hydroxychloroquine group, 8,081 for the hydroxychloroquine with azithromycin group and 12,930 for the control group. Hydroxychloroquine was not significantly associated with mortality: pooled Relative Risk RR=0.83 (95% CI: 0.65-1.06, n=17 studies) for all studies and RR=1.09 (95% CI: 0.97-1.24, n=3 studies) for RCTs. Hydroxychloroquine with azithromycin was associated with an increased mortality: RR=1.27 (95% CI: 1.04-1.54, n=7 studies). We found similar results with a Bayesian meta-analysis. Conclusion Hydroxychloroquine alone was not associated with reduced mortality in hospitalized COVID-19 patients but the combination of hydroxychloroquine and azithromycin significantly increased mortality.spa
dc.format.extent25 páginasspa
dc.format.mimetypeimage/jepgspa
dc.language.isoengspa
dc.publisherClinical Microbiology and Infectionspa
dc.sourcereponame:Expeditio Repositorio Institucional UJTLspa
dc.sourceinstname:Universidad de Bogotá Jorge Tadeo Lozanospa
dc.subjectHydroxychloroquinespa
dc.subjectAzithromycinspa
dc.subjectMortalityspa
dc.subjectCOVID-19spa
dc.subjectPatientsspa
dc.titleEffect of hydroxychloroquine with or without azithromycin on the mortality of COVID-19 patients: a systematic review and meta-analysisspa
dc.type.localArtículospa
dc.subject.lembSíndrome respiratorio agudo gravespa
dc.subject.lembCOVID-19spa
dc.subject.lembSARS-CoV-2spa
dc.subject.lembCoronavirusspa
dc.rights.accessrightsinfo:eu-repo/semantics/embargoedAccessspa
dc.type.hasversioninfo:eu-repo/semantics/acceptedVersionspa
dc.rights.localAcceso restringidospa
dc.identifier.doihttps://doi.org/10.1016/j.cmi.2020.08.022spa
dc.type.coarhttp://purl.org/coar/resource_type/c_2df8fbb1spa


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