Virological and clinical cure in COVID-19 patients treated with hydroxychloroquine: A systematic review and meta-analysis

Following the demonstration of the efficacy of hydroxychloroquine against severe acute respiratory syndrome coronavirus 2 in vitro, many trials started to evaluate its efficacy in clinical settings. However, no systematic review and meta-analysis have addressed the issue of the safety and efficacy of hydroxychloroquine (HCQ) in coronavirus disease 2019. We conducted a systematic review and meta-analysis with the objectives of evaluation of safety and efficacy of HCQ alone or in combination in terms of “time to clinical cure,” “virological cure,” “death or clinical worsening of disease,” “radiological progression,” and safety. RevMan was used for meta-analysis. We searched 16 literature databases out of which seven studies (n = 1358) were included in the systematic review. In terms of clinical cure, two studies reported possible benefit in “time to body temperature normalization” and one study reported less “cough days” in the HCQ arm. Treatment with HCQ resulted in less number of cases showing the radiological progression of lung disease (odds ratio [OR], 0.31, 95% confidence interval [CI], 0.11-0.9). No difference was observed in virological cure (OR, 2.37, 95% CI, 0.13-44.53), death or clinical worsening of disease (OR, 1.37, 95% CI, 1.37-21.97), and safety (OR, 2.19, 95% CI, 0.59-8.18), when compared with the control/conventional treatment. Five studies reported either the safety or efficacy of HCQ + azithromycin. Although seems safe and effective, more data are required for a definitive conclusion. HCQ seems to be promising in terms of less number of cases with radiological progression with a comparable safety profile to control/conventional treatment. We need more data to come to a definite conclusion.     

A review on point of care tests in parasitology

BackgroundInfectious diseases can be of serious public concerns because of its transmissibility. The parasitic infectious diseases in particular are often seen as neglected diseases of poverty. The diagnostic tests for parasitic diseases barring malaria are not easily available specially in low resources settings where they are needed most. The conventional mode of diagnosis based on centralized laboratory is time consuming and resource intensive. The modern-day medicine has shifted the focus to patient care. The use of point of care tests (POCT) has increased worldwide because they provide rapid diagnosis within the consultation time that too near patient care areas. This is very useful for starting initial treatment. These POCT provide excellent solution for rural and hard to reach areas where parasitic diseases are most prevalent. Despite the high demand, a relatively limited number of validated rapid diagnostics are commercially available for parasitic infections.Objectives and contentThis review aims to discuss various POCT available for these neglected parasitic diseases. Accurate detection of parasitic infection underpins a holistic approach to its control and management. The POCT can also be used to screen mass population to detect asymptomatic reservoirs and monitor interventions planned for elimination programs for many parasitic diseases. Recently focus is on integrated platforms and analysis of multiple analytes from single sample. Researchers are striving to produce POCT based on innovative technology such as lab-on-chip that can be made more affordable and suitable for low resource settings.