Chloroquine and hydroxychloroquine in the management of COVID-19: Much kerfuffle but little evidence

Roustit, Matthieu; Guilhaumou, Romain; Molimard, Mathiéu; Drici, Milou‐Daniel; Laporte, Silvy; Montastruc, J. L.

doi:10.1016/j.therap.2020.05.010

Cited by 41 publications

(39 citation statements)

References 58 publications

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“…In vitro, both chloroquine and HCQ may block the transport of SARS-CoV-2 from early endosomes to endolysosomes, in view of the in vitro activity of chloroquine against SARS-CoV [69,70]. Despite the potential efficacy of hydroxychloroquine in vitro, to date, no evidence supports its use as a COVID-19 treatment [17]. However, the question remains regarding patients already using this treatment before being exposed to SARS-CoV-2.…”

Section: Is There a Prophylactic Effect Of Hydroxychloroquine On Covimentioning

confidence: 99%

“…The increasing understanding of the COVID-19 has led to a growing interest in certain drugs used in these pathologies, including some non-specific antivirals and immunomodulators [13]. Chloroquine or hydroxychloroquine, particularly used in SLE, have been tested in many research protocols focusing on treatment of the infection or in postexposure prophylaxis [14][15][16][17]. The rational for use of other antirheumatic drugs is based on the inflammatory reaction associated with the cytokine storm (i.e.…”

Section: Introductionmentioning

confidence: 99%

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Challenges of autoimmune rheumatic disease treatment during the COVID-19 pandemic: A review

Grange

Guilpain

Truchetet³

et al. 2020

Therapies

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, the COVID-19 pandemic has become a major public health problem. To date, there is no evidence of a higher incidence of COVID in patients with autoimmune rheumatic diseases and we support the approach of maintaining chronic rheumatological treatments. However, once infected there is a small but significant increased risk of mortality. Among the different treatments, NSAIDs are associated with higher rates of complications, but data for other drugs are conflicting or incomplete. The use of certain drugs for autoimmune inflammatory rheumatisms appears to be a potentially interesting options for the treatment. The rationale for their use is based on the immune system runaway and the secretion of proinflammatory cytokines (Il1, IL6, TNF␣) in severe forms of the disease. Notably, patients on chloroquine or hydroxychloroquine as a treatment for their autoimmune rheumatic disease are not protected from COVID-19.

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Section: Is There a Prophylactic Effect Of Hydroxychloroquine On Covimentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Challenges of autoimmune rheumatic disease treatment during the COVID-19 pandemic: A review

Grange

Guilpain

Truchetet³

et al. 2020

Therapies

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“…It has been shown subsequently that chloroquine increased viral production when the drug was applied to cells after viral adsorption [ 93 ]. Serious adverse drug reactions have been reported in patients with COVID-19 receiving hydroxychloroquine, justifying limitation of its prescription and to perform suitable cardiac and therapeutic drug monitoring [ 94 ].…”

Section: Glutathione and Viral Infectionsmentioning

confidence: 99%

Glutathione Supplementation as an Adjunctive Therapy in COVID-19

et al. 2020

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Morbidity and mortality of coronavirus disease 2019 (COVID-19) are due in large part to severe cytokine storm and hypercoagulable state brought on by dysregulated host-inflammatory immune response, ultimately leading to multi-organ failure. Exacerbated oxidative stress caused by increased levels of interleukin (IL)-6 and tumor necrosis factor α (TNF-α) along with decreased levels of interferon α and interferon β (IFN-α, IFN-β) are mainly believed to drive the disease process. Based on the evidence attesting to the ability of glutathione (GSH) to inhibit viral replication and decrease levels of IL-6 in human immunodeficiency virus (HIV) and tuberculosis (TB) patients, as well as beneficial effects of GSH on other pulmonary diseases processes, we believe the use of liposomal GSH could be beneficial in COVID-19 patients. This review discusses the epidemiology, transmission, and clinical presentation of COVID-19 with a focus on its pathogenesis and the possible use of liposomal GSH as an adjunctive treatment to the current treatment modalities in COVID-19 patients.

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“…These interventions have a major effect in response to therapy; if the type and intensity of such interventions are not the same in the groups to be compared, it will interfere with the results of the clinical trial 8 . As a result, efficacy has been overestimated in some cases (as in the use of hydroxychloroquine) 9 , and some side effects have halted the use of others, but most of the time this occurs after some time of its use. Many pharmacological therapies employed have daily updates based on rapid emerging literature, mostly constructed using a "trial-error" approach.…”

Section: Accurate Versus Fast-moving Informationmentioning

confidence: 99%

Bioethics in the COVID-19 Pandemic Research: Challenges and Strategies

González‐Duarte

Kaufer‐Horwitz

Aguilar-Salinas

2021

RIC

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As all other aspects in times of the coronavirus disease (COVID)-19 pandemic, carrying-out quality clinical research has been challenging. Many well-established paradigms have shifted as a consequence of the rapid demand for new knowledge. New treatments are fast-moving, informed consent forms are difficult to obtain, a competitive invitation from researchers to participate in different studies is common, and non-COVID-19 research protocols are suffering continuity. However, these challenges should not imply taking shortcuts or accepting deficiencies in bioethical standards, but rather enhance the alertness for rigorous ethical approaches despite these less than ideal circumstances. In this manuscript, we point out some interrogates in COVID-19 research and outline possible strategies to overcome the difficult task to continue with high-quality research without violating the ethical principles. (REV INVEST CLIN. [AHEAD OF PRINT]

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Chloroquine and hydroxychloroquine in the management of COVID-19: Much kerfuffle but little evidence

Cited by 41 publications

References 58 publications

Challenges of autoimmune rheumatic disease treatment during the COVID-19 pandemic: A review

Challenges of autoimmune rheumatic disease treatment during the COVID-19 pandemic: A review

Glutathione Supplementation as an Adjunctive Therapy in COVID-19

Bioethics in the COVID-19 Pandemic Research: Challenges and Strategies

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