Abstract
The pandemic of COVID-19, caused by SARS-CoV-2, has recently overwhelmed medical centers and paralyzed economies. The unparalleled public distress caused by this pandemic mandated an urgent quest for an effective approach to manage or treat this disease. Due to their well-established anti-infectious and anti-inflammatory properties, quinine derivatives have been sought as potential therapies for COVID-19. Indeed, these molecules were originally employed in the treatment and prophylaxis of malaria, and later in the management of various autoimmune rheumatic and dermatologic diseases. Initially, some promising results for the use of hydroxychloroquine (HCQ) in treating COVID-19 patients were reported by a few in vitro and in vivo studies. However, current evidence is not yet sufficiently solid to warrant its use as a therapy for this disease. Additionally, the therapeutic effects of HCQ are not without many side effects, which range from mild gastrointestinal effects to life-threatening cardiovascular and neurological effects. In this review, we explore the controversy associated with the repurposing of HCQ to manage or treat COVID-19, and we discuss the cellular and molecular mechanisms of action of HCQ.
Highlights
Coronaviruses (CoVs) belong to the Coronaviridae family, and usually cause mild acute respiratory illnesses or “common cold” (Su et al, 2016)
The first study conducted by Gautret el al is a single-center non-randomized clinical trial limited by the lack of randomization and blinding and the minimal number of enrolled participants
This study demonstrated that HCQ and azithromycin can be safely used in patients with early disease, in the absence of associated complications
Summary
Coronaviruses (CoVs) belong to the Coronaviridae family, and usually cause mild acute respiratory illnesses or “common cold” (Su et al, 2016). The cause of these cases appeared to be a novel coronavirus (CoV) This novel virus shares around 96% with bat-CoV RaTG13 and around 80% sequence similarity with the SARSCoV (Lu et al, 2020; Zhou et al, 2020b). It was given the name SARS-CoV-2, and the disease it causes was called coronavirus infectious disease 2019, or shortly COVID-19. Various clinical symptoms with multi-organ involvement related to COVID-19 infection have been reported (Guan et al, 2020) These include respiratory, gastrointestinal, renal, neurologic and integumentary manifestations (Adhikari et al, 2020; Recalcati, 2020). We discuss the therapeutic value of this drug, along with its adverse effects
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