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HCQ for COVID-19 : real-time meta analysis of 253 studies

 

100% of the 29 early treatment studies report a positive effect (13 statistically significant in isolation).

•Random effects meta-analysis with pooled effects using the most serious outcome reported shows 66% improvement for the 29 early treatment studies (RR 0.34 [0.24-0.49]). Results are similar after exclusion based sensitivity analysis : 67% (RR 0.33 [0.24-0.44]), and after restriction to 20 peer-reviewed studies : 65% (RR 0.35 [0.25-0.47]). Restricting to the 6 RCTs shows 46% improvement (RR 0.54 [0.33-0.86]). Restricting to the 13 mortality results shows 75% lower mortality (RR 0.25 [0.16-0.40]).

•Late treatment is less successful, with only 70% of the 171 studies reporting a positive effect. Very late stage treatment is not effective and may be harmful, especially when using excessive dosages.

•The probability that an ineffective treatment generated results as positive as the 253 studies to date is estimated to be 1 in 1 quadrillion (p = 0.00000000000000083).

•87% of Randomized Controlled Trials (RCTs) for early, PrEP, or PEP treatment report positive effects, the probability of this happening for an ineffective treatment is 0.0037.

•There is substantial evidence of bias towards publishing negative results. 82% of prospective studies report positive effects, and only 72% of retrospective studies do. Studies from North America are 3.3 times more likely to report negative results than studies from the rest of the world combined, p = 0.0000000084.