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Mortality outcomes ...
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Axfors, CathrineUppsala universitet,Obstetrisk och reproduktiv hälsoforskning,Stanford Univ, Meta Res Innovat Ctr Stanford METRICS, Stanford, CA 94305 USA.
(författare)
Mortality outcomes with hydroxychloroquine and chloroquine in COVID-19 from an international collaborative meta-analysis of randomized trials
- Artikel/kapitelEngelska2021
Förlag, utgivningsår, omfång ...
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2021-04-15
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Springer Nature,2021
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electronicrdacarrier
Nummerbeteckningar
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LIBRIS-ID:oai:DiVA.org:uu-442888
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https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-442888URI
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https://doi.org/10.1038/s41467-021-22446-zDOI
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Språk:engelska
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Sammanfattning på:engelska
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Ämneskategori:ref swepub-contenttype
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Ämneskategori:art swepub-publicationtype
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Correction in: Nature Communications, year: 2021, volume: 12, Article number: 3001, DOI: 10.1038/s41467-021-23559-1 Shared first authorship: Cathrine Axfors and Andreas M. Schmitt.
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Substantial COVID-19 research investment has been allocated to randomized clinical trials (RCTs) on hydroxychloroquine/chloroquine, which currently face recruitment challenges or early discontinuation. We aim to estimate the effects of hydroxychloroquine and chloroquine on survival in COVID-19 from all currently available RCT evidence, published and unpublished. We present a rapid meta-analysis of ongoing, completed, or discontinued RCTs on hydroxychloroquine or chloroquine treatment for any COVID-19 patients (protocol: https://osf.io/QESV4/). We systematically identified unpublished RCTs (ClinicalTrials.gov, WHO International Clinical Trials Registry Platform, Cochrane COVID-registry up to June 11, 2020), and published RCTs (PubMed, medRxiv and bioRxiv up to October 16, 2020). All-cause mortality has been extracted (publications/preprints) or requested from investigators and combined in random-effects meta-analyses, calculating odds ratios (ORs) with 95% confidence intervals (CIs), separately for hydroxychloroquine and chloroquine. Prespecified subgroup analyses include patient setting, diagnostic confirmation, control type, and publication status. Sixty-three trials were potentially eligible. We included 14 unpublished trials (1308 patients) and 14 publications/preprints (9011 patients). Results for hydroxychloroquine are dominated by RECOVERY and WHO SOLIDARITY, two highly pragmatic trials, which employed relatively high doses and included 4716 and 1853 patients, respectively (67% of the total sample size). The combined OR on all-cause mortality for hydroxychloroquine is 1.11 (95% CI: 1.02, 1.20; I-2=0%; 26 trials; 10,012 patients) and for chloroquine 1.77 (95%CI: 0.15, 21.13, I-2=0%; 4 trials; 307 patients). We identified no subgroup effects. We found that treatment with hydroxychloroquine is associated with increased mortality in COVID-19 patients, and there is no benefit of chloroquine. Findings have unclear generalizability to outpatients, children, pregnant women, and people with comorbidities. Hydroxychloroquine and chloroquine have been investigated as a potential treatment for Covid-19 in several clinical trials. Here the authors report a meta-analysis of published and unpublished trials, and show that treatment with hydroxychloroquine for patients with Covid-19 was associated with increased mortality, and there was no benefit from chloroquine.
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Biuppslag (personer, institutioner, konferenser, titlar ...)
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Schmitt, Andreas M.Univ Basel, Univ Hosp Basel, Dept Clin Res, Basel, Switzerland.;Univ Basel, Dept Med Oncol, Basel, Switzerland.
(författare)
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Janiaud, PerrineUniv Basel, Univ Hosp Basel, Dept Clin Res, Basel, Switzerland.
(författare)
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van't Hooft, JannekeStanford Univ, Meta Res Innovat Ctr Stanford METRICS, Stanford, CA 94305 USA.;Univ Amsterdam, Amsterdam Univ Med Ctr, Amsterdam, Netherlands.
(författare)
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Abd-Elsalam, SheriefTanta Univ, Fac Med, Trop Med & Infect Dis Dept, Tanta, Egypt.
(författare)
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Abdo, Ehab F.Assiut Univ, Fac Med, Trop Med & Gastroenterol Dept, Assiut, Egypt.
