Hydroxychloroquine and chloroquine in COVID-19: should they be used as standard therapy?

Ibáñez, Sebastián; Martinez, O.; Valenzuela, Felipe; Silva, Francisco; Valenzuela, Omar

doi:10.1007/s10067-020-05202-4

Cited by 43 publications

(41 citation statements)

References 41 publications

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“…The low prevalence of this clinical condition we found in patients with COVID-19 could be due to the use of HCQ and corticosteroids for the treatment of the viral infection which may prevent or weaken the inflammatory joint manifestations. Despite HCQ has not demonstrated to be effective in the treatment of COVID-19 [ 26 ], it has proven efficacy in the management of systemic rheumatological diseases, especially with inflammatory joint involvement. HCQ is the anchor drug in systemic lupus erythematosus, acting as immunomodulator, and prevents or mitigates lupus clinical manifestation in autoantibody positive asymptomatic subjects [ 27 ]; it is also part of the treatment for the milder forms of rheumatoid arthritis and Sjogren syndrome with frequent episodes of joint pain [ 28 ].…”

Section: Discussion and Review Of The Literaturementioning

confidence: 99%

Post-COVID-19 arthritis: a case report and literature review

et al. 2021

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Severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) is the novel pathogen responsible for the coronavirus disease 19 (COVID-19) outbreak. Researchers and clinicians are exploring the pathogenetic mechanisms of the viral-induced damage and growing interest is focusing on the short-term and long-term immune-mediated consequences triggered by the infection. We will focus on post-SARS-CoV2 infection arthritis which may arise as a new pathological condition associated with COVID-19. In this article, we describe a case of acute oligoarthritis occurring 13 days after a SARS-CoV2 severe pneumonia in a middle-aged Caucasian man and we go over a brief review of the current available literature. We hypothesize that molecular mimicry might be the basic immunological mechanism responsible for the onset of COVID-19-related arthritis based on the current knowledge of SARS-CoV2 and on the known pathogenetic mechanism of viral-induced arthritis.

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Section: Discussion and Review Of The Literaturementioning

confidence: 99%

Post-COVID-19 arthritis: a case report and literature review

et al. 2021

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“…An adequate quantity of antibodies must be administered to achieve effective results of the therapy. The protection given by this antibody to the patient depends upon Ibáñez et al [42] In vitro and clinical trial Hydroxychloroquine and chloroquine…”

Section: Results: Convalescent Plasmamentioning

confidence: 99%

An updated review of potential therapeutic agents against COVID-19

Ahmad

Sohail

Chishti

2020

Preprint

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Coronavirus disease of 2019 (COVID-19) is a public health emergency of international concern caused by a novel coronavirus, i.e., Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2). Since it is a new virus, an effective remedy against the virus is yet unknown. SARS-CoV-2 is a member of order nidovirales, family coronaviridae. Previously known treatment strategies against Middle East Respiratory Syndrome and Severe Acute Respiratory Syndromes are being tested for their effectiveness against SARS-CoV-2. Thus, various clinical and observational studies aimed at identifying potential therapies against the disease. In our study, we reviewed various drugs along with their mechanism of action, including anti-virals, anti-bacterials, glucocorticoids, ACE inhibitors, anti retrovirals, antimalarials, monoclonal antibodies, plasma, and many more. Individual drugs are described and evaluated for their potential to treat SARS-CoV-2 infection. This study offers a brief review of the findings of trials conducted so far. Dexamethasone, convalescent plasma therapy, tocilizumab, remdesivir, and combination therapies are found to be beneficial against SARS-CoV-2.

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“…All patients presented biomarkers compatible with hyperinflammation, impaired gas exchange, and rapid worsening of these despite receiving usual treatment. The use of hydroxychloroquine was infrequent since its prescription decreased when reports were published that warned of the ineffectiveness and risk of adverse events of its use ( 16 ).…”

Section: Discussionmentioning

confidence: 99%

First Report of Tocilizumab Use in a Cohort of Latin American Patients Hospitalized for Severe COVID-19 Pneumonia

et al. 2020

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Introduction/objectives: An interleukin-6 inhibition strategy could be effective in selected COVID-19 patients. The objective is to present our experience of tocilizumab use in patients with severe COVID-19. Methods: Observational retrospective cohort study. Hospitalized patients were evaluated by our multidisciplinary team for eventual use of tocilizumab. Patients with progressive ventilatory impairment and evidence of a hyperinflammatory state despite usual treatment received tocilizumab 8 mg/kg intravenous (maximum dose 800 mg), in addition to standard treatment. The use and time of use of mechanical ventilation (MV), the change of the Alveolar-arterial (A-a) gradient, of the ratio of arterial oxygen partial pressure to fractional inspired oxygen (PaO 2 /FiO 2 ) and of inflammation laboratory parameters after 72 h of tocilizumab use was evaluated. Results: 29 patients received tocilizumab. 93.1% were men, 37.9% were obese, and 34.5% had hypertension. Of the 20 patients who were not on MV when receiving tocilizumab, 11 required non-invasive MV, for an average of 5 days, and one of them required intubation. A-a gradient, PaO 2 /FiO 2 , and inflammation parameters improved significantly. A better lymphocyte count, which improved significantly after tocilizumab use, was significantly associated with less use of MV. Five patients presented positive culture samples after tocilizumab, three being of clinical significance. A lower lymphocyte count was associated with having a positive culture. No other significant adverse events were seen. Conclusion: Our study suggests the utility and shows the safety of tocilizumab use in COVID-19 patients who have respiratory failure and evidence of hyperinflammation. Lymphocyte improvement was a predictor of good response.

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Hydroxychloroquine and chloroquine in COVID-19: should they be used as standard therapy?

Cited by 43 publications

References 41 publications

Post-COVID-19 arthritis: a case report and literature review

Post-COVID-19 arthritis: a case report and literature review

An updated review of potential therapeutic agents against COVID-19

First Report of Tocilizumab Use in a Cohort of Latin American Patients Hospitalized for Severe COVID-19 Pneumonia

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