Therapeutic use of chloroquine and hydroxychloroquine in COVID-19 and other viral infections: A narrative review

Travel Med Infect Dis. 2020 May-Jun:35:101735. doi: 10.1016/j.tmaid.2020.101735. Epub 2020 May 6.

Abstract

The rapidly spreading Coronavirus Disease (COVID-19) pandemic, caused by the severe acute respiratory syndrome coronavirus (SARS-CoV-2), represents an unprecedented serious challenge to the global public health community. The extremely rapid international spread of the disease with significant morbidity and mortality made finding possible therapeutic interventions a global priority. While approved specific antiviral drugs against SARS-CoV-2 are still lacking, a large number of existing drugs are being explored as a possible treatment for COVID-19 infected patients. Recent publications have re-examined the use of Chloroquine (CQ) and/or Hydroxychloroquine (HCQ) as a potential therapeutic option for these patients. In an attempt to explore the evidence that supports their use in COVID-19 patients, we comprehensively reviewed the previous studies which used CQ or HCQ as an antiviral treatment. Both CQ and HCQ demonstrated promising in vitro results, however, such data have not yet been translated into meaningful in vivo studies. While few clinical trials have suggested some beneficial effects of CQ and HCQ in COVID-19 patients, most of the reported data are still preliminary. Given the current uncertainty, it is worth being mindful of the potential risks and strictly rationalise the use of these drugs in COVID-19 patients until further high quality randomized clinical trials are available to clarify their role in the treatment or prevention of COVID-19.

Keywords: COVID-19; Chloroquine; Hydroxychloroquine; SARS-CoV-2.

Publication types

  • Review

MeSH terms

  • Animals
  • Antimalarials / adverse effects
  • Antimalarials / blood
  • Antimalarials / pharmacokinetics
  • Antimalarials / therapeutic use*
  • Antiviral Agents / blood
  • Antiviral Agents / pharmacokinetics
  • Antiviral Agents / therapeutic use*
  • Betacoronavirus / drug effects
  • Betacoronavirus / physiology*
  • Biological Availability
  • COVID-19
  • COVID-19 Drug Treatment
  • Coronavirus Infections / drug therapy*
  • Coronavirus Infections / virology
  • Half-Life
  • Humans
  • Hydroxychloroquine / adverse effects
  • Hydroxychloroquine / blood
  • Hydroxychloroquine / pharmacokinetics
  • Hydroxychloroquine / therapeutic use*
  • Pandemics
  • Pneumonia, Viral / drug therapy*
  • Pneumonia, Viral / virology
  • SARS-CoV-2
  • Treatment Outcome
  • Virus Internalization / drug effects
  • Virus Replication / drug effects

Substances

  • Antimalarials
  • Antiviral Agents
  • Hydroxychloroquine