Effect of hydroxychloroquine on SARS-CoV-2 viral load in patients with COVID-19

Faíco-Filho, Klinger Soares; Conte, D.; Luna, Luciano Kleber de Souza; Carvalho, Joseane Mayara Almeida; Perosa, Ana Helena; Bellei, Nancy

doi:10.1101/2020.06.16.20133066

Cited by 2 publications

(3 citation statements)

References 16 publications

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“…[41][42][43][44][45][46] 3. Inconsistent results: 13 studies show benefits of HCQ, 40,[47][48][49][50][51][52][53][54][55][56][57][58] 18 report no significant benefit [59][60][61][62][63][64][65][66][67][68][69][70][71][72][73][74][75] and four report increased risks. [76][77][78][79] 4.…”

Section: Identifying Appropriate Designsmentioning

confidence: 99%

“…Limitations and biases: all 35 studies have been widely criticized and considered methodologically very biased by several commentators 41‐46 Inconsistent results: 13 studies show benefits of HCQ, 40,47‐58 18 report no significant benefit 59‐75 and four report increased risks 76‐79 Significant number of retracted studies: three studies on HCQ were retracted 50,78,80 and another was the subject of a statement of concern from Elsevier and is currently under investigation 47 …”

Section: Identifying Appropriate Designsmentioning

confidence: 99%

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COVID‐19 and the generation of novel scientific knowledge: Research questions and study designs

Perillat

Baigrie

2021

Evaluation Clinical Practice

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Rationale, aims, and objectives One of the sectors challenged by the COVID‐19 pandemic is medical research. COVID‐19 originates from a novel coronavirus (SARS‐CoV‐2) and the scientific community is faced with the daunting task of creating a novel model for this pandemic or, in other words, creating novel science. This paper is the first part of a series of two papers that explore the intricate relationship between the different challenges that have hindered biomedical research and the generation of scientific knowledge during the COVID‐19 pandemic. Methods During the early stages of the pandemic, research conducted on hydroxychloroquine (HCQ) was chaotic and sparked several heated debates with respect to the scientific methods used and the quality of knowledge generated. Research on HCQ is used as a case study in both papers. The authors explored biomedical databases, peer‐reviewed journals, pre‐print servers, and media articles to identify relevant literature on HCQ and COVID‐19, and examined philosophical perspectives on medical research in the context of this pandemic and previous global health challenges. Results This paper demonstrates that a lack of prioritization among research questions and therapeutics was responsible for the duplication of clinical trials and the dispersion of precious resources. Study designs, aimed at minimising biases and increasing objectivity, were, instead, the subject of fruitless oppositions. The duplication of research works, combined with poor‐quality research, has greatly contributed to slowing down the creation of novel scientific knowledge. Conclusions The COVID‐19 pandemic presented challenges in terms of (1) finding and prioritising relevant research questions and (2) choosing study designs that are appropriate for a time of emergency.

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Section: Identifying Appropriate Designsmentioning

confidence: 99%

Section: Identifying Appropriate Designsmentioning

confidence: 99%

COVID‐19 and the generation of novel scientific knowledge: Research questions and study designs

Perillat

Baigrie

2021

Evaluation Clinical Practice

View full text Add to dashboard Cite

show abstract

“…The small sample size, lack of a control arm, and short follow-up were the limitations of this study. A prospective study measuring consecutive viral loads in 66 patients admitted with moderately severe COVID-19 did not find any difference in viral load clearance over time in vivo with use of HCQ compared to those not treated with HCQ [ 69 ]. Again, small sample size and variation in time for serial sampling were some limitations with this study.…”

Section: Covid-19 and Hcq Literature Reviewmentioning

confidence: 99%

Hydroxychloroquine: a comprehensive review and its controversial role in coronavirus disease 2019

et al. 2020

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Hydroxychloroquine, initially used as an antimalarial, is used as an immunomodulatory and antiinflammatory agent for the management of autoimmune and rheumatic diseases such as systemic lupus erythematosus. Lately, there has been interest in its potential efficacy against severe acute respiratory syndrome coronavirus 2, with several speculated mechanisms. The purpose of this review is to elaborate on the mechanisms surrounding hydroxychloroquine. The review is an in-depth analysis of the antimalarial, immunomodulatory, and antiviral mechanisms of hydroxychloroquine, with detailed and novel pictorial explanations. The mechanisms of hydroxychloroquine are related to potential cardiotoxic manifestations and demonstrate potential adverse effects when used for coronavirus disease 2019 (COVID-19). Finally, current literature associated with hydroxychloroquine and COVID-19 has been analyzed to interrelate the mechanisms, adverse effects, and use of hydroxychloroquine in the current pandemic. Currently, there is insufficient evidence about the efficacy and safety of hydroxychloroquine in COVID-19. KEY MESSAGES 1. HCQ, initially an antimalarial agent, is used as an immunomodulatory agent for managing several autoimmune diseases, for which its efficacy is linked to inhibiting lysosomal antigen processing, MHC-II antigen presentation, and TLR functions. 2. HCQ is generally well-tolerated although severe life-threatening adverse effects including cardiomyopathy and conduction defects have been reported. 3. HCQ use in COVID-19 should be discouraged outside clinical trials under strict medical supervision.

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Effect of hydroxychloroquine on SARS-CoV-2 viral load in patients with COVID-19

Cited by 2 publications

References 16 publications

COVID‐19 and the generation of novel scientific knowledge: Research questions and study designs

COVID‐19 and the generation of novel scientific knowledge: Research questions and study designs

Hydroxychloroquine: a comprehensive review and its controversial role in coronavirus disease 2019

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