Substantial COVID-19 research investment has been allocated to randomized clinical trials (RCTs) on hydroxychloroquine/chloroquine, which currently face recruitment challenges or early discontinuation. We aim to estimate the effects of hydroxychloroquine and chloroquine on survival in COVID-19 from all currently available RCT evidence, published and unpublished.

We present a rapid meta-analysis of ongoing, completed, or discontinued RCTs on hydroxychloroquine or chloroquine treatment for any COVID-19 patients.

We systematically identified unpublished RCTs, and published RCTs.

All-cause mortality has been extracted (publications/preprints) or requested from investigators and combined in random-effects meta-analyses, calculating odds ratios (ORs) with 95% confidence intervals (CIs), separately for hydroxychloroquine and chloroquine.

Prespecified subgroup analyses include patient setting, diagnostic confirmation, control type, and publication status.

63 trials were potentially eligible. We included 14 unpublished trials (1,308 patients) and 14 publications/preprints (9011 patients).

Results for hydroxychloroquine are dominated by RECOVERY and WHO SOLIDARITY, two highly pragmatic trials, which employed relatively high doses and included 4,716 and 1,853 patients, respectively (67% of the total sample size).

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