(författare)
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Abella, Benjamin S.Univ Penn, Dept Emergency Med, Philadelphia, PA 19104 USA.
(författare)
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Akram, JavedUniv Hlth Sci, Dept Internal Med, Lahore, Punjab, Pakistan.
(författare)
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Amaravadi, Ravi K.Univ Penn, Abramson Canc Ctr, Philadelphia, PA 19104 USA.;Univ Penn, Dept Med, Philadelphia, PA 19104 USA.
(författare)
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Angus, Derek C.Univ Pittsburgh, Clin Res Invest & Syst Modeling Acute Illness CRI, Dept Crit Care Med, Pittsburgh, PA USA.;Univ Pittsburgh, UPMC Hlth Syst Off Healthcare Innovat, Med Ctr, Pittsburgh, PA USA.
(författare)
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Arabi, Yaseen M.King Saud Bin Abdulaziz Univ Hlth Sci, Intens Care Dept, Riyadh, Saudi Arabia.;King Abdullah Int Med Res Ctr, Riyadh, Saudi Arabia.
(författare)
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Azhar, ShehnoorUniv Hlth Sci, Dept Publ Hlth, Lahore, Punjab, Pakistan.
(författare)
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Baden, Lindsey R.Brigham & Womens Hosp, Div Infect Dis, 75 Francis St, Boston, MA 02115 USA.
(författare)
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Baker, Arthur W.Duke Univ, Med Ctr, Dept Med, Div Infect Dis & Int Hlth, Durham, NC 27710 USA.
(författare)
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Belkhir, LeilaCatholic Univ Louvain, Infect Dis Dept, Clin Univ St Luc, Brussels, Belgium.
(författare)
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Benfield, ThomasCopenhagen Univ Hosp, Ctr Res & Disrupt Infect Dis, Dept Infect Dis, Hvidovre, Denmark.
(författare)
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Berrevoets, Marvin A. H.Elisabeth Tweesteden Hosp, Dept Internal Med, Tilburg, Netherlands.
(författare)
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Chen, Cheng-PinMinist Hlth & Welf, Dept Infect Dis, Taoyuan Gen Hosp, Taoyuan, Taiwan.
(författare)
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Chen, Tsung-ChiaMinist Hlth & Welf, Dept Internal Med, Taichung Hosp, Taichung, Taiwan.
(författare)
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Cheng, Shu-HsingMinist Hlth & Welf, Dept Infect Dis, Taoyuan Gen Hosp, Taoyuan, Taiwan.
(författare)
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Cheng, Chien-YuMinist Hlth & Welf, Dept Infect Dis, Taoyuan Gen Hosp, Taoyuan, Taiwan.
(författare)
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Chung, Wei-ShengMinist Hlth & Welf, Dept Internal Med, Taichung Hosp, Taichung, Taiwan.
(författare)
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Cohen, Yehuda Z.Sanofi, Bridgewater, NJ USA.
(författare)
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Cowan, Lisa N.Sanofi, Bridgewater, NJ USA.
(författare)
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Dalgard, OlavAkershus Univ Hosp, Dept Infect Dis, Div Med, Lorenskog, Norway.;Univ Oslo, Fac Med, Inst Clin Med, Oslo, Norway.
(författare)
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de Almeida e Val, Fernando F.Fundacao Med Trop Dr Heitor Vieira Dourado, Manaus, Amazonas, Brazil.
(författare)
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de Lacerda, Marcus V. G.Fundacao Med Trop Dr Heitor Vieira Dourado, Manaus, Amazonas, Brazil.;FIOCRUZ AM, Inst Leonidas & Maria Deane ILMD, Manaus, Amazonas, Brazil.
(författare)
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de Melo, Gisely C.Fundacao Med Trop Dr Heitor Vieira Dourado, Manaus, Amazonas, Brazil.;Univ Estado Amazonas, Manaus, Amazonas, Brazil.
(författare)
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Derde, LennieUniv Med Ctr Utrecht, Julius Ctr Hlth Sci & Primary Care, Utrecht, Netherlands.;Univ Med Ctr Utrecht, Intens Care Ctr, Utrecht, Netherlands.
(författare)
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Dubee, VincentAngers Univ Hosp, Infect & Trop Dis Dept, Angers, France.
