A systematic review protocol of the antiviral activity of chloroquine and hydroxychloroquine against COVID-19

  1. Kofi Boamah Mensah
  2. Adwoa Bemah Boamah Mensah
  3. Varsha Bangalee
  4. Frasia Oosthuizen

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Abstract

Introduction

The recent outbreak of the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), or COVID-19 with no approved medicines has led to global health threat. Currently, repositioning of old medicines seems the most responsible strategy for potential cure and prevention COVID-19. Hydroxychloroquine and chloroquine have shown promising efficacy against COVID-19 related pneumonia in clinical studies. However, the mode of drug action of chloroquine and hydroxychloroquine against SARS-CoV-2 infection is not clear. This review aims to gather evidence on antiviral activity and possible mechanism of drug action of chloroquine and hydroxychloroquine on SARS-CoV-2, including in-vitro, animal studies, and studies in humans.

Method

A structured search of five bibliographic databases namely; Medline, Web of Science, PubMed, Cochrane CENTRAL, and Google Scholar will be undertaken to retrieve studies that describe the antiviral activity and possible mechanism of drug action of chloroquine and hydroxychloroquine on SARS-CoV-2. No restrictions will be placed on publication date, but studies will be limited to only publications in English. Duplication of studies will be removed using EndNote reference manager. Three authors will screen the citations independently based on inclusion criteria. Data extraction and assessment of risk of bias will be done independently. Meta-analysis of selected studies will be done wherever suitable.

Ethics and dissemination

Primary data collection will not be involved in this study, hence no need for formal ethical clearance. Findings from the study will be disseminated through a peer-reviewed publication and conference meeting.

Trial registration number

https://doi.org/10.17605/OSF.IO/7DJMU

Strengths and limitations of this study

  • This study is the first systematic review to gather current evidence on the antiviral effect and mode of action of chloroquine and hydroxychloroquine on SARS-CoV-2 infection. We expect that data that will be synthesis will provide enough information to inform COVID-19 care pathways and help clinicians caring for COVID-19 patients.

  • Furthermore, this systematic review will expand our knowledge on the benefits and risks of chloroquine and hydroxychloroquine in management of COVID-19 patients and identify areas of controversies, and quality assessment.

  • We anticipate that there will be few studies reporting on the mechanism of drug action and antiviral effects of chloroquine and hydroxychloroquine on SARS-CoV-2 infection.

Article activity feed

  1. ScreenIT

    SciScore for 10.1101/2020.06.13.20130245: (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
    This review will follow the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) and conform to the standards and recommendations described by the Cochrane Collaboration.
    Cochrane Collaboration
    suggested: None
    IO/7DJMU Eligibility criteria: Search strategy: We will retrieve studies using five bibliographic databases: Medline, Web of Science, PubMed
    Medline
    suggested: (MEDLINE, RRID:SCR_002185)
    PubMed
    suggested: (PubMed, RRID:SCR_004846)
    , Cochrane CENTRAL, and Google Scholar.
    Cochrane CENTRAL
    suggested: (Cochrane Central Register of Controlled Trials, RRID:SCR_006576)
    Google Scholar
    suggested: (Google Scholar, RRID:SCR_008878)
    The bibliographic software, EndNote, will be employed to organize, store, and manage all the citations and provide exhaustive and systematic search.
    EndNote
    suggested: (EndNote, RRID:SCR_014001)
    Firstly, controlled descriptors such as MeSH terms and their keywords were checked in the selected database.
    MeSH
    suggested: (MeSH, RRID:SCR_004750)

    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:
    Possible limitations are the heterogeneity of measures and outcomes appraised and the possibly decreased number of studies in subgroup analyses, which can impact negatively on the statistical power in the synthesis of data.

    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.
    • No protocol registration statement was detected.

    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.

  2. Version published to 10.1101/2020.06.13.20130245v1 on medRxiv