COVID-19: a recommendation to examine the effect of hydroxychloroquine in preventing infection and progression

Abstract

A novel coronavirus disease (COVID-19), caused by infection with SARS-CoV-2, has swept across 31 provinces in China and over 40 countries worldwide. The transition from first symptoms to acute respiratory distress syndrome (ARDS) is highly likely to be due to uncontrolled cytokine release. There is an urgent need to identify safe and effective drugs for treatment. Chloroquine (CQ) exhibits a promising inhibitory effect. However, the clinical use of CQ can cause severe side effects. We propose that hydroxychloroquine (HCQ), which exhibits an antiviral effect highly similar to that of CQ, could serve as a better therapeutic approach. HCQ is likely to attenuate the severe progression of COVID-19, inhibiting the cytokine storm by suppressing T cell activation. It has a safer clinical profile and is suitable for those who are pregnant. It is cheaper and more readily available in China. We herein strongly urge that clinical trials are performed to assess the preventive effects of HCQ in both disease infection and progression.

Review of Current Evidence of Hydroxychloroquine in Pharmacotherapy of COVID-19

“…12 The non-glycosylated ACE2 receptor might interact inefficiently with the SARS-CoV-2 spike protein, thus inhibiting the viral entry. 13 These myriad mechanisms of HCQ and its relative lesser toxicity profile as compared to chloroquine make it an attractive candidate in the pursuit of drug repositioning. In this highly demanding scenario of huge unmet need and steeply increasing morbidity and mortality of COVID-19, many government bodies and expert panels have recommended the use of chloroquine and HCQ for the prophylaxis and treatment of COVID-19.…”

Old and new antirheumatic drugs for the treatment of COVID-19

“…A recent French study on 36 patients indicated that adding azithromycin to HCQ resulted in further reduction of viral load [15]. Furthermore, the role of HCQ has been emphasized in the treatment of COVID infection during pregnancy [16]. The development of cytokine release syndrome and T cell abnormalities plays a key role in the progression of COVID-19.…”

All about COVID-19 in brief

“…Despite the efficacy of these two drugs in the recovery process, there may be some side effects including gastrointestinal responses, risk of cardiac arrhythmias and risk of retinal damage; especially with long term use [16,17].…”