Chloroquine, hydroxychloroquine, and COVID-19: Systematic review and narrative synthesis of efficacy and safety

  1. Michael Takla
  2. Kamalan Jeevaratnam

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Abstract

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  1. Version published to 10.1016/j.jsps.2020.11.003
  2. ScreenIT

    SciScore for 10.1101/2020.05.28.20115741: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board Statementnot detected.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    Therefore, on May 26 2020, MEDRXIV, along with PubMed, Web of Science and Embase, acted as the databases for the initial search of items relevant to the PICOT-formatted question.
    PubMed
    suggested: (PubMed, RRID:SCR_004846)
    Embase
    suggested: (EMBASE, RRID:SCR_001650)
    As such, following the collation of items in EndNote and the removal of duplicates, application of these criteria excluded unique items for which there was either no English version or no original data.
    EndNote
    suggested: (EndNote, RRID:SCR_014001)

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    However, this study had several considerable limitations. In addition to the lack of randomisation and the use of a Ct of 35 rather than 40 as the threshold for viral clearance, the sample size of 36 was very small. Moreover, 23% of patients in the treatment, but none of those in the control, group were lost in the follow-up due to transfer to the ICU, disenrollment, or premature cessation, leaving the sample even further underpowered. Indeed, Bayesian reanalysis of the data demonstrates that the statistical evidence for efficacy weakens to anecdotally positive upon the exclusion of untested patients, and even to anecdotally negative with the assumption that untested patients were infected with SARSCoV-2 [77]. Other research coming to the same conclusion regarding the efficacy of CQ and/or HCQ in COVID-19 patients similarly exhibited numerous shortcomings. For instance, although a randomised controlled trial found that, compared to the control group administered lopinavir/ritonavir, patients with moderate and severe symptoms given CQ exhibited more than double the rate of improvement in CT scan indicators of pulmonary health, the sample consisted of only 22 individuals [36]. Likewise, half of the observational studies showing a lower mortality rate or higher probability of viral clearance with low dose CQ and/or HCQ treatment in patients with severe symptoms were severely underpowered, with a significant imbalance in size of the treatment (48) and control (502) groups [43]. B...

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a protocol registration statement.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  3. Version published to 10.1101/2020.05.28.20115741v1 on medRxiv