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Advances in the use of chloroquine and hydroxychloroquine for the treatment of COVID-19.
Postgrad Med. 2020 Sep; 132(7):604-613.PM

Abstract

Coronavirus Disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is spreading worldwide. Antiviral therapy is the most important treatment for COVID-19. Among the drugs under investigation, anti-malarials, chloroquine (CQ) and hydroxychloroquine (HCQ), are being repurposed as treatment for COVID-19. CQ/HCQ were shown to prevent receptor recognition by coronaviruses, inhibit endosome acidification, which interferes with membrane fusion, and exhibit immunomodulatory activity. These multiple mechanisms may work together to exert a therapeutic effect on COVID-19. A number of in vitro studies revealed inhibitory effects of CQ/HCQ on various coronaviruses, including SARS-CoV-2 although conflicting results exist. Several clinical studies showed that CQ/HCQ alone or in combination with a macrolide may alleviate the clinical symptoms of COVID-19, promote viral conversion, and delay disease progression, with less serious adverse effects. However, recent studies indicated that the use of CQ/HCQ, alone or in combination with a macrolide, did not show any favorable effect on patients with COVID-19. Adverse effects, including prolonged QT interval after taking CQ/HCQ, may develop in COVID-19 patients. Therefore, current data are not sufficient enough to support the use of CQ/HCQ as therapies for COVID-19 and increasing caution should be taken about the application of CQ/HCQ in COVID-19 before conclusive findings are obtained by well-designed, multi-center, randomized, controlled studies.

Authors+Show Affiliations

Xi'an Medical University , Xi'an, China. Department of Infectious Diseases, First Affiliated Hospital of Xi'an Jiaotong University , Xi'an, China.Xi'an Medical University , Xi'an, China. Department of Infectious Diseases, First Affiliated Hospital of Xi'an Jiaotong University , Xi'an, China.Department of Infectious Diseases, First Affiliated Hospital of Xi'an Jiaotong University , Xi'an, China.Department of Infectious Diseases, First Affiliated Hospital of Xi'an Jiaotong University , Xi'an, China.Department of Infectious Diseases, First Affiliated Hospital of Xi'an Jiaotong University , Xi'an, China.Department of Infectious Diseases, First Affiliated Hospital of Xi'an Jiaotong University , Xi'an, China.

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

32496926

Citation

Sun, JingKang, et al. "Advances in the Use of Chloroquine and Hydroxychloroquine for the Treatment of COVID-19." Postgraduate Medicine, vol. 132, no. 7, 2020, pp. 604-613.
Sun J, Chen Y, Fan X, et al. Advances in the use of chloroquine and hydroxychloroquine for the treatment of COVID-19. Postgrad Med. 2020;132(7):604-613.
Sun, J., Chen, Y., Fan, X., Wang, X., Han, Q., & Liu, Z. (2020). Advances in the use of chloroquine and hydroxychloroquine for the treatment of COVID-19. Postgraduate Medicine, 132(7), 604-613. https://doi.org/10.1080/00325481.2020.1778982
Sun J, et al. Advances in the Use of Chloroquine and Hydroxychloroquine for the Treatment of COVID-19. Postgrad Med. 2020;132(7):604-613. PubMed PMID: 32496926.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Advances in the use of chloroquine and hydroxychloroquine for the treatment of COVID-19. AU - Sun,JingKang, AU - Chen,YuTing, AU - Fan,XiuDe, AU - Wang,XiaoYun, AU - Han,QunYing, AU - Liu,ZhengWen, Y1 - 2020/06/21/ PY - 2020/6/5/pubmed PY - 2020/11/6/medline PY - 2020/6/5/entrez KW - Coronavirus KW - antiviral KW - chloroquine KW - hydroxychloroquine KW - sars-CoV-2 SP - 604 EP - 613 JF - Postgraduate medicine JO - Postgrad Med VL - 132 IS - 7 N2 - Coronavirus Disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is spreading worldwide. Antiviral therapy is the most important treatment for COVID-19. Among the drugs under investigation, anti-malarials, chloroquine (CQ) and hydroxychloroquine (HCQ), are being repurposed as treatment for COVID-19. CQ/HCQ were shown to prevent receptor recognition by coronaviruses, inhibit endosome acidification, which interferes with membrane fusion, and exhibit immunomodulatory activity. These multiple mechanisms may work together to exert a therapeutic effect on COVID-19. A number of in vitro studies revealed inhibitory effects of CQ/HCQ on various coronaviruses, including SARS-CoV-2 although conflicting results exist. Several clinical studies showed that CQ/HCQ alone or in combination with a macrolide may alleviate the clinical symptoms of COVID-19, promote viral conversion, and delay disease progression, with less serious adverse effects. However, recent studies indicated that the use of CQ/HCQ, alone or in combination with a macrolide, did not show any favorable effect on patients with COVID-19. Adverse effects, including prolonged QT interval after taking CQ/HCQ, may develop in COVID-19 patients. Therefore, current data are not sufficient enough to support the use of CQ/HCQ as therapies for COVID-19 and increasing caution should be taken about the application of CQ/HCQ in COVID-19 before conclusive findings are obtained by well-designed, multi-center, randomized, controlled studies. SN - 1941-9260 UR - https://www.unboundmedicine.com/medline/citation/32496926/Advances_in_the_use_of_chloroquine_and_hydroxychloroquine_for_the_treatment_of_COVID_19_ L2 - https://www.tandfonline.com/doi/full/10.1080/00325481.2020.1778982 DB - PRIME DP - Unbound Medicine ER -