{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,21]],"date-time":"2026-02-21T05:06:10Z","timestamp":1771650370216,"version":"3.50.1"},"reference-count":46,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2021,5,2]],"date-time":"2021-05-02T00:00:00Z","timestamp":1619913600000},"content-version":"vor","delay-in-days":1,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["ascpt.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Translational Sci"],"published-print":{"date-parts":[[2021,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Many meta\u2010analyses have been published about the efficacy of hydroxychloroquine (HCQ) in coronavirus disease 2019 (COVID\u201019). Most of them included observational studies, and few have assessed HCQ as a prophylaxis or evaluated its safety profile. We searched multiple databases and preprint servers for randomized controlled trials (RCTs) that assessed HCQ for the treatment or prevention of COVID\u201019. We summarized the effect of HCQ on mortality, viral clearance, and other clinical outcomes. Out of 768 papers screened, 21 RCTs with a total of 14,138 patients were included. A total of 9 inpatient and 3 outpatient RCTs assessed mortality in 8596 patients with a pooled risk difference of 0.01 (95% confidence interval [CI] 0.00\u20130.03, <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup>\u00a0=\u00a01%, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.07). Six studies assessed viral clearance at 7\u00a0days with a pooled risk ratio (RR) of 1.11 (95% CI 0.86\u20131.42, <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup>\u00a0=\u00a061%, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.44) and 5 studies at 14\u00a0days with a pooled RR of 0.96 (95% CI 0.89\u20131.04, <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup>\u00a0=\u00a00%, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.34). Several trials showed no significant effect of HCQ on other clinical outcomes and. Five prevention RCTs with 5012 patients found no effect of HCQ on the risk of acquiring COVID\u201019. Thirteen trials showed that HCQ was associated with increased risk of adverse events. We observed, with high level of certainty of evidence, that HCQ is not effective in reducing mortality in patients with COVID\u201019. Lower certainty evidence also suggests that HCQ neither improves viral clearance and other clinical outcomes, nor prevents COVID\u201019 infection in patients with high\u2010risk exposure. HCQ is associated with an increased rate of adverse events.<\/jats:p>","DOI":"10.1111\/cts.13001","type":"journal-article","created":{"date-parts":[[2021,2,19]],"date-time":"2021-02-19T18:01:07Z","timestamp":1613757667000},"page":"1101-1112","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Mortality, viral clearance, and other clinical outcomes of hydroxychloroquine in COVID\u201019 patients: A systematic review and meta\u2010analysis of randomized controlled trials"],"prefix":"10.1111","volume":"14","author":[{"given":"Zakariya","family":"Kashour","sequence":"first","affiliation":[{"name":"Department of Medicine University of Alberta Edmonton AB Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tarek","family":"Kashour","sequence":"additional","affiliation":[{"name":"Department of Cardiac Sciences King Fahad Cardiac Center King Saud University Medical City Riyadh Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Danielle","family":"Gerberi","sequence":"additional","affiliation":[{"name":"Mayo Clinic Libraries Mayo Clinic Rochester Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Imad M.","family":"Tleyjeh","sequence":"additional","affiliation":[{"name":"Infectious Diseases Section Department of Medical Specialties King Fahad Medical City Riyadh Saudi Arabia"},{"name":"Division of Infectious Diseases Mayo Clinic College of Medicine and Science Rochester Minnesota USA"},{"name":"Division of Epidemiology Mayo Clinic College of Medicine and Science Rochester Minnesota USA"},{"name":"College of Medicine Alfaisal University Riyadh Saudi 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