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A pharmacological perspective of chloroquine in SARS-CoV-2 infection: An old drug for the fight against a new coronavirus?
Int J Antimicrob Agents. 2020 Sep; 56(3):106078.IJ

Abstract

The coronavirus disease 2019 (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is having serious consequences on health and the economy worldwide. All evidence-based treatment strategies need to be considered to combat this new virus. Drugs need to be considered on scientific grounds of efficacy, safety and cost. Chloroquine (CQ) and hydroxychloroquine (HCQ) are old drugs used in the treatment of malaria. Moreover, their antiviral properties have been previously studied, including against coronaviruses, where evidence of efficacy has been found. In the current race against time triggered by the COVID-19 pandemic, the search for new antivirals is very important. However, consideration should be given to old drugs with known anti-coronavirus activity, such as CQ and HCQ. These could be integrated into current treatment strategies while novel treatments are awaited, also in light of the fact that they display an anticoagulant effect that facilitates the activity of low-molecular-weight heparin, aimed at preventing acute respiratory distress syndrome (ARDS)-associated thrombotic events. The safety of CQ and HCQ has been studied for over 50 years, however recently published data raise concerns for cardiac toxicity of CQ/HCQ in patients with COVID-19. This review also re-examines the real information provided by some of the published alarming reports, although concluding that cardiac toxicity should in any case be stringently monitored in patients receiving CQ/HCQ.

Authors+Show Affiliations

Department of Pharmacology, Facultad de Medicina, Universidad Nacional Mayor de San Marcos, Lima, Peru, and Drug Safety Research Center, Facultad de Medicina Humana, Universidad de San Martín de Porres, Hospital Almenara, ESSALUD, Lima, Peru. Electronic address: tjoscanoae2017@gmail.com.Discipline of Medical Gerontology, Mercer's Institute for Successful Ageing, St James's Hospital, Dublin, Ireland, and Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland.Centro de Estudios sobre la Seguridad de los Medicamentos (CESME), Universidad de Valladolid, Valladolid, Spain.Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy.

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

32629115

Citation

Oscanoa, Teodoro J., et al. "A Pharmacological Perspective of Chloroquine in SARS-CoV-2 Infection: an Old Drug for the Fight Against a New Coronavirus?" International Journal of Antimicrobial Agents, vol. 56, no. 3, 2020, p. 106078.
Oscanoa TJ, Romero-Ortuno R, Carvajal A, et al. A pharmacological perspective of chloroquine in SARS-CoV-2 infection: An old drug for the fight against a new coronavirus? Int J Antimicrob Agents. 2020;56(3):106078.
Oscanoa, T. J., Romero-Ortuno, R., Carvajal, A., & Savarino, A. (2020). A pharmacological perspective of chloroquine in SARS-CoV-2 infection: An old drug for the fight against a new coronavirus? International Journal of Antimicrobial Agents, 56(3), 106078. https://doi.org/10.1016/j.ijantimicag.2020.106078
Oscanoa TJ, et al. A Pharmacological Perspective of Chloroquine in SARS-CoV-2 Infection: an Old Drug for the Fight Against a New Coronavirus. Int J Antimicrob Agents. 2020;56(3):106078. PubMed PMID: 32629115.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A pharmacological perspective of chloroquine in SARS-CoV-2 infection: An old drug for the fight against a new coronavirus? AU - Oscanoa,Teodoro J, AU - Romero-Ortuno,Roman, AU - Carvajal,Alfonso, AU - Savarino,Andrea, Y1 - 2020/07/04/ PY - 2020/03/31/received PY - 2020/06/24/revised PY - 2020/06/28/accepted PY - 2020/7/7/pubmed PY - 2020/9/12/medline PY - 2020/7/7/entrez KW - Antiviral KW - COVID-19 KW - Chloroquine KW - Hydroxychloroquine KW - SARS-CoV-2 SP - 106078 EP - 106078 JF - International journal of antimicrobial agents JO - Int J Antimicrob Agents VL - 56 IS - 3 N2 - The coronavirus disease 2019 (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is having serious consequences on health and the economy worldwide. All evidence-based treatment strategies need to be considered to combat this new virus. Drugs need to be considered on scientific grounds of efficacy, safety and cost. Chloroquine (CQ) and hydroxychloroquine (HCQ) are old drugs used in the treatment of malaria. Moreover, their antiviral properties have been previously studied, including against coronaviruses, where evidence of efficacy has been found. In the current race against time triggered by the COVID-19 pandemic, the search for new antivirals is very important. However, consideration should be given to old drugs with known anti-coronavirus activity, such as CQ and HCQ. These could be integrated into current treatment strategies while novel treatments are awaited, also in light of the fact that they display an anticoagulant effect that facilitates the activity of low-molecular-weight heparin, aimed at preventing acute respiratory distress syndrome (ARDS)-associated thrombotic events. The safety of CQ and HCQ has been studied for over 50 years, however recently published data raise concerns for cardiac toxicity of CQ/HCQ in patients with COVID-19. This review also re-examines the real information provided by some of the published alarming reports, although concluding that cardiac toxicity should in any case be stringently monitored in patients receiving CQ/HCQ. SN - 1872-7913 UR - https://www.unboundmedicine.com/medline/citation/32629115/A_pharmacological_perspective_of_chloroquine_in_SARS_CoV_2_infection:_An_old_drug_for_the_fight_against_a_new_coronavirus L2 - https://linkinghub.elsevier.com/retrieve/pii/S0924-8579(20)30248-X DB - PRIME DP - Unbound Medicine ER -