COVID-19, Chloroquine Repurposing, and Cardiac Safety Concern: Chirality Might Help

Lentini, Giovanni; Cavalluzzi, Maria Maddalena; Habtemariam, Solomon

doi:10.3390/molecules25081834

Cited by 41 publications

(38 citation statements)

References 32 publications

(33 reference statements)

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“…Perhaps an avenue of future research could look into whether this could attenuate the off-target effect of HCQ and CQ on the hERG potassium channel, thereby improving clinical safety in terms of cardiotoxicity. 47…”

Section: Special Populationsmentioning

confidence: 99%

Hydroxychloroquine use in COVID-19: is the risk of cardiovascular toxicity justified?

et al. 2020

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The outbreak of COVID-19 in Wuhan, China and its declaration as a global pandemic by WHO has left the medical community under significant pressure to rapidly identify effective therapeutic and preventative strategies. Chloroquine (CQ) and its analogue hydroxychloroquine (HCQ) were found to be efficacious against SARS-CoV-2 when investigated in preliminary in vitro experiments. Reports of success in early clinical studies were widely publicised by news outlets, politicians and on social media. These results led several countries to approve the use of these drugs for the treatment of patients with COVID-19. Despite having reasonable safety profiles in the treatment of malaria and certain autoimmune conditions, both drugs are known to have potential cardiotoxic side effects. There is a high incidence of myocardial injury and arrhythmia reported with COVID-19 infection, and as such this population may be more susceptible to this side-effect profile. Studies to date have now demonstrated that in patients with COVID-19, these drugs are associated with significant QTc prolongation, as well as reports of ventricular arrhythmias. Furthermore, subsequent studies have failed to demonstrate clinical benefit from either drug. Indeed, clinical trials have also been stopped early due to safety concerns over HCQ. There is an urgent need for credible solutions to the global pandemic, but we argue that in the absence of high-quality evidence, there needs to be greater caution over the routine use or authorisation of drugs for which efficacy and safety is unproven.

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Section: Special Populationsmentioning

confidence: 99%

Hydroxychloroquine use in COVID-19: is the risk of cardiovascular toxicity justified?

et al. 2020

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“…Both the enantiomers show good antiviral activity, however, optimization in chirality will help to reduce side effects (diarrhea, nausea, cutaneous reactions, etc.) [43].…”

Section: Other Antiviralsmentioning

confidence: 99%

Drug repurposing: new strategies for addressing COVID-19 outbreak

Shende¹,

Khanolkar²,

Gaud³

2020

Expert Review of Anti-infective Therapy

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“…In fact, chloroquine [65][66][67][68], currently used to treat COVID-19, is structurally related to methylene blue. Preliminary data of a recent study suggest that methylene blue might be a good treatment for influenza-like illnesses, such as COVID-19 [69].…”

mentioning

confidence: 99%

Antimicrobial Photodynamic Therapy in the Control of COVID-19

2020

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Antimicrobial photodynamic therapy (aPDT), using well known, safe and cost-effective photosensitizers, such as phenothiazines, e.g., methylene blue (MB), or porphyrins, e.g., protoporphyrin-IX (PP-IX), might help to mitigate the COVID-19 either to prevent infections or to develop photoactive fabrics (e.g., masks, suits, gloves) to disinfect surfaces, air and wastewater, under artificial light and/or natural sunlight.

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COVID-19, Chloroquine Repurposing, and Cardiac Safety Concern: Chirality Might Help

Cited by 41 publications

References 32 publications

Hydroxychloroquine use in COVID-19: is the risk of cardiovascular toxicity justified?

Hydroxychloroquine use in COVID-19: is the risk of cardiovascular toxicity justified?

Drug repurposing: new strategies for addressing COVID-19 outbreak

Antimicrobial Photodynamic Therapy in the Control of COVID-19

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