Eficacia y seguridad de las aminoquinolinas para el tratamiento de infecciones a SARS-CoV-2: Una revisión sistemática de la literatura

Introduction: Amoniquinolines such as hydroxycholorquine have shown to inhibit SARS-CoV2 replication in-vitro. However, their benefit in clinical terms are controversial. Objectives: To synthesize the available evidence regarding the use of aminoquinolines for treating patients with COVID-19. Methods: A systematic review was undertaken. Five databases were searched for randomized trials assessing chloroquine o hydroxychloroquine in the treatment of patients infected with SARS-CoV-2. All studies were assessed using the criteria endorsed by the Cochrane Collaboration. Metaanalyses were undertaken whenever possible. Results: The literature search yielded 852 references, and 5 randomized trials were included. All were at high risk of bias. All studies included several cointerventions, such as antibiotics, steroids and antivirals and only two of them included critically-ill patients. When meta-analyses were conducted, aminoquinolines showed no benefit in terms of viral clearance or clinical improvement. However, a significant increase in the incidence of adverse events was observed (RR 3.11, 95CI% 1.64-5.89, p < 0.001). Discussion: The inhibitory properties of aminoquinolines do not seem to translate in clinical benefits amongst patients with CO-VID-19. The perceived high risk of bias of included studies along the significant increase in terms of adverse events recommends against the routine use of these drugs for treating patients with COVID-19.