COVID-19 treatment: evidence review

Trinity postgraduate and clinical GP Kome Gbinigie is part of a team reviewing the evidence for possible coronavirus treatments, including chloroquine.

There has been growing interest in the use of existing medicines as potential treatments for COVID-19, such as chloroquine and hydroxychloroquine. Both drugs have been incorporated into some national guidelines to treat COVID-19 in certain situations, despite the lack of rigorous clinical trial data. Dr Gbinigie and a colleague analysed the findings of a study of 30 COVID-19 patients in China, published on 6 March 2020, and a second trial of 36 COVID-19 patients in France, published on 17 March 2020.

In their review, Dr Gbinigie and Dr Kerstin Frie from the Nuffield Department of Primary Care Health Sciences have concluded there is currently not enough evidence from clinical trials of chloroquine and hydroxychloroquine to determine whether the drugs are safe and effective treatments for COVID-19. In their rapid review of clinical trial data for BJGP Open, they found that larger, randomised clinical trials are urgently needed in both community and hospital settings. Such studies would guide policy-makers and clinicians to make decisions for patients based on high-quality evidence.

Dr Gbinigie says: ‘Data from two clinical trials reveal conflicting results about the effectiveness of hydroxychloroquine. Both studies had small numbers of participants, provided no medium or long-term follow-up with patients and had methodological limitations.

‘Fortunately, more than 20 clinical trials of chloroquine and hydroxycholoquine are already registered, which should help to inform whether these drugs are effective, as well as the optimal dose and the duration that is necessary to treat COVID-19.’

Dr Gbinige has also looked at the evidence for efficacy of the HIV drug Lopinavir/ritonavir in the treatment of COVID-19, concluding there is no strong evidence to support its use of treatment for COVID-19.

Posted: 15 April 2020

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