SARS-CoV-2 infection in a patient on chronic hydroxychloroquine therapy: Implications for prophylaxis

Dousa, Khalid M; Malavade, Sharad; Furin, Jennifer; Gripshover, Barbara; Hatszegi, Marjorie; Hojat, Leila; Saade, Elie; Salata, Robert A.

doi:10.1016/j.idcr.2020.e00778

Cited by 8 publications

(9 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…At this moment, dozens of clinical trials are ongoing worldwide to evaluate the safety and efficacy of CQ and HCQ in SARS-CoV-2 infection [ 111 ]. In addition, many trials are evaluating their use as potential prophylactic therapy [ 112 ]. Some of those recent clinical trials are listed in Table 2 .…”

Section: Therapeutic Agents With the Potential Of Interfering With Comentioning

confidence: 99%

Tackling the cytokine storm in COVID-19, challenges and hopes

et al. 2020

View full text Add to dashboard Cite

The outbreak of Coronavirus disease 2019 (COVID-19) is the current world health concern, presenting a public health dilemma with ascending morbidity and mortality rates exceeding any previous viral spread, without a standard effective treatment yet. SARS-CoV-2 infection is distinguished with multiple epidemiological and pathological features, one of them being the elevated levels of cytokine release, which in turn trigger an aberrant uncontrolled response known as “cytokine storm”. This phenomenon contributes to severe acute respiratory distress syndrome (ARDS), leading to pneumonia and respiratory failure, which is considered a major contributor to COVID-19-associated fatality rates. Taking into account that the vast majority of the COVID-19 cases are aggravated by the respiratory and multiorgan failure triggered by the sustained release of cytokines, implementing therapeutics that alleviate or diminish the upregulated inflammatory response would provide a therapeutic advantage to COVID-19 patients. Indeed, dexamethasone, a widely available and inexpensive corticosteroid with anti-inflammatory effects, has shown a great promise in reducing mortality rates in COVID-19 patients. In this review, we have critically compared the clinical impact of several potential therapeutic agents that could block or interfere with the cytokine storm, such as IL-1 inhibitors, IL-6 inhibitors, mast cell targeting agents, and corticosteroids. This work focused on highlighting and contrasting the current success and limitations towards the involvement of these agents in future treatment protocols.

show abstract

Section: Therapeutic Agents With the Potential Of Interfering With Comentioning

confidence: 99%

Tackling the cytokine storm in COVID-19, challenges and hopes

et al. 2020

View full text Add to dashboard Cite

show abstract

“…40,41 In a case study, the clinical outcomes of a SARS-CoV-2infected patient (39-year-old female), who, due to her RA medical history, was already on an oral HCQ treatment regimen (200 mg once a day), were measured. 42 Upon hospitalization, no treatments specifically targeting SARS-CoV-2 or inflammatory cascades were administered to the patient other than the continued use of HCQ. The patient was observed to have mild COVID-19 symptoms and was discharged from the hospital after 2 days.…”

Section: Clinical Trials and Human Datamentioning

confidence: 99%

A Review of the Preclinical and Clinical Efficacy of Remdesivir, Hydroxychloroquine, and Lopinavir-Ritonavir Treatments against COVID-19

et al. 2020

View full text Add to dashboard Cite

In December of 2019, an outbreak of a novel coronavirus flared in Wuhan, the capital city of the Hubei Province, China. The pathogen has been identified as a novel enveloped RNA beta-coronavirus named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The virus SARS-CoV-2 is associated with a disease characterized by severe atypical pneumonia known as coronavirus 2019 (COVID-19). Typical symptoms of this disease include cough, fever, malaise, shortness of breath, gastrointestinal symptoms, anosmia, and, in severe cases, pneumonia.1 The high-risk group of COVID-19 patients includes people over the age of 60 years as well as people with existing cardiovascular disease and/or diabetes mellitus. Epidemiological investigations have suggested that the outbreak was associated with a live animal market in Wuhan. Within the first few months of the outbreak, cases were growing exponentially all over the world. The unabated spread of this deadly and highly infectious virus is a health emergency for all nations in the world and has led to the World Health Organization (WHO) declaring a pandemic on March 11, 2020. In this report, we consolidate and review the available clinically and preclinically relevant results emanating from in vitro animal models and clinical studies of drugs approved for emergency use as a treatment for COVID-19, including remdesivir, hydroxychloroquine, and lopinavir-ritonavir combinations. These compounds have been frequently touted as top candidates to treat COVID-19, but recent clinical reports suggest mixed outcomes on their efficacies within the current clinical protocol frameworks.

show abstract

“…PrEP would also prevent high-risk individuals from acquiring infection from close contacts infected with the virus, and it would hopefully attenuate SARS-CoV-2 infection if it did occur. 13 Although a higher-dose regimen might be more effective, higher dosing would also increase the risk of adverse events without clear benefit at this point in the pandemic. 38 , 39 If symptoms of COVID-19 develop despite the use of PrEP, further treatment should be instituted immediately, as outlined in our previous publication.…”

Section: Hydroxychloroquine Prepmentioning

confidence: 99%

“…Based on worldwide experience with SARS-CoV-2, we now know that certain groups carry a higher risk of developing severe complications of COVID-19. 3,13,14 These groups can be classified according to the following risk factors: In addition, medical personnel have more than three times the risk of acquiring the disease from repeated exposure to infected patients and household contacts. 15,16 As schools reopen and asymptomatic children increase the risk of viral transmission, more teachers and parents will need protection against viral infection.…”

Section: Introductionmentioning

confidence: 99%

“…Based on worldwide experience with SARS-CoV-2, we now know that certain groups carry a higher risk of developing severe complications of COVID-19. 3 , 13 , 14 These groups can be classified according to the following risk factors: Hypertension Diabetes Obesity Chronic kidney disease Asthma/emphysema/smoking Congestive heart failure Liver cirrhosis Malignancy/immune suppression Age over 80 years old …”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

<p>Flattening the Risk: Pre-Exposure Prophylaxis for COVID-19</p>

Stricker¹,

Fesler²

2020

IDR

View full text Add to dashboard Cite

To date, more than 35 million people worldwide have been infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the agent of coronavirus disease 2019 (COVID-19), and more than one million have died in the COVID-19 pandemic. International economies are stalled and social isolation based on palpable fear of death remains the order of the day. The United States and other countries are moving toward resuming work activities and social interaction to boost economic recovery. While this makes financial sense, from a medical perspective our population has already suffered and will continue to suffer severe losses in the absence of a viable aggressive prophylaxis strategy for SARS-CoV-2. Herein, we present a plan to address this problem.

show abstract

SARS-CoV-2 infection in a patient on chronic hydroxychloroquine therapy: Implications for prophylaxis

Cited by 8 publications

References 18 publications

Tackling the cytokine storm in COVID-19, challenges and hopes

Tackling the cytokine storm in COVID-19, challenges and hopes

A Review of the Preclinical and Clinical Efficacy of Remdesivir, Hydroxychloroquine, and Lopinavir-Ritonavir Treatments against COVID-19

<p>Flattening the Risk: Pre-Exposure Prophylaxis for COVID-19</p>

Contact Info

Product

Resources

About