Hydroxychloroquine/chloroquine and the risk of acute kidney injury in COVID-19 patients: a systematic review and meta-analysis.

OBJECTIVES: Hydroxychloroquine/chloroquine has been widely used as part of the standard treatment for patients with coronavirus disease 2019 (COVID-19). We conducted a systematic review and meta-analysis to determine whether hydroxychloroquine/chloroquine increases the risk of acute kidney injury (AKI) in COVID-19 patients. METHODS: PubMed and Embase were searched for related publications from inception to Dec 31, 2021, including randomized controlled trials (RCTs) and non-randomized studies of interventions (NRSIs) comparing the risk of AKI and/or increased creatinine in COVID-19 patients receiving hydroxychloroquine/chloroquine and other controls (active treatment and placebo). We conducted separate meta-analyses for RCTs and NRSIs based on fixed-effect model, with odds ratios (ORs) being considered as effect sizes. RESULTS: We included 21 studies in the analysis, with 12 were RCTs. Based on the RCTs, compared to placebo, the OR was 1.19 (95% confidence interval [CI]: 0.86, 1.64; p = .30, n = 4, moderate quality) for AKI and 1.00 (95%CI: 0.64, 1.56; p = .99, n = 5, moderate quality) for increased creatinine for patients received hydroxychloroquine/chloroquine treatment; compared to active treatment, the odds was 1.28 (95%CI: 0.65, 2.53; p = .47, n = 2, low quality) for AKI and 0.64 (95%CI: 0.13, 3.20; p = .59, n = 1, low quality) for increased creatine. Evidence from NRSIs showed slightly increased odds of AKI, with low quality. CONCLUSION: Based on current available studies which were graded as low to moderate quality, there is insufficient evidence to conclude that hydroxychloroquine/chloroquine use is associated with increased risk of AKI or raised creatinine. Abbreviations: AKI: acute kidney injury; COVID-19: Coronavirus Disease 2019; RCT: randomized controlled trials; NRSI: non-randomized studies of interventions; OR: odds ratios; ROBIS-I: Risk Of Bias In Non-randomized Studies - of Interventions.

The Status Quo and Attribution of Wildlife Crimes: A Study of Cases in China From the Perspective of Ecological Economic Ethics.

The COVID-19 pandemic, which has ravaged the world, has led to a rethinking of the relationship between humans and nature and the clichés of the economic-centered model. Thus, the ecological economy has been reviewed, especially from an ethical worldview. This paper uses statistical methods to retrieve and categorize 3,646 wildlife crime cases for analysis and quantitative research. It adopts legal and ethical perspectives to analyze the subject and the subjective, incidence, and sentencing factors of wildlife crimes and uses the ecological economic ethical model to measure wildlife crimes. We argue that the existing judicial system fails to answer the difficulties of the economic ethics of wildlife crimes. It is recommended that ecological and economic ethical awareness be internalized. We suggest calling for comprehensive legislation on wildlife crimes from the perspective of ecological economic ethics to effectively prevent and reduce wildlife crime and eventually promote public health.