COVID-19 Pandemic - A Narrative Review
of the Potential Roles of Chloroquine and
Hydroxychloroquine

Barros, Carlos M; Almeida, Carolina Aparecida de Faria; Pereira, B; Costa, Karla Cristinne Mancini; Pinheiro, Flaviane A; Maia, Livia Del Bianco; Trindade, Cristiano M; Garcia, Raphael Caio Tamborelli; Torres, Larissa H; Diwan, Sudhir; Boralli, Vanessa Bergamin

doi:10.36076/ppj.2020/23/s351

Cited by 10 publications

(5 citation statements)

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“…Many recommendations call for additional studies from different geographic regions with different population genetic structures, since there is no precise statement on the efficacy or safety of the drug at any time in the course of COVID-19 treatment. 98 Intense debates and constructive criticisms have been raised. For instance, while many satisfactory responses have been summarized, the major mechanisms, pharmacokinetics, therapeutic applications, and safety profiles of the immunomodulatory and antiviral drug, 53 have called into question the safety and mechanism of action of the drug.…”

Section: Discussionmentioning

confidence: 99%

Profiles of Independent-Comorbidity Groups in Senior COVID-19 Patients Reveal Low Fatality Associated with Standard Care and Low-Dose Hydroxychloroquine over Antivirals

Said¹,

Alsolami²,

Alreshidi³

et al. 2023

JMDH

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The lack of feasible therapies and comorbidities aggravate the COVID-19 case-fatality rate (CFR). However, reports examining CFR associations with diabetes, concomitant cardiovascular diseases, chronic kidney disease, and chronic liver disease (CLD) are limited. More studies assessing hydroxychloroquine (Hcq) and antivirals are needed. Purpose: To examine associations of COVID-19 CFR in comorbid patient groups each with single comorbidities and after treatment with Hcq, favipiravir, and dexamethasone (Dex), either alone or in combination versus standard care. Methods: Using statistical analysis, we descriptively determined these associations among 750 COVID-19 patient groups during the last quarter of 2021. Results: A diabetes comorbidity (40%, n=299) showed twice the fatality (CFR 14%) of the others (CFR 7%; P=0.001). Hypertension (Htn) was the second-commonest comorbidity (29.5%, n=221), with similar CFR to diabetes (15% and 7% for Htn and non-Htn, respectively), but with higher significance (P=0.0006167). Although only 4% (n=30) heart failure (HF) was reported, the CFR (40%) was much higher than in those without it (8%). A similar rate (4%) for chronic kidney disease was reported, with CFRs of 33% and 9% among those with and without it, respectively (P=0.00048). Ischemic heart disease was 11% (n=74), followed by chronic liver disease (0.4%) and history of smoking (1%); however, these were not significant due to the sample sizes. Treatment indicated standard care and Hcq alone or in combination were superior (CFR of 4% and 0.5%, respectively) compared to favipiravir (25%) or Dex (38.5%) independently or in combination (35.4%). Furthermore, Hcq performed well (CFR 9%) when combined with Dex (9%; P=4.28-26 ). Conclusion:The dominance of diabetes and other comorbidities with significant association with CFR implied existence of a common virulence mechanism. The superiority of low-dose Hcq and standard care over antivirals warrants further studies.

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Section: Discussionmentioning

confidence: 99%

Profiles of Independent-Comorbidity Groups in Senior COVID-19 Patients Reveal Low Fatality Associated with Standard Care and Low-Dose Hydroxychloroquine over Antivirals

Said¹,

Alsolami²,

Alreshidi³

et al. 2023

JMDH

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“…A hidroxicloroquina apresenta prejuízos significativos relativos ao risco de internações e alta taxa de mortalidade pelo possível aumento de arritmias cardíacas que ocasionam paradas cardíacas e óbito 17 . O uso de medicamentos sem prescrição médica gera complicações e efeitos colaterais no organismo, interferindo em diagnósticos médicos e até nos exames para detectar precocemente os sintomas de infecções 18 .…”

Section: Discussionunclassified

Perfil de automedicação por acadêmicos de uma Instituição de Ensino Superior na pandemia da Covid-19

Pereira

Silva

Xavier

et al. 2023

R. Saúde Públ. Paraná

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A automedicação é um problema recorrente de saúde pública devido ao uso indiscriminado de medicamentos. Este estudo analisou o perfil de automedicação por acadêmicos de uma Instituição de Ensino Superior na pandemia da Covid-19 com base em um questionário aplicado on-line. A maioria dos participantes era do gênero feminino, cursando Farmácia, no 10° semestre e já atuando como profissional de saúde. Destes, 36,9% foram diagnosticados com a doença pelo médico a partir de exames laboratoriais, e os principais sintomas relatados foram dor de cabeça (16%) e febre (13,7%). Os medicamentos mais utilizados, prescritos ou não por médicos, foram analgésicos e antitérmicos. A indicação de medicamentos foi realizada por outros profissionais de saúde, como o farmacêutico. Conclui-se que a automedicação se agravou durante a pandemia devido à procura por medicação para atenuar os sintomas da Covid-19 ou a falta de fármacos eficazes para o tratamento do novo coronavírus.

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“…The absence of specific antiviral for COVID-19 gave the debatable medication “HCQ” a window to be used in a multi-center study that concluded that HQC alone was associated with a reduction in COVID-19 associated mortality [ 19 ].…”

Section: Discussionmentioning

confidence: 99%

The utilization of hydroxychloroquine to reduce the main signs and symptoms of COVID-19 patients, a cross-sectional study

Alsuwaidan

Memish

Alaklobi

et al. 2021

Annals of Medicine and Surgery

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Hydroxychloroquine and chloroquine were found to have positive results in some non-randomized clinical trials with more benefit in decreasing the viral load of COVID-19. Hydroxychloroquine (HCQ) is a lysosomotropic and lipophilic drug that can penetrate cell membranes, which accumulates in the acidic lysosomes. The high concentration of alkaline HCQ increases the pH in lysosomes from the normal levels of 4.7–4.8 to 6 which leads to inhibition of lysosomes functions and thus, prevents the entry of coronavirus into cells. Objectives and Aim: The main aim of this study is to find out the appropriateness of using HCQ in asymptomatic/mildly symptomatic COVID-19 positive patients in an attempt to reduce the development of signs and symptoms of COVID-19 and severe disease. Methodology Randomized selection, open-label trial to evaluate the efficacy of HCQ for patients presenting with asymptomatic COVID-19 upon diagnosis. Cases that met the inclusion criteria were divided into two arms [102 subjects to take HCQ (a loading dose of 400 mg twice daily given orally, followed by a maintenance dose of 200 mg twice daily for 4 days), and 100 subjects were used as a control group]. A follow-up for all the participants on daily basis for 14 days for any signs and symptoms (fever, cough, and shortness of breath). The main variables are action profile (represented by Area under the curve (AUC) for fever, cough, and shortness of breath statistically analyzed to differentiate between the two groups. Results Data in this study showed that HCQ has a positive action by reducing body temperature from the first day along the five days with HCQ intake for the subject receiving HCQ; this positive action was with a very significant action made a difference with (p < 0.001) compared with subjects who didn't receive HCQ. While there was no significant effect on cough or Shortness of breath. Conclusion The recommendation of this study is to utilize HCQ to all subjects with asymptomatic COVID-19 infection providing that these subjects are within the inclusion criteria of this study. There was no adverse drug reaction observed for HCQ on daily follow-up. ECG could be done after starting loading dose not before.

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COVID-19 Pandemic - A Narrative Review of the Potential Roles of Chloroquine and Hydroxychloroquine

Cited by 10 publications

References 0 publications

Profiles of Independent-Comorbidity Groups in Senior COVID-19 Patients Reveal Low Fatality Associated with Standard Care and Low-Dose Hydroxychloroquine over Antivirals

Profiles of Independent-Comorbidity Groups in Senior COVID-19 Patients Reveal Low Fatality Associated with Standard Care and Low-Dose Hydroxychloroquine over Antivirals

Perfil de automedicação por acadêmicos de uma Instituição de Ensino Superior na pandemia da Covid-19

The utilization of hydroxychloroquine to reduce the main signs and symptoms of COVID-19 patients, a cross-sectional study

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