A Systematic Review and Meta-Analysis on the Effect of Hydroxychloroquine on Major Clinical Outcomes at Different Time Points in COVID-19 Patients Based on Randomized Clinical Trials

Objective :  We aimed to summarize the effect of HCQ on mortality, mechanical ventilation, virus clearance at different time points. Methods: We researched published and pre-published articles from multi-database up to 12 March 2022. Cochrane risk of bias tool was used to assess risk of bias and random-effects model was used to data analysis. Results : We included 17 RCTs with 9517 patients for meta-analysis. HCQ has no significant benefit for 15-day mortality (OR: 1.10, 95% CI: 0.96-1.25, 12 trails, 8633 patients) and 28-day mortality (OR:1.09, 95% CI: 0.97-1.22, 11 trails, 8332 patients). it is uncertain whether HCQ increases or decreases the risk of mechanical ventilation at 15 day (OR:0.77, 95% CI: 0.24-2.48, 3 trails, 731 patients). Meanwhile, HCQ probably has no visible association with 28-day mechanical ventilation (OR:1.11, 95% CI: 0.90-1.38, 10 trails, 5264 patients). We also analyzed the effect of HCQ on virus clearance at 7th day (OR: 0.88, 95% CI: 0.41-1.86, 2 trails, 135 patients), 10th day (OR: 1.00, 95% CI: 0.65-1.55, 2 trails, 135 patients) and 28th day (OR:1.41, 95% CI:1.64-3.09, 2 trails, 194 patients). Conclusion : Combined HCQ therapy lacks efficacy in improving 15-day and 28-day mortality, mechanical ventilation, as well as 7, 10, and 28-day viral clearance. Funding Information: This study was supported by funds from the National Natural Science Foundation of China (grant numbers: 82074361, 81774278,81973831) and Sichuan Provincial Administration of Traditional Chinese Medicine of China (grant numbers: 2020LC0077). Declaration of Interests: There is no conflict of interest in this article.