(författare)
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Elfakir, AnissaIvidata Life Sci, Levallois Perret, France.
(författare)
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Gordon, Anthony C.Imperial Coll London, Dept Surg & Canc Anaesthet Pain Med & Intens Care, London, England.;Imperial Coll Healthcare NHS Trust, London, England.
(författare)
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Hernandez-Cardenas, Carmen M.Inst Nacl Enfermedades Resp Ismael Cosio Villegas, Crit Care Dept, Ciudad De Mexico, Mexico.
(författare)
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Hills, ThomasMed Res Inst New Zealand, Wellington, New Zealand.;Auckland City Hosp, Auckland, New Zealand.
(författare)
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Hoepelman, Andy I. M.Univ Med Ctr Utrecht, Dept Infect Dis, Utrecht, Netherlands.
(författare)
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Huang, Yi-WenMinist Hlth & Welf, Dept Internal Med, Chang Hua Hosp, Changhua, Taiwan.
(författare)
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Igau, BrunoSanofi, Bridgewater, NJ USA.
(författare)
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Jin, RonghuaCapital Med Univ, Beijing Youan Hosp, Beijing, Peoples R China.
(författare)
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Jurado-Camacho, FelipeInst Nacl Enfermedades Resp Ismael Cosio Villegas, Crit Care Dept, Ciudad De Mexico, Mexico.
(författare)
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Khan, Khalid S.Univ Granada, Hosp Real, Dept Prevent Med & Publ Hlth, Ave Hosp, Granada, Spain.
(författare)
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Kremsner, Peter G.Univ Tubingen, Inst Trop Med, Tubingen, Germany.;Ctr Rech Med Lambarene, Lambarene, Gabon.;German Ctr Infect Res, Partner Site Tubingen, Tubingen, Germany.
(författare)
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Kreuels, BennoUniv Med Ctr Hamburg Eppendorf, Dept Med, Div Trop Med, Hamburg, Germany.;Univ Med Ctr Hamburg Eppendorf, Div Infect Dis, Hamburg, Germany.;Bernhard Nocht Inst Trop Med, Dept Trop Med, Hamburg, Germany.
(författare)
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Kuo, Cheng-YuMinist Hlth & Welf, Dept Internal Med, Pingtung Hosp, Pingtung, Taiwan.
(författare)
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Le, Thuy
(författare)
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Lin, Yi-ChunMinist Hlth & Welf, Dept Infect Dis, Taoyuan Gen Hosp, Taoyuan, Taiwan.
(författare)
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Lin, Wu-PuMinist Hlth & Welf, Dept Internal Med, Taipei Hosp, New Taipei, Taiwan.
(författare)
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Lin, Tse-HungMinist Hlth & Welf, Dept Internal Med, Chang Hua Hosp, Changhua, Taiwan.
(författare)
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Lyngbakken, Magnus NakremUniv Oslo, Fac Med, Inst Clin Med, Oslo, Norway.;Akershus Univ Hosp, Div Med, Lorenskog, Norway.
(författare)
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McArthur, ColinMed Res Inst New Zealand, Wellington, New Zealand.;Auckland City Hosp, Auckland, New Zealand.;Monash Univ, Australian & New Zealand Intens Care Res Ctr, Sch Epidemiol & Prevent Med, Melbourne, Vic, Australia.
(författare)
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McVerry, Bryan J.Univ Pittsburgh, Dept Med, Pittsburgh, PA USA.
(författare)
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Meza-Meneses, PatriciaHosp Reg Alta Especialidad Ixtapaluca, Ixtapaluca, Mexico.
(författare)
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Monteiro, Wuelton M.Fundacao Med Trop Dr Heitor Vieira Dourado, Manaus, Amazonas, Brazil.;Univ Estado Amazonas, Manaus, Amazonas, Brazil.
(författare)
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Morpeth, Susan C.Middlemore Hosp, Auckland, New Zealand.
(författare)
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Mourad, AhmadDuke Univ, Dept Med, Med Ctr, Durham, NC 27710 USA.
(författare)
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Mulligan, Mark J.NYU Grossman Sch Med, Dept Microbiol, New York, NY USA.;NYU Grossman Sch Med, Dept Internal Med, Div Infect Dis & Immunol, New York, NY USA.
(författare)
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Murthy, SrinivasUniv British Columbia, Sch Med, Vancouver, BC, Canada.
(författare)
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Naggie, SusannaDuke Univ, Med Ctr, Dept Med, Div Infect Dis & Int Hlth, Durham, NC 27710 USA.
(författare)
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Narayanasamy, ShantiDuke Univ, Med Ctr, Dept Med, Div Infect Dis & Int Hlth, Durham, NC 27710 USA.
(författare)
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Nichol, AlistairMonash Univ, Australian & New Zealand Intens Care Res Ctr, Sch Epidemiol & Prevent Med, Melbourne, Vic, Australia.;Alfred Hlth, Dept Intens Care, Melbourne, Vic, Australia.;St Vincents Univ Hosp, Dept Anesthesia & Intens Care, Dublin, Ireland.;Univ Coll Dublin, Sch Med & Med Sci, Dublin, Ireland.
(författare)
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Novack, Lewis A.Harvard Med Sch, Brigham & Womens Hosp, Div Infect Dis, Boston, MA 02115 USA.
(författare)
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O'Brien, Sean M.Duke Univ, Dept Biostat & Bioinformat, Med Ctr, Durham, NC USA.;Duke Clin Res Inst, Durham, NC USA.
(författare)
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Okeke, Nwora LanceDuke Univ, Med Ctr, Dept Med, Div Infect Dis & Int Hlth, Durham, NC 27710 USA.
(författare)
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Perez, LenaExcelya, Montpellier, France.
(författare)
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Perez-Padilla, RogelioInst Nacl Enfermedades Resp Ismael Casio Villegas, Dept Smoking & COPD, Ciudad De Mexico, Mexico.
(författare)
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Perrin, LaurentSanofi, Montpellier, France.
(författare)
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Remigio-Luna, ArantxaInst Nacl Enfermedades Resp Ismael Casio Villegas, Dept Smoking & COPD, Ciudad De Mexico, Mexico.
(författare)
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Rivera-Martinez, Norma E.Hosp Reg Alta Especialidad Oaxaca, Oaxaca, Oaxaca, Mexico.
(författare)
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Rockhold, Frank W.Duke Univ, Dept Biostat & Bioinformat, Med Ctr, Durham, NC USA.;Duke Clin Res Inst, Durham, NC USA.
(författare)
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Rodriguez-Llamazares, SebastianInst Nacl Enfermedades Resp Ismael Casio Villegas, Dept Smoking & COPD, Ciudad De Mexico, Mexico.
(författare)
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Rolfe, RobertDuke Univ, Med Ctr, Dept Med, Div Infect Dis & Int Hlth, Durham, NC 27710 USA.
(författare)
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Rosa, RossanaUnityPoint Hlth, Des Moines, IA USA.
(författare)
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Rosjo, HelgeUniv Oslo, Fac Med, Inst Clin Med, Oslo, Norway.;Akershus Univ Hosp, Div Res & Innovat, Lorenskog, Norway.
(författare)
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Sampaio, Vanderson S.Fundacao Med Trop Dr Heitor Vieira Dourado, Manaus, Amazonas, Brazil.;Fundacao Vigilancia Saude Amazonas, Manaus, Amazonas, Brazil.
(författare)
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Seto, Todd B.Univ Hawaii, John A Burns Sch Med, Honolulu, HI 96822 USA.;Queens Med Ctr, Honolulu, HI USA.
(författare)
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Shahzad, MuhammadUniv Hlth Sci, Dept Pharmacol, Lahore, Punjab, Pakistan.
(författare)
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Soliman, ShaimaaMenoufia Univ, Publ Hlth & Community Med, Menoufia, Egypt.
(författare)
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Stout, Jason E.Duke Univ, Med Ctr, Dept Med, Div Infect Dis & Int Hlth, Durham, NC 27710 USA.
(författare)
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Thirion-Romero, IreriInst Nacl Enfermedades Resp Ismael Casio Villegas, Dept Smoking & COPD, Ciudad De Mexico, Mexico.
(författare)
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Troxel, Andrea B.NYU Grossman Sch Med, Dept Populat Hlth, Div Biostat, New York, NY USA.
(författare)
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Tseng, Ting-YuMinist Hlth & Welf, Dept Internal Med, Taichung Hosp, Taichung, Taiwan.
(författare)
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Turner, Nicholas A.Duke Univ, Med Ctr, Dept Med, Div Infect Dis & Int Hlth, Durham, NC 27710 USA.
(författare)
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Ulrich, Robert J.NYU Grossman Sch Med, Dept Med, Div Infect Dis & Immunol, New York, NY USA.
(författare)
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Walsh, Stephen R.Brigham & Womens Hosp, Div Infect Dis, 75 Francis St, Boston, MA 02115 USA.
(författare)
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Webb, Steve A.Monash Univ, Australian & New Zealand Intens Care Res Ctr, Sch Epidemiol & Prevent Med, Melbourne, Vic, Australia.;St John God Hosp, Subiaco, WA, Australia.
(författare)
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Weehuizen, Jesper M.Univ Med Ctr Utrecht, Dept Infect Dis, Utrecht, Netherlands.
(författare)
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Velinova, MariaPRA Hlth Sci, Groningen, Netherlands.
(författare)
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Wong, Hon-LaiMinist Hlth & Welf, Dept Internal Med, Keelung Hosp, Keelung, Taiwan.
(författare)
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Wrenn, RebekahDuke Univ, Med Ctr, Dept Med, Div Infect Dis & Int Hlth, Durham, NC 27710 USA.
(författare)
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Zampieri, Fernando G.HCor Hosp Coracao, Res Inst, Sao Paulo, Brazil.;BRICNet Brazilian Res Intens Care Network, Res Inst, Sao Paulo, Brazil.;IDor Res Inst, Sao Paulo, Brazil.
(författare)
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Zhong, WuBeijing Inst Pharmacol & Toxicol, Natl Engn Res Ctr Emergency Drug, Beijing, Peoples R China.
(författare)
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Moher, DavidOttawa Hosp Res Inst, Ctr Journalol, Clin Epidemiol Program, Ottawa, ON, Canada.
(författare)
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Goodman, Steven N.Stanford Univ, Meta Res Innovat Ctr Stanford METRICS, Stanford, CA 94305 USA.;Stanford Univ, Sch Med, Stanford, CA 94305 USA.;Stanford Univ, Dept Epidemiol & Populat Hlth, Sch Med, Stanford, CA 94305 USA.
(författare)
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Ioannidis, John P. A.Stanford Univ, Meta Res Innovat Ctr Stanford METRICS, Stanford, CA 94305 USA.;Stanford Univ, Sch Med, Stanford, CA 94305 USA.;Stanford Univ, Dept Epidemiol & Populat Hlth, Sch Med, Stanford, CA 94305 USA.;Stanford Univ, Dept Med, Stanford Prevent Res Ctr, Stanford, CA 94305 USA.;Berlin Inst Hlth, Meta Res Innovat Ctr Berlin METRIC B, Berlin, Germany.
(författare)
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Hemkens, Lars G.Stanford Univ, Meta Res Innovat Ctr Stanford METRICS, Stanford, CA 94305 USA.;Univ Basel, Univ Hosp Basel, Dept Clin Res, Basel, Switzerland.;Berlin Inst Hlth, Meta Res Innovat Ctr Berlin METRIC B, Berlin, Germany.
(författare)
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Uppsala universitetObstetrisk och reproduktiv hälsoforskning
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Ingår i:Nature Communications: Springer Nature12:12041-1723
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Axfors, Cathrine
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Schmitt, Andreas ...
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Janiaud, Perrine
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van't Hooft, Jan ...
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Abd-Elsalam, She ...
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Abdo, Ehab F.
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visa fler...
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Abella, Benjamin ...
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Akram, Javed
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Amaravadi, Ravi ...
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Angus, Derek C.
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Arabi, Yaseen M.
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Azhar, Shehnoor
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Baden, Lindsey R ...
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Baker, Arthur W.
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Belkhir, Leila
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Benfield, Thomas
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Berrevoets, Marv ...
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Chen, Cheng-Pin
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Chen, Tsung-Chia
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Cheng, Shu-Hsing
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Cheng, Chien-Yu
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Chung, Wei-Sheng
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Cohen, Yehuda Z.
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Cowan, Lisa N.
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Dalgard, Olav
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de Almeida e Val ...
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de Lacerda, Marc ...
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de Melo, Gisely ...
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Perez, Lena
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Moher, David
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Goodman, Steven ...
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Ioannidis, John ...
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