Coalition: Advocacy for prospective clinical trials to test the post-exposure potential of hydroxychloroquine against COVID-19

Abstract

Our coalition of public health experts, doctors, and scientists worldwide want to draw attention to the need for high-quality evaluation protocols of the potential beneficial effect of hydroxychloroquine (HCQ) as a post-exposure drug for exposed people, meaning people with close contact with positive tested patients, including home and medical caregivers. We have reviewed the mechanisms of antiviral effect of HCQ, the risk-benefit ratio taking into consideration the PK/PD of HCQ and the thresholds of efficacy.We have studied its use as an antimalarial, an antiviral, and an immunomodulating drug and concluded that the use of HCQ at does matching that of the standard treatment of Systemic Lupus erythematous, which has proven safety and efficacy in terms of HCQ blood and tissue concentration adapted to bodyweight (2,3), at 6mg/kg/day 1 (loading dose) followed by 5 mg/kg/day, with a maximum limit of 600 mg/day in all cases should swiftly be clinically evaluated as a post-exposure drug for exposed people. J o u r n a l P r e -p r o o f Journal Pre-proof epidemic. However, its administration should be done under medical control to avo id potential side effects and to prevent an uncontrolled use leading to supply shortages. J o u r n a l P r e -p r o o f Journal Pre-proof J o u r n a l P r e -p r o o f Journal Pre-proof J o u r n a l P r e -p r o o f Journal Pre-proof J o u r n a l P r e -p r o o f Journal Pre-proof 40. Ujike M, Taguchi F. Incorporation of spike and membrane glycoproteins into coronavirus virions. Viruses. 3 avr 2015;7(4):1700-25. 41. Schrezenmeier E, Dörner T. Mechanisms of action of hydroxychloroquine and chloroquine: implications for rheumatology. Nat Rev Rheumatol. mars 2020;16(3):155-66. 42. Liu J, Cao R, Xu M, Wang X, Zhang H, Hu H, et al. Hydroxychloroquine, a less toxic derivative of chloroquine, is effective in inhibiting SARS-CoV-2 infection in vitro. Cell Discov. 2020;6:16.

Contributions of Latin American researchers in the understanding of the novel coronavirus outbreak: a literature review

“…However, concerns are focused on whether these medications could decrease viral load or prevent infection, clinical disease, clinical severity, or even death. Other factors, such as side effects, should also be considered (Kim et al, 2020;Monteiro et al, 2020;Picot et al, 2020). COVID-19 mainly affects the respiratory system, but it can also alter the central nervous system.…”

Global public health significances, healthcare perceptions of communities, treatments, prevention and control methods of COVID-19

“…Picot et al [31] Chloroquine and Hydroxychloroquine are mostly used to Prevention and treatment of Novel Coronavirus Disease (COVID-19) in Africa.…”

“…Currently, the main scientific surveillance and administration of supportive drugs for COVID-19 patients are helped to protect and assessed using a prospective methodical judgments to investigate its complication of hydroxychloroquine [30,31]. Mostly, drugs like chloroquine and hydroxychloroquine were used for the prevention and control of COVID-19 transmission and effectively treated the novel COVID-19 outbreak in Africa region [32].…”

A new proposed mechanism of some known drugs targeting the SARS-CoV-2 spike glycoprotein using molecular docking

“…Chloroquine and hydroxychloroquine, which have been used for malaria prevention and treatment for decades, as well as for the treatment and management of chronic in ammatory diseases such as systemic lupus erythematosus and rheumatoid arthritis, have gained signi cant focus as possible therapies [12][13][14]. Lopinavir is an antiretroviral protease inhibitor used in the treatment of HIV-1 infection combined with other antiretrovirals [15].…”