Meta-analysis: hydroxychloroquine therapy approach with or without azithromycin against covid-19

Authors

  • Josilene Nascimento do Lago University of Amazon (UNAMA)
  • Cosmo de Sousa Costa Federal University of Pará (UFPA)
  • Larissa Emily de Carvalho Moraes University of Amazon (UNAMA)
  • Raissa Ribeiro da Silva University of Amazon (UNAMA)
  • Gleiciane Moraes Gonçalves University of Amazon (UNAMA)
  • Thainar Stefanie Barbosa de Oliveira University of Amazon (UNAMA)
  • Tatiane Roseli Alves Castro Federal University of Viçosa (UFV)
  • Thalles Ricardo Melo de Souza State University of Pará (UEPA)
  • Christian Pacheco de Almeida State University of Pará (UEPA)
  • Lorena Victória de Souza Ferreira Paulista University (UNIP)
  • Alex Jean Ferreira da Silva University of Amazon (UNAMA)
  • Widson Davi Vaz de Matos Federal University of Pará (UFPA)
  • Renan Rocha Granato Federal University of Pará (UFPA)
  • Ademir Ferreira da Silva Júnior Federal University of Pará (UFPA)

DOI:

https://doi.org/10.31686/ijier.vol8.iss8.2493

Keywords:

Azithromycin, Covid-19, Hydroxychloroquine, SARS-CoV-2

Abstract

Objective: identify and analyse the evidences about the use of hydroxychloroquine with or without azithromycin in covid-19. Methods: This is a systematic review with meta-analysis using posted articles in December 2019 until May 2020. The research was formulated by a question structured using PICO strategy, in these data bases: BVS, PUBMED, MEDLINE, LILACS, BDENF e SCIELO. Results and discussion: Resulted in 9 articles founded by the PRISMA, approaching 4182 patients. PICO strategy selected and analysed 5 articles projected in Forest plots. Resulting in tree clinical trials (RR: 1.15; IC95%, 0.76 a 1.73), which did not found big differences in the outcome in the groups of patients who used HCQ with or without AZT, comparing with the control group. Two studies analysed the number of deaths/intubations in comparative group, experimental group and control (RR:1.86; IC: 95%, 1.54 a 2.26) resulting in more chance of death /intubation in patients who used HCQ. Conclusion: It was found that is not possible to prove the efficacy of these drugs, due to the limited number of randomized and controlled clinical trials. Therefore, the encourage of scientific production about the HCQ and AZT against Covid-19 is more than necessary.

Downloads

Download data is not yet available.

Author Biographies

  • Josilene Nascimento do Lago, University of Amazon (UNAMA)

    Nursing Academic

  • Cosmo de Sousa Costa, Federal University of Pará (UFPA)

    Medical Academic

  • Larissa Emily de Carvalho Moraes, University of Amazon (UNAMA)

    Nursing Academic

  • Raissa Ribeiro da Silva, University of Amazon (UNAMA)

    Nursing Academic

  • Gleiciane Moraes Gonçalves, University of Amazon (UNAMA)

    Nursing Academic

  • Thainar Stefanie Barbosa de Oliveira, University of Amazon (UNAMA)

    Nursing Academic

  • Tatiane Roseli Alves Castro, Federal University of Viçosa (UFV)

    Nursing Academic

  • Thalles Ricardo Melo de Souza, State University of Pará (UEPA)

    Medical Academic

  • Christian Pacheco de Almeida, State University of Pará (UEPA)

    Physiotherapy Academic

  • Lorena Victória de Souza Ferreira, Paulista University (UNIP)

    Nursing Academic

  • Alex Jean Ferreira da Silva, University of Amazon (UNAMA)

    Nursing Academic

  • Widson Davi Vaz de Matos, Federal University of Pará (UFPA)

    Resident Nurse, Oncology Nursing Residency Program

  • Renan Rocha Granato, Federal University of Pará (UFPA)

    Physician in vascular surgery and adjunct professor of Medical Academy

  • Ademir Ferreira da Silva Júnior, Federal University of Pará (UFPA)

