Chloroquine and Hydroxychloroquine for the Prevention and Treatment of COVID-19: A Fiction, Hope or Hype? An Updated Review

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 po...

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Published in:	Therapeutics and clinical risk management Vol. 17; pp. 371 - 387
Main Authors:	Saghir, Sultan A M, AlGabri, Naif A, Alagawany, Mahmoud M, Attia, Youssef A, Alyileili, Salem R, Elnesr, Shaaban S, Shafi, Manal E, Al-Shargi, Omar Y A, Al-Balagi, Nader, Alwajeeh, Abdullah S, Alsalahi, Omar S A, Patra, Amlan K, Khafaga, Asmaa F, Negida, Ahmed, Noreldin, Ahmed, Al-Amarat, Wesam, Almaiman, Amer A, El-Tarabily, Khaled A, Abd El-Hack, Mohamed E
Format:	Journal Article
Language:	English
Published:	New Zealand Dove Medical Press Limited 01-01-2021 Taylor & Francis Ltd Dove Dove Medical Press
Subjects:	Amino acids Antibiotics Antiviral agents Antiviral drugs Asymptomatic Care and treatment chloroquine Contraindications Coronaviruses COVID-19 Disease transmission Drug dosages drug safety Electrocardiography Enzymes Fatalities Glycoproteins Hallucinations Health aspects Hepatitis C virus HIV (Viruses) hydroxychloroquine Medical research Medicine, Experimental Pandemics Peptides Prevention Proteins Review Rheumatoid arthritis sars-cov-2 Severe acute respiratory syndrome coronavirus 2 treatments Viruses China Egypt COVID-19 chloroquine SARS-CoV-2 hydroxychloroquine drug safety antiviral drugs treatments
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Summary:	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.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 ObjectType-Review-3 content type line 23
ISSN:	1176-6336 1178-203X 1178-203X
DOI:	10.2147/TCRM.S301817