Role of Chloroquine and Hydroxychloroquine in the Treatment of COVID-19 Infection- A Systematic Literature Review

Kapoor, Krishan Mohan; Kapoor, Aanandita

doi:10.1101/2020.03.24.20042366

Cited by 42 publications

(