    Post doctor in Safety of patient and associated Professor in Academy of Medicine 

References

A.C.D. Lima, D.A. Cunha, R.C. Albuquerque, R.N.A. Costa, H.J. Silva, Alterações sensoriais em respiradores orais: revisão sistemática baseada no método prisma. Revista Paulista de Pediatria, 37(1), 97-103, 2019. DOI: https://doi.org/10.1590/1984-0462/;2019;37;1;00012

D. Sadigurskya, M.D. Sousa, Y.G.L. Cajaíba, R.R. Martins, D.M.V. Lobão. Profilaxia infecciosa com aplicação local de vancomicina em pó em cirurgias ortopédicas: revisão sistemática com metanálise. Revista brasileira de ortopedia, 54(6), 617-626, 13, 2019. DOI: https://doi.org/10.1016/j.rbo.2017.12.003

D.N. Juurlink, Safety considerations with chloroquine, hydroxychloroquine and azithromycin in the management of sars-cov-2 infection. Can. Med. Association journal, 2020; 192: 450-453, 2020. DOI: https://doi.org/10.1503/cmaj.200528

E.S. Rosenberge, E.M. Dufort, T. Udo, L.A. Wilberschied, J. Kumar, J. Tesoriero, P. Weinberg, J. Kirkwood, A. Muse, J. DeHovitz, D.S. Blog, B. Hutton, David R Holtgrave, H.A. Zucker. association of treatment with hydroxychloroquine or azithromycin with in-hospital mortality in patients with covid-19 in new york state, jama, e208630, 2020. DOI: https://doi.org/10.1001/jama.2020.8630

F. R. Bessière, H. Roccia, A. Delinière. Assessment of qt intervals in a case series of patients with coronavirus disease 2019 (covid-19) infection treated with hydroxychloroquine alone or in combination with azithromycin in an intensive care unit. Jama cardiol, e201787.Cognition. (2008). In Oxford reference online premium dictionary, 2020. DOI: https://doi.org/10.1001/jamacardio.2020.1787

J. Andreani, M. Bideau, I. Duflot, P. Jardot, C. Rolland, M. Boxberger, N. WurtzabIn, J.M. Rolain, P. Colson. B.L. Scola, D. Raoult. vitro testing of combined hydroxychloroquine and azithromycin on sars-cov-2 shows synergistic effect. Microbial pathogenesis, v.145, p.1-4, 2020. DOI: https://doi.org/10.1016/j.micpath.2020.104228

J. Chean, D. Liu, L. Liu, P. Liu, Q. Xu, L. Xia, Y. Ling, D. Huang, S. Song, D. Zhang, Z. Qian, T. Li, Y. Shen, H. Lu, A pilot study of hydroxychloroquine in the treatment of patients with common coronavirus-19 disease (covid-19), Zhejiang da xue xue bao.Yi xue ban, Journal of Zhejiang University. Medical sciences, 49(2), 215–21, 2020.

J. Geleris. Y. Sun, J. Platt, J. Zucker, M. Baldwin, G. Hripcsak, A. Labella, D.K. Manson, C. Kubin, R.G. Barr, M.E. Sobieszczyk, N.W. Schluger. Observational study of hydroxychloroquine in hospitalized patients with covid-19. The new england journal of medicine, 2012410. Advance online publication, 2020. DOI: https://doi.org/10.1056/NEJMoa2012410

J. Molina, C. Delaugerre, J. Le Goff, B. Mela-Lima, D. Ponscarme, L. Goldwirt, N. Castro. No evidence of rapid antiviral clearance or clinical benefit with the combination of hydroxychloroquine and azithromycin in patients with severe COVID-19 infection. Medecine et maladies infectieuses, 50(4), 384, 2020. DOI: https://doi.org/10.1016/j.medmal.2020.03.006

M. Million, J.C. Lagier, P. Gautret, P. Colson, P.E. Fournier, S. Amrane, M. Hocquart, M. Mailhe, V. Esteves-Vieira, B. Doudier, C. Aubry, F. Correard, A. Giraud-Gatineau, Y. Roussel, C. Berenger, N. Cassir, P. Seng, C. Zandotti, C. Dhiver, I. Ravaux,… D. Raoult. Early treatment of 1061 covid-19 patients with hydroxychloroquine and azithromycin, marseille, France. Travel medicine and infectious disease, 101738, 2020. DOI: https://doi.org/10.1016/j.tmaid.2020.101738

P. Gautret., J.C. Lagier, P. Parola, V.T. Hoang, L. Meddeb, J. Sevestre, M. Mailhe, B. Doudier, C. Aubry, S. Amrane, P. Seng, M. Hocquart, C. Eldin, J. Finance, V. E. Vieira, H. T. Tissot-Dupont, S. S. Honoré, A. Million, M. Colson, D. Raoult, Clinical and microbiological effect of a combination of hydroxychloroquine and azithromycin in 80 covid-19 patients with at least a six-day follow up: a pilot observational study. Travel medicine and infectious disease, travel med infect dis, v.34 (101663): p.1-7, 2020. DOI: https://doi.org/10.1016/j.tmaid.2020.101663

P. Gautret., J.C. Lagier, P. Parola, V.T. Hoang, L. Meddeb, J. Sevestre, M. Mailhe, B. Doudier, C. Aubry, S. Amrane, P. Seng, M. Hocquart, C. Eldin, J. Finance, V. E. Vieira, H. T. Tissot-Dupont, S. S. Honoré, A. Million, P., Chabrière, E., La Scola, B., Rolain, J. M., Brouqui, P.D. Raoult, Hydroxychloroquine and azithromycin as a treatment of covid-19: results of an open-label non-randomized clinical trial, international journal of antimicrobial agents, v.20 (105949): 1-24, 2020. DOI: https://doi.org/10.1016/j.ijantimicag.2020.105949

P. Zhai., Y.X. Ding, J. Long, Y. Zhong, Y. Li. The epidemiology, diagnosis and treatment of COVID-19. International journal of antimicrobial agents, 55(5), 105955, 2020. DOI: https://doi.org/10.1016/j.ijantimicag.2020.105955

R.M. Lana, F.C. Coelho, M.F.C. Gomes, O.G. Cruz, L.S. Bastos, D.A.M. Villela, C.T. Codeço. Emergência do novo coronavírus (sars-cov-2) e o papel de uma vítima nacional em saúde e efetiva. Cafajeste. Saúde pública. 36 (3): 1-3, 2020. DOI: https://doi.org/10.1590/0102-311x00019620

S. J. S. Pacheco, S. Kong, P. P. Santacruz, R.W. Murphy, L. Kubatko. Median-joining network analysis of SARS-CoV-2 genomes is neither phylogenetic nor evolutionary. Proceedings of the National Academy of Sciences of the United States of America, 117(23), 12518–12519, 2020. DOI: https://doi.org/10.1073/pnas.2007062117

T. Strabelli, D.E. Uip. COVID-19 and the Heart. COVID-19 e o Coração. Arquivos brasileiros de cardiologia, 114(4), 598–600, 2020. DOI: https://doi.org/10.36660/abc.20200209

W. Tang, Z. Cao, M. Han, Z. Wang, J. Chen, W. Sun, Y. Wu, W. Xiao, S. Liu, E. Chen, W. Chen, X. Wang, J. Yang, J. Lin, Q. Zhao, Y. Yan, Z. Xie, D. Li, Y. Yang, L. Liu, J. Qu, G. Ning, G Shi, Q. Xie. Hydroxychloroquine in patients with mainly mild to moderate coronavirus disease 2019: open label, randomised controlled trial. The BMJ (Clinical research ed.), 369: m1849, 2020. DOI: https://doi.org/10.1136/bmj.m1849

Downloads

Published

2020-08-01

How to Cite

Lago, J. N. do ., Costa, C. de S. ., Moraes, L. E. de C. ., Silva, R. R. da ., Gonçalves, G. M. ., Oliveira, T. S. B. de ., Castro, T. R. A. ., Souza, T. R. M. de ., Almeida, C. P. de ., Ferreira, L. V. de S. ., Silva, A. J. F. da ., Matos, W. D. V. de ., Granato, R. R. ., & Júnior, A. F. da S. . (2020). Meta-analysis: hydroxychloroquine therapy approach with or without azithromycin against covid-19. International Journal for Innovation Education and Research, 8(8), 73-87. https://doi.org/10.31686/ijier.vol8.iss8.2493

Most read articles by the same author(s)