Hydroxychloroquine in SARS-CoV-2 infection: Understanding the misadventure

Abstract

The widespread outbreak of SARS-CoV-2 was declared a public health emergency by the World Health Organization and various governments worldwide. This prompted the implementation of stringent infection control measures to curb the spread of the virus. Amidst this, the medical community faced the challenge of treating the virus without specific therapies or a vaccine, leading to reliance on empirical treatment approaches. In this context, hydroxychloroquine, an antimalarial and antirheumatic drug, gained attention as a potential treatment option. Despite its theoretical benefits, such as inhibiting viral entry, reducing inflammation, and modulating immune responses, empirical studies yielded inconsistent results. Some indicated a potential for symptom relief, while others showed no significant improvement in patient outcomes. The initial enthusiasm waned as the lack of substantial evidence led to revoking its Emergency Use Authorization, and several clinical trials were prematurely halted. The review in question critically examines the factors contributing to the ineffectiveness of hydroxychloroquine in treating SARS-CoV-2 infection, highlighting the complexities of drug repurposing during a rapidly evolving pandemic.