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?:abstract
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As anti-malarial drugs have been found to inhibit Corona viruses in vitro, studies have evaluated the effect of these drugs inCOVID-19 infection We conducted an updated meta-analysis of clinical trials and observational studies published till June 2020 Patients with reverse transcription polymerase chain reaction (RT-PCR) confirmed Severe Acute Respiratory Syndrome Coronavirus 2 (COVID-19) infection were included The drugs used in the intervention group are Chloroquine (CQ)/Hydroxychloroquine (HCQ) with or without Azithromycin The primary outcome is time to achieve virological cure Of 1040 citations, 11 studies provided data of 1215 patients Compared to control, CQ/HCQ has no significant effect on the time to negative COVID-19 RT-PCR results, neither in clinical trials (mean difference [MD] 1 55;95% confidence interval [CI] - 0 7 to 3 79;P = 0 18;n = 180), nor in observational studies (MD 1 14;95%CI - 11 98 to 14 26;P = 0 86, n = 407) CQ/HCQ did not affect the virological cure after day 3, 7, 10, 14, 21 and 28;except after day 5, as shown by a single small non-randomised trial (odds ratio [OR] 9 33;95% CI 1 51 to 57 65;P = 0 02, n = 30) Pooled data from 2 observational studies showed a significant effect of CQ/HCQ on virological cure by after day 10 (OR 7 86;95% CI 4 4 to 14 04, P < 0 001, n = 373) and day 14 (OR 6 37;95% CI 3 01 to 13 48, P < 0 001, n = 407) The GRADE evidence generated was of \'very low-quality/certainty\' To conclude, CQ/HCQ does not affect the time to virological cure compared to usual/standard of care in COVID-19 infection Recurrent infection in a smaller number of patients was noted in the CQ/HCQ group As the evidence generated was of \'very low-quality/certainty)\', large good quality studies are needed to confirm the present findings
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