Rheumotologitsts’ view on the use of hydroxychloroquine to treat COVID-19

Abstract

The current pandemic coronavirus disease 2019 caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) calls urgently for effective therapies. Anti-malarial medicine chloroquine (CQ) and particularly its chemical analogue hydroxychloroquine (HCQ) have been recommended as promising candidate therapeutics that are now under either compassionate off-label use or clinical trials for the treatment of COVID-19 patients. However, there are public concerns and disputes about both the safety and efficacy of CQ and HCQ for this new application. Given the fact that for decades HCQ has been approved as an immunomodulatory drug for the long term treatment of chronic rheumatic diseases, as experienced rheumatologists, we would like to share our thoughts in this regard and trigger a brainstorm among clinical care providers for exchanging their diverse opinions on this urgent topic.

<p>Hypothesis: What is the Best We Can Do with Hydroxychloroquine for COVID-19?</p>

“…Despite controversies, accumulating evidence has been demonstrating the potential anti-COVID-19 activity of both HCQ and CQ, on the basis of observational studies, randomized controlled clinical trials and basic studies. 5,[8][9][10][11][12][14][15][16] Risch reviews in detail the experiences in the USA and other countries of administering HCQ, with or without an antibiotic, to early stage COVID-19 patients, concluding that the observational evidence of efficacy is very strong; 17 formal clinical trials in an outpatient setting have now begun, with the first results expected in September, 2020.…”

“…Given the rather cost-effective and safe outcomes from recent observational experiences with HCQ, 8,9,11,14,16,31 pending the outcomes of the ongoing clinical trials, we would propose, prepare now and implement promptly the following outline protocol for this and possibly subsequent outbreaks of COVID-19 (Figure 1).…”

Quantum Deep Learning Functional Similarities on Remdesivir, Drug Synergies to Treat COVID-19 in Practice.

“…(15,16, A signi cant variability in the solutions can be observed. (15,17,. The docking calculation (20,21,23-48) for estimating the nonpolar solvation energy was performed on the prepared dataset of 195 SARS-COV-2 receptors and FDA ligands by using the BiogenetoligandorolTM Cluster of docking softwares and work ows based on default parameters.…”

Host-microbe-drug triad: Role of chloroquine/hydroxychloroquine in Covid-19 treatment-focus on inflammatory cytokine inhibition

“…Chloroquine and hydroxychloroquine have been demonstrated to contain strong antiviral effects against SARS-CoV when administered before and after infection (Chang et al, 2014;Keyaerts et al, 2004;Sun et al, 2020;Vincent et al, 2005). This means that it can serve as both a prophylactic and a treatment drug for SARS-CoV infections (Vincent et al, 2005).…”