Use Of Chloroquine Research Articles

Safety profile of COVID-19 drugs in a real clinical setting.

PurposeThe coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus has affected millions all over the world and has been declared pandemic, as of 11 March 2020. In addition to the ongoing research and development of vaccines, there is still a dire need for safe and effective drugs for the control and treatment against the SARS-CoV-2 virus infection. Numerous repurposed drugs are under clinical investigations whose reported adverse events can raise worries about their safety. The aim of this review is to illuminate the associated adverse events related to the drugs used in a real COVID-19 setting along with their relevant mechanism(s).MethodThrough a literature search conducted on PubMed and Google Scholar database, various adverse events suspected to be induced by eight drugs, including dexamethasone, hydroxychloroquine, chloroquine, remdesivir, favipiravir, lopinavir/ritonavir, ivermectin, and tocilizumab, administered in COVID-19 patients in clinical practice and studies were identified in 30 case reports, 3 case series, and 10 randomized clinical trials.ResultsMild, moderate, or severe adverse events of numerous repurposed and investigational drugs caused by various factors and mechanisms were observed. Gastrointestinal side effects such as nausea, abdominal cramps, diarrhea, and vomiting were the most frequently followed by cardiovascular, cutaneous, and hepatic adverse events. Few other rare adverse drug reactions were also observed.ConclusionIn light of their ineffectiveness against COVID-19 as evident in large clinical studies, drugs including hydroxychloroquine, lopinavir/ritonavir, and ivermectin should neither be used routinely nor in clinical studies. While lack of sufficient data, it creates doubt regarding the reliability of chloroquine and favipiravir use in COVID-19 patients. Hence, these two drugs can only be used in clinical studies. In contrast, ample well-conducted studies have approved the use of remdesivir, tocilizumab, and dexamethasone under certain conditions in COVID-19 patients. Consequently, it is significant to establish a strong surveillance system in order to monitor the proper safety and toxicity profile of the potential anti-COVID-19 drugs with good clinical outcomes.

Use of chloroquine and hydroxychloroquine in COVID-19 patients: A dilemma

The terror of coronavirus disease 2019 (COVID-19) is present universally. The number of cases is on rise. There is always debate about the use of chloroquine and hydroxychloroquine as a prophylaxis. Healthcare workers being the front-line soldiers need additional protection as compared to general population. This review article highlighted the mechanism of action of both drugs and their role in COVID-19 patients.

Patients’ approach to medicines in COVID-19

Several different guidelines and therapeutic recommendations have been reported for the treatment of COVID-19 since the announcement of the pandemic. In our study, the attitudes and approaches of patients with a medical indication for COVID-19 who were given drugs towards drug usage were evaluated. We aimed to present our data on the drug usage characteristics of patients to contribute to the literature. A total of 399 patients were included in the study. In the study, 51.1% of the patients were female, and 48.9% were male. The highest number of the patients were in the 18-30 age group (27.6%), the lowest number of the patients were 65 years old or older (9.8%). Twenty-five questions prepared by the researchers were asked to the patients to evaluate "their knowledge and attitudes on drug usage and disease prevention in COVID-19." Of the patients, 75.7% were not smokers. No history of chronic disease was present in 65.5% of the patients. It was determined that no drug was recommended for 9.8% of the patients, and hydroxychloroquine and favipiravir were recommended together in 49.9%. The rate of the use of chloroquine alone was 4.8%, and the rate of using only favipiravir was 32.8%. Eighty-two percent of the patients reported that they regularly used the drugs that were recommended. Among the patients, 11.5% either never used the recommended drugs or did not use them at the recommended dose and time. Of the 46 (11.5%) patients who did not use the prescribed drugs regularly, none died. In other words, improvement was observed in the patients who did not use the drugs that were recommended to them. Our aim in this study was to determine the rate and characteristics of the drugs prescribed by physicians in diagnosed patients. In this cross-sectional sample of Turkey, it was determined that the rate of recommended drug usage was sufficient with the data of the city where the study was carried out.

Clinical considerations with use of psychotropic medications in COVID-19 patients

Clinical considerations with use of psychotropic medications in COVID-19 patients

Hydroxychloroquine/Chloroquine Prophylaxis among Health-care Workers: Was it Really Preventive? - Evidence from a Multicentric Cross-sectional Study.

Background:Despite the low level of clinical evidence in hydroxychloroquine (HCQ) favor, it was prescribed for pre- and post-exposure prophylaxis in India and worldwide. In absence of a large randomized control trial, the evidence needs to be generated through observation study, hence the study was conducted to find the evidence for prophylaxis of HCQ.Materials and Methods:A multi-centric cross-sectional study involving government hospitals was chosen for serosurvey conducted from August 21, 2020, to November 20, 2020. Questionnaire was adopted from WHO. Data about chloroquine (CQ) use among health-care workers (HCWs) were added and the duration of CQ intake was also noted.Results:A total of 2,224 HCWs were recruited. The mean duration of time of taking HCQ was 7.1 weeks (standard deviation ± 6.1 weeks, median = 4 weeks with IQR, 3–10 weeks). Training on personal protective equipment (PPE), knowledge of handwashing, direct care to the patient, availability of alcohol hand rub, close contact with the patient, duration of contact, and usage of PPE were associated with HCQ intake. The antibody formation in group taking HCQ was 16.9% compared to 19.8% not taking it (P = 0.08). The Chi-square for linear trend for weeks of HCQ intake and antibody formation. However, the same was not statistically significant (Chi-square = 3.61, P = 0.06).Conclusion:Our study did not find a statistically significant association in the large multicentric study. The absolute difference of 2.9% in the two groups may not be sufficient to warrant its widespread use for prophylaxis.

Temporal evolution of the resistance genotypes of Plasmodium falciparum in isolates from Equatorial Guinea during 20\xa0years (1999 to 2019)

BackgroundMalaria is one of the deadliest diseases in the world, particularly in Africa. As such, resistance to anti-malarial drugs is one of the most important problems in terms of global malaria control. This study assesses the evolution of the different resistance markers over time and the possible influence of interventions and treatment changes that have been made in Equatorial Guinea.MethodsA total of 1223 biological samples obtained in the period 1999 to 2019 were included in the study. Screening for mutations in the pfdhfr, pfdhps, pfmdr1, and pfcrt genes was carried out by nested PCR and restriction-fragment length polymorphisms (RFLPs), and the study of pfk13 genes was carried out by nested PCR, followed by sequencing to determine the presence of mutations.ResultsThe partially and fully resistant haplotypes (pfdhfr + pfdhps) were found to increase over time. Moreover, in 2019, the fully resistant haplotype was found to be increasing, although its super-resistant counterpart remains much less prevalent. A continued decline in pfmdr1 and pfcrt gene mutations over time was also found. The number of mutations detected in pfk13 has increased since 2008, when artemisinin-based combination therapy (ACT) were first introduced, with more mutations being observed in 2019, with two synonymous and five non-synonymous mutations being detected, although these are not related to resistance to ACT. In addition, the non-synonymous A578S mutation, which is the most frequent on the African continent, was detected in 2013, although not in the following years.ConclusionsWithdrawal of the use of chloroquine (CQ) as a treatment in Equatorial Guinea has been shown to be effective over time, as wild-type parasite populations outnumber mutant populations. The upward trend observed in sulfadoxine-pyrimethamine (SP) resistance markers suggest its misuse, either alone or in combination with artesunate (AS) or amodiaquine (AQ), in some areas of the country, as was found in a previous study conducted by this group, which allows selective pressure from SP to continue. Single nucleotide polymorphisms (SNPs) 540E and 581G do not exceed the limit of 50 and 10%, respectively, thus meaning that SP is still effective as an intermittent preventive treatment (IPT) in this country. As for the pfk13 gene, no mutations have been detected in relation to resistance to ACT. However, in 2019 there is a greater accumulation of non-synonymous mutations compared to years prior to 2008.Graphical

Symptomatic severe acute respiratory syndrome coronavirus\xa02 reinfection in a lupus patient treated with hydroxychloroquine: a case report

BackgroundHydroxychloroquine and chloroquine have been used for hospitalized coronavirus disease 2019 patients because of their antiviral and anti-inflammatory function. However, little research has been published on the impact of the immunomodulatory effect of (hydroxy)chloroquine on humoral immunity.Case presentationWe report a case of symptomatic severe acute respiratory syndrome coronavirus 2 reinfection, diagnosed 141 days after the first episode, in a 56-year-old man of Black African origin treated with hydroxychloroquine for lupus erythematosus. No anti-severe acute respiratory syndrome coronavirus 2 IgG antibodies could be detected 127 days after the initial episode of coronavirus disease 2019.ConclusionsThe treatment with hydroxychloroquine probably explains the decreased immune response with negative serology and subsequent reinfection in our patient. As humoral immunity is crucial to fight a severe acute respiratory syndrome coronavirus 2 infection, the use of (hydroxy)chloroquine is likely to have a detrimental effect on the spread of the virus. This case emphasizes that more needs to be learned about the role of antibodies in protecting against severe acute respiratory syndrome coronavirus 2 (re)infection and the role of (hydroxy)chloroquine on humoral immunity.

Prospective Analysis Between Neutrophil-to-Lymphocyte Ratio on Admission and Development of Delirium Among Older Hospitalized Patients With COVID-19.

Objective: To examine any prospective association between neutrophil-to-lymphocyte ratio (NLR) at hospital admission and subsequent delirium in older COVID-19 hospitalized patients comparing by sex and age groups.Methods: The sample consisted of 1,785 COVID-19 adult inpatients (minimum sample size required of 635 participants) admitted to a public general hospital in Madrid (Spain) between March 16th and April 15th, 2020. Variables were obtained from electronic health records. Binary logistic regression models were performed between baseline NLR and delirium adjusting for age, sex, medical comorbidity, current illness severity, serious mental illness history and use of chloroquine and dexamethasone. An NLR cut-off was identified, and stratified analyses were performed by age and sex. Also, another biomarker was tested as an exposure (the systemic immune-inflammation index –SII).Results: 55.3% of the patients were men, with a mean age of 66.8 years. Roughly 13% of the patients had delirium during hospitalization. NLR on admission predicted subsequent delirium development (adjusted OR = 1.02, 95 percent CI: 1.00–1.04, p = 0.024). Patients between 69 and 80 years with NLR values > 6.3 presented a twofold increased risk for delirium (p = 0.004). There were no sex differences in the association between baseline NLR and delirium (p > 0.05) nor SII predicted delirium development (p = 0.341).Conclusion: NLR is a good predictor of delirium during hospitalization, especially among older adults, independently of medical comorbidity, illness severity, and other covariates. Routine blood tests on admission might provide valuable information to guide the decision-making process to be followed with these especially vulnerable patients.

OR13. Cardiac Arrythmias on COVID19 Patients: Characteristics, Correlated Risk Factors and Associated Outcomes

BackgroundArrythmias in COVID19 patients were often found. This study was aimed to investigate characteristic, risk factors, and outcome of arrhythmic COVID19 patients.MethodsThis was a single-centered study. All confirmed COVID19 patients admitted from May 2020 until March 2021 were included. Data were obtained from medical records. Patients with no ECG or incomplete medical record were excluded. Bivariate analysis through Chi Square was used to define association between arrhythmia risk factors, and outcomes.Results374 patients were included, ranged from 2 until 85 years old (mean 52.5 ± 15, median 54). Mostly were males (53.7%) with 10 days median hospice care. Fifty eight patients (15.50%) had arrhythmia, which were mainly sinus tachycardia, supraventricular tachycardia, ventricular extra systole (3.7% each) and atrial fibrillation (3.5%). Congestive heart failure (CHF) (31.9%) and hypertension (28.7%) were the main comorbid. Bivariate analysis was conducted. CHF increased risk of arrhythmia by two times (RR: 2.15, CI 95%: 1.21 – 3.83, p < 0.008) and chloroquine use by 1.17 times (RR: 1.17, CI 95%: 1.05 – 1.11, p < 0.04). Arrhythmia events increased mortality risk by 2.5 times (RR: 2.52, CI 95%: 1.41–4.48, p < 0.001). Eighteen patients (31.03%) with arrhythmia died, especially those with atrial fibrillation (7 patients).ConclusionSinus tachycardia, supraventricular tachycardia, ventricular extra systole, and atrial fibrillation were the most arrhythmia found. CHF and the use of chloroquine increased risk of arrhythmia. Arrythmia itself, especially atrial fibrillation, should be monitored as it increased mortality.

Clinical Review of COVID-19; Pathogenesis, Diagnosis, and Management.

Severe acute respiratory syndrome-coronavirus (SARS-CoV-2, or COVID-19 virus) is a worldwide pandemic pathogen infecting 210 territories. It belongs to the family coronaviriadae and the order Nidovirales. The SARS-CoV-2 virus is a positive-sense single-stranded RNA enveloped virus that includes spike proteins projecting from the envelope. The spike (S) protein interacts with the human angiotensin-converting enzyme 2 (ACE2) receptor, which plays a role in the viral entry into the cell. The SARS-CoV-2 virus is zoonotic; the wet animal market where live animals are sold is expected to be the source of infection. It is the third zoonotic coronavirus, after SARS-CoV and MERS-CoV. Transmission of the virus among humans is confirmed by direct contact, droplet infection, fecal-oral, and blood transmission. The symptoms of COVID 19 include fever, dry cough, headache, and difficulty in breathing. COVID 19 complications, including the development of acute respiratory distress syndrome (ARDS), acute organ injury, secondary infection, and shock, are common in immunocompromised and elderly patients. Up till now, there is no established treatment for COVID-19, and supportive measures including mechanical ventilation and the use of nonspecific anti-viral therapies such as Remdesevir, Liponavir, and chloroquine, are currently applied in severe cases. Also, until now, there is no approved vaccine for COVID-19. In this review, we have provided an update on the SARS-COV2 virus, focusing on the epidemiology, pathogenesis, clinical presentations, treatment options, and preventive measures associated with COVID-19 cases.

Peroxiredoxin 1 is essential for natamycin-triggered apoptosis and protective autophagy in hepatocellular carcinoma.

Hepatocellular carcinoma (HCC) is one of the most prevalent and lethal cancers worldwide and lacks effective treatment. Herein, we found that the antifungal Natamycin (NAT) exhibits antitumor activity by inducing apoptosis both in vitro and in vivo. Mechanistically, NAT downregulates the expression of Peroxiredoxin 1 (PRDX1) by promoting ubiquitination-mediated degradation, thereby leading to increased reactive oxygen species (ROS) accumulation and subsequent apoptosis. Exogenous overexpression of PRDX1 or N-acetyl-l-cysteine (NAC) pretreatment abrogates NAT-induced cytotoxicity in PLC/PRF/5 and Huh7 cells, suggesting the vital role of ROS in the antitumor properties of NAT. Of note, downregulation of PRDX1 decreases the phosphorylation of AKT, thereby inducing cytoprotective autophagy and combinational use of NAT and chloroquine (CQ) achieves better anti-tumor efficacy. Moreover, NAT acts synergistically with sorafenib (SOR) in HCC suppression. Collectively, our study provides an important molecular basis for NAT-induced cell death and suggests that the antifungal NAT holds the potential to be repurposed as an anticancer drug for HCC treatment.

Клінічний випадок хлорохінової макулопатії при тривалому лікуванні хлорохіном у пацієнтки із саркоїдозом легень

The article is on an important subject, chloroquine maculopathy associated with long-term use of chloroquine. Given that chloroquine has been widely used for the treatment of COVID-19, it is important to accumulate data on adverse reaction to chloroquine and its derivatives, especially in the populations of Europe where the practice of using these antimalarials was not so common as in Asia and Africa. The reported case exemplifies possible ocular side effects in patients on long-term use of chloroquine (Delagil). © Malachkova N. V., Kozlova T. Ie., 2021

Dialogical positions in a Whatsapp group regarding the use of chloroquine and hydroxychloroquine in the treatment of Covid-19

The objective of this article is to analyze the established discourses in conversations among members of WhatsApp group “Academia Saudável” (Healthy Academy), having as central issue the controversy of the use of chloroquine and hydroxychloroquine medicines in the treatment of Covid-19. For the analysis, the concepts of concrete utterance, responsible act, alien and authorial discourse, field of communication and discourse genres of Bakhtin's Dialogical Theory of Language and the Circle were summoned. The results demonstrate that each individual of the group has a prominent role in guaranteeing the conversation theme through his/her discursive positionings favorable or not to the use of these drugs in the fight against the new coronavirus.

Antitumor effects of chloroquine/hydroxychloroquine mediated by inhibition of the NF-κB signaling pathway through abrogation of autophagic p47 degradation in adult T-cell leukemia/lymphoma cells

Adult T-cell leukemia/lymphoma (ATLL) originates from human T-cell leukemia virus type 1 (HTLV-1) infection due to the activation of the nuclear factor-κB (NF-κB) signaling pathway to maintain proliferation and survival. An important mechanism of the activated NF-κB signaling pathway in ATLL is the activation of the macroautophagy (herafter referred to as autophagy in the remainder of this manuscript)-lysosomal degradation of p47 (NSFL1C), a negative regulator of the NF-κB pathway. Therefore, we considered the use of chloroquine (CQ) or hydroxychloroquine (HCQ) (CQ/HCQ) as an autophagy inhibitor to treat ATLL; these drugs were originally approved by the FDA as antimalarial drugs and have recently been used to treat autoimmune diseases, such as systemic lupus erythematosus (SLE). In this paper, we determined the therapeutic efficacy of CQ/HCQ, as NF-κB inhibitors, in ATLL mediated by blockade of p47 degradation. Administration of CQ/HCQ to ATLL cell lines and primary ATLL cells induced cell growth inhibition in a dose-dependent manner, and the majority of cells underwent apoptosis after CQ administration. As to the molecular mechanism, autophagy was inhibited in CQ-treated ATLL cells, and activation of the NF-κB pathway was suppressed with the restoration of the p47 level. When the antitumor effect of CQ/HCQ was examined using immunodeficient mice transplanted with ATLL cell lines, CQ/HCQ significantly suppressed tumor growth and improved the survival rate in the ATLL xenograft mouse model. Importantly, HCQ selectively induced ATLL cell death in the ATLL xenograft mouse model at the dose used to treat SLE. Taken together, our results suggest that the inhibition of autophagy by CQ/HCQ may become a novel and effective strategy for the treatment of ATLL.

No difference in biomarkers of ischemic heart injury and heart failure in patients with COVID-19 who received treatment with chloroquine phosphate and those who did not.

BackgroundChloroquine was promoted as a COVID-19 therapeutic early in the pandemic. Most countries have since discontinued the use of chloroquine due to lack of evidence of any benefit and the risk of severe adverse events. The primary aim of this study was to examine if administering chloroquine during COVID-19 imposed an increased risk of ischemic heart injury or heart failure.MethodsMedical records, laboratory findings, and electrocardiograms of patients with COVID-19 who were treated with 500 mg chloroquine phosphate daily and controls not treated with chloroquine were reviewed retrospectively. Controls were matched in age and severity of disease.ResultsWe included 20 patients receiving chloroquine (500 mg twice daily) for an average of five days, and 40 controls. The groups were comparable regarding demographics and biochemical analyses including C-reactive protein, thrombocytes, and creatinine. There were no statistically significant differences in cardiac biomarkers or in electrocardiograms. Median troponin T was 10,8 ng/L in the study group and 17.9 ng/L in the control group, whereas median NT-proBNP was 399 ng/L in patients receiving chloroquine and 349 ng/L in the controls.ConclusionsWe found no increased risk of ischemic heart injury or heart failure as a result of administering chloroquine. However, the use of chloroquine to treat COVID-19 outside of clinical trials is not recommended, considering the lack of evidence of its effectiveness, as well as the elevated risk of fatal arrythmias.

Antimalarial chloroquine indicated for viral infections: myth ou hope?

Aim: this article describes the use of chloroquine as an antimalarial agent with potential antivirotic indications for COVID-19 infections. Methods: On line searches and gray literature have been used in the construction of this articles, whose database include PUBMED Central, BVS/BIREME, Web of Science, Science Direct, Higher Level Personnel Improvement Coordinator (CAPES), Periodic Door (Portal de Periódicos da CAPES, The Cochrane Library and PROSPERO). Results: chloroquine and hydroxychloroquine has shown appropriate clinical reports when associated with the antibiotic Azithromycin. It has been authorized for the clinical treatment of grave acute forms of COVID infections by countries like Brazil and USA. Conclusions: Chloroquine seems to have potential antivirotic properties that may be useful in the treatment of the grave acute forms of COVID-19 associated with Azithromycin. Nevertheless, Its indication must include ECG monitoring due to the risk of cardiac QT prolongation able to cause sudden deaths.

Chloroquine and Hydroxychloroquine Use During Pregnancy and the Risk of Adverse Pregnancy Outcomes Using Real-World Evidence.

Introduction: Chloroquine (CQ) and hydroxychloroquine (HCQ) are currently used for the prevention/treatment of malaria, and treatment of systemic lupus erythematosus (SLE), and rheumatoid arthritis (RA). Although present data do not show their efficacy to treat COVID-19, they have been used as potential treatments for COVID-19. Given that pregnant women are excluded from randomized controlled trials, and present evidence are inconsistent and inconclusive, we aimed to investigate the safety of CQ or HCQ use in a large pregnancy cohort using real-world evidence.Methods: Using Quebec Pregnancy Cohort, we identified women who delivered a singleton liveborn, 1998–2015, (n = 233,748). The exposure time window for analyses on prematurity and low birth weight (LBW) was the second/third trimesters; was any time during pregnancy; only first trimester exposure was considered for analyses on major congenital malformations (MCM). The risk of prematurity, LBW, and MCM (overall and organ-specific) were quantified using generalized estimation equations.Results: We identified 288 pregnancies (0.12%) exposed to CQ (183, 63.5%) or HCQ (105, 36.5%) that resulted in liveborn singletons; CQ/HCQ was used for RA (17.4%), SLE (16.3%) or malaria (0.7%). CQ/HCQ was used for 71.8 days on average [standard-deviation (SD) 70.5], at a dose of 204.3 mg/d (SD, 155.6). We did not observe any increased risk related to CQ/HCQ exposure for prematurity (adjusted odds ratio [aOR] 1.39, 95%CI 0.84–2.30), LBW (aOR 1.11, 95%CI 0.59–2.06), or MCM (aOR 1.01, 95%CI 0.67–1.52).Conclusion: in this large CQ/HCQ exposed pregnancy cohort, we saw no clear increased risk of prematurity, LBW, or MCM, although number of exposed cases remained low.

Management of glioblastoma: a perspective from Mexico.

Access to healthcare in Mexico is available to its population via publicly and privately funded institutions. The public sector, administered by both the local and federal government under the jurisdiction of the Department of Health, provides healthcare to the majority of the country's population. Privately funded institutions vary in size and scope of practice, ranging from small clinics focused on family practice, to large tertiary hospitals with capacity for treating patients with complex conditions and performing clinical research. The evaluation and treatment of patients with cancer in Mexico is also available through both sectors. In the country's capital, Mexico City, patients with glioblastoma are primarily treated at the National Institute of Neurology and Neurosurgery and the National Institute of Oncology. Epidemiological data is incomplete due to the lack of a national cancer registry. In the case of neoplasms of the central nervous system, the available information suggests that gliomas represent 33% of all intracranial tumors. The treatment of patients in Mexico diagnosed with glioblastoma has not been standardized owing to the lack of resources in some communities and the expense of antineoplastic agents. Current options range from a biopsy only to maximal safe resection followed by adjuvant treatment with radiation and chemotherapy. Currently, basic science and clinical research is being conducted in academic institutions associated with universities and in private hospitals. Studies include the evaluation of tumor biology, neuroimaging biomarkers and new treatment options such as the use of chloroquine.

Systemic lupus erythematosus: Pharmacological differences between women and men and among age groups and geographical regions

Systemic lupus erythematosus (SLE) is a chronic and potentially fatal autoimmune disease. There are clinical differences between women and men and among age groups. Its treatment involves a heterogeneous group of drugs. The objective was to determine the pharmacological treatment patterns in a group of patients with SLE and compare them according to sex, age group and geographic region. This was a cross-sectional study that identified outpatient drugs used in patients with SLE from a population database of Colombians affiliated with the Colombian Health System. Sociodemographic and pharmacological variables were considered. Descriptive and bivariate analyses were performed. A total of 4307 patients with SLE were identified (median age, 44.2 years; 89.4% women). Disease-modifying antirheumatics were the most prescribed drugs (90.5%), especially chloroquine (54.4%), which predominated in all age groups and geographical regions. Hydroxychloroquine and methotrexate were the predominant prescribed drugs for women, while corticosteroids, chloroquine, azathioprine, and mycophenolate were the predominant prescribed drugs for men. The use of corticosteroids (prednisolone and prednisone) decreased with increasing age. Differences were found in the prescription of drugs for patients with SLE between women and men and among geographic regions and age groups. The use of chloroquine predominated over hydroxychloroquine, contrasting with clinical practice guidelines.

Opinion and uptake of chloroquine for treatment of COVID-19 during the mandatory lockdown in the sub-Saharan African region.

BackgroundAs the search for effective treatment of coronavirus disease 2019 (COVID-19) infection continues, the public opinion around the potential use of chloroquine (CQ) in treating COVID-19 remains mixed.AimTo examine opinion and uptake of CQ for treating COVID-19 in the sub-Saharan African (SSA) region.SettingThis study was conducted through an online survey software titled SurveyMonkey.MethodsAnonymous online survey of 1829 SSA countries was conducted during the lockdown period using Facebook, WhatsApp and authors’ networks. Opinion and uptake of CQ for COVID-19 treatment were assessed using multivariate analyses.ResultsAbout 14% of respondents believed that CQ could treat COVID-19 and of which, 3.2% took CQ for COVID-19 treatment. Multivariate analyses revealed that respondents from Central (adjusted odds ratios [aOR]: 2.54, 95% confidence interval [CI] 1.43, 4.43) and West Africa (aOR: 1.79, 95% CI 1.15, 2.88) had higher odds of believing that CQ could treat COVID-19. Respondents from East Africa reported higher odds for uptake of CQ for COVID-19 than Central, Western and Southern Africans. Knowledge of the disease and compliance with the public health advice were associated with both belief and uptake of CQ for COVID-19 treatment.ConclusionCentral and West African respondents were more likely to believe in CQ as a treatment for COVID-19 whilst the uptake of the medication during the pandemic was higher amongst East Africans. Future intervention discouraging the unsupervised use of CQ should target respondents from Central, West and East African regions.