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. 2021 Jul 12;43:102135. doi: 10.1016/j.tmaid.2021.102135

Table 1.

Characteristics of included reviews.

First author, date of publication/submission, study design Scope of review Types of included studies and total participants Tool used to assess risk of bias ROB summary
Sarma (13 April 2020) [49]
Design - SRMA
Evaluation of safety and efficacy of HCQ alone or in combination RCTs – 3
Observational – 4
Participants −1358
ROBINS‐I tool, Newcastle
Ottawa Scale
High risk of selection, performance and detection bias. Unclear risk of bias in attrition & reporting bias
Chowdhury (28 April 2020) [28]
Design - SR
To review the literature currently available regarding the clinical use of CQ and HCQ as treatment in COVID-19 RCTs - 7
Total participants = 486
Cochrane ROB tool High risk (randomization, allocation concealment, and overall risk). 3 RCTs, 2 single arm, 1 observational
Singh (7 May 2020) [50]
Design - SRMA
Efficacy of HCQ in COVID-19 subjects on viral clearance and death due to all causes. RCTs = 5 (2 non-randomized CT
Observational = 5
Total participants = 2042
Jadad checklist, ROBINS I tool, Newcastle-Ottawa Scale 5/8 on Jadad checklist, Moderate quality on ROBINS I tool (n = 2), 7/8 on Newcastle-Ottawa Scale(n = 2)
Suranagi (13 May 2020) [51]
Design - SR
To systematically explore, analyse, rate the existing evidence of hydroxychloroquine in the light of published, unpublished and clinical trial data. RCTs- 3
Observational – 5
Total participants - 2047
Oxford CEBM critical appraisal tool Risk of bias was serious-very serious. Level of evidence quality/strength rating was GRADE level (low-very low) and CEBM level 2b–3b
Yang (14 May 2020) [52]
Design – SRMA
To demonstrate the significance of present evidence regarding benefits and safety of HCQ for treatment of COVID-19 RCTs- 3
Observational – 2
Total participants - 677
The Modified Downs and Black risk assessment scale The average Downs and Black score were 19, with a range between 18 and 22
Rodrigo (16 May 2020) [53]
Design – SR
To summarize evidence from human clinical studies for using HCQ or CQ as antiviral agents for any viral infection
20 agents for any viral infection
RCTs – 6
Total participants - 387
Cochrane risk of bias tool and Robbins Average score (3–5 out of 7). Main types of bias were selection, reporting, performance and detection bias
Chacko (20 May 2020) [54]
Design – SRMA
To evaluate the efficacy and safety of hydroxychloroquine among patients with COVID-19 infection. RCTs – 3
Observational – 8
Total participants 4306
Cochrane risk of bias tool and Robbins-1 Observational (3 low risk, 4 moderate, 1 high risk), RCT (risk of randomization bias, allocation bias and blinding)
Hernandez (27 May 2020) [30]
Design – SR
Summarize evidence about the benefits and harms of HCQ or CQ treatment or prophylaxis of (COVID-19). RCT – 3
Observational – 20
Total participants - 4186
ROBINS-I and the Cochrane Risk of Bias 2.0 Either no information or some concerns of bias to critical risk of bias
Shamshirian (28 May 2020) [55]
Design - SRMA
A review to overcome the controversies about the effectiveness of HCQ against COVID-19 RCTs – 14
Observational – 7
Total participants - 103 486
Jadad scale, ROBINS-I tool and Newcastle-Ottawa Scale High risk of bias in randomization sequence generation, allocation concealment, blinding and outcome assessment
Das (28 May 2020) [56]
Design – SR
Systematically review the therapeutic role of HCQ in COVID-19 RCT – 4
Observational – 8
NOS, Cochrane ROB tool High risk of bias in most included studies
Takla (30 May 2020) [31]
Design – SR
Clarify the strength of evidence for the relative efficacy and safety of CQ and HCQ treatment RCTs- 4
Observational – 15
Total participants - 107 948
Checklist of Review Criteria - Task Force of Academic Medicine and GERIME committee All the studies included scored 13 in the risk assessment criteria. “12 were judged to be of scientific rigour"
Jankelson (31 May 2020) [23]
Design – SR
Review risk of QT prolongation, torsades, ventricular arrhythmia and sudden death with short courses of CQ and HCQ in COVID-19 RCTs – 5
Observational – 6
Total participants - 1515
None reported Not reported
Wang (1 June 2020) [57]
Design – SR
Assess the published studies of Chloroquine (CQ) and hydroxychloroquine (HCQ) for the treatment of COVID-19 RCTs – 10
Total participants - 1831
Not reported Not reported