Hydroxychloroquine, a less toxic derivative of chloroquine, is effective in inhibiting SARS-CoV-2 infection in vitro

Abstract

Background: The rst case of a corona virus 2019 (COVID-19) infection in a Sri Lankan was reported on March 11, 2020. The situation in Sri Lanka changed with the rapid increase of personnel contracting COVID-19 in a Naval base camp that housed more than 4000 people. This provided a unique opportunity to study the effectiveness of hydroxychloroquine (HCQ) for post-exposure prophylaxis (PEP), while taking stringent, non-pharmacologic, public health measures to prevent spread. Our aim is to study the effectiveness and safety of HCQ for PEP among naval personnel with exposure to COVID-19 positive patients. Methods/design: This is a placebo-controlled, randomized, clinical trial carried out in the Naval base camp and quarantine centers of the Sri Lanka Navy, Ministry of Defense, Sri Lanka. Navy personnel who are exposed to a patient with con rmed COVID-19 infection but test negative for the virus on reverse, real-time polymerase chain reaction (rRT-PCR) at recruitment will be randomized, 200 to each arm, to receive HCQ or placebo, and monitored for the development of symptoms or rRT-PCR positivity for severe acute respiratory syndrome corona virus 2 (SARS-CoV-2) virus for 14 days. Discussion: This trial will provide high-quality evidence of the effectiveness and safety of HCQ as PEP for COVID-19. The study design is unique due to the circumstances of the outbreak in a con ned area among otherwise healthy adults, at a relatively early stage of its spread.

Chloroquine and hydroxychloroquine in the treatment of COVID-19 with or without diabetes: A systematic search and a narrative review with a special reference to India and other developing countries

“…However, an important question that still remains is whether HCQ has a similar effect on SARS-CoV-2 infection. Some data show HCQ effectively inhibited both the entry, transport and the post-entry stages of SARS-CoV-2, similar to the chloroquine and one study found HCQ to be a more potent agent than chloroquine in inhibiting SARS-CoV-2 in vitro [12,13]. In addition, HCQ acts effectively on other intracellular bacterial infections such as Coxiella burnetii (Q fever) and Tropheryma whipplei (Whipple's disease) [14,15].…”

COVID-19 for the Cardiologist

“…CQ prevented viral replication of SARS-CoV1 in vitro (138). A follow-up study demonstrated comparable efficacy of HCQ, a less toxic derivative, and suggested that the mechanism of impaired endosomal maturation indeed applied to SARS-CoV2 infection in vitro (139). Only poor-quality, non-randomized, unblinded data exists assessing the benefit of HCQ in COVID-19 (140).…”

Blocking drug-induced autophagy with chloroquine in HCT-116 colon cancer cells enhances DC maturation and T cell responses induced by tumor cell lysate

“…As anti-inflammatory drugs, quinolones have been used to treat some autoimmune diseases [22]. Currently, there are a number of clinical trials and experimental studies focusing on the feasibility of using CQ and hydroxychloroquine against SARS-CoV-2 (COVID-19) [23,24] . In addition, the combination of CQ and antineoplastic drugs enhances the clinical response in patients with breast [25] and kidney cancer [26], showing a synergistic effect on the activation of mTOR (mammalian target of rapamycin), inhibiting autophagy, and thus increasing tumor cell death.…”