Open AccessChloroquine and Hydroxychloroquine for the Prevention and Treatment of COVID-19: A Fiction, Hope or Hype? An Updated Review
Author(s) -
Sultan Ayesh Mohammed Saghir,
Naif A. Al-Gabri,
Mahmoud Alagawany,
Youssef A. Attia,
Salem R. Alyileili,
Shaaban S. Elnesr,
Manal E. Shafi,
Omar Alshargi,
Nader Al-balagi,
Abdullah Saleh Al-wajeeh,
Omar Saeed Ali Al-Salahi,
Amlan Kumar Patra,
Asmaa F. Khafaga,
Ahmed Negida,
Ahmed E. Noreldin,
Wesam Al-Amarat,
Amer Abdulrahman Almaiman,
Khaled A. ElTarabily,
Mohamed E. Abd ElHack
Publication year - 2021
Publication title -
therapeutics and clinical risk management
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.719
H-Index - 55
eISSN - 1178-203X
pISSN - 1176-6336
DOI - 10.2147/tcrm.s301817
Subject(s) - medicine , hydroxychloroquine , repurposing , regimen , pandemic , clinical trial , chloroquine , azithromycin , intensive care medicine , virology , pharmacology , covid-19 , disease , immunology , malaria , infectious disease (medical specialty) , ecology , microbiology and biotechnology , biology , antibiotics
In December 2019, the novel coronavirus disease pandemic (COVID-19) that began in China had infected so far more than 109,217,366 million individuals worldwide and accounted for more than 2,413,912 fatalities. With the dawn of this novel coronavirus (SARS-CoV-2), there was a requirement to select potential therapies that might effectively kill the virus, accelerate the recovery, or decrease the case fatality rate. Besides the currently available antiviral medications for human immunodeficiency virus (HIV) and hepatitis C virus (HCV), the chloroquine/hydroxychloroquine (CQ/HCQ) regimen with or without azithromycin has been repurposed in China and was recommended by the National Health Commission, China in mid-February 2020. By this time, the selection of this regimen was based on its efficacy against the previous SARS-CoV-1 virus and its potential to inhibit viral replication of the SARS-CoV-2 in vitro. There was a shortage of robust clinical proof about the effectiveness of this regimen against the novel SARS-CoV-2. Therefore, extensive research effort has been made by several researchers worldwide to investigate whether this regimen is safe and effective for the management of COVID-19. In this review, we provided a comprehensive overview of the CQ/HCQ regimen, summarizing data from in vitro studies and clinical trials for the protection against or the treatment of SARS-CoV-2. Despite the initial promising results from the in vitro studies and the widespread use of CQ/HCQ in clinical settings during the 1st wave of COVID-19, current data from well-designed randomized controlled trials showed no evidence of benefit from CQ/HCQ supplementation for the treatment or prophylaxis against SARS-CoV-2 infection. Particularly, the two largest randomized controlled trials to date (RECOVERY and WHO SOLIDARITY trials), both confirmed that CQ/HCQ regimen does not provide any clinical benefit for COVID-19 patients. Therefore, we do not recommend the use of this regimen in COVID-19 patients outside the context of clinical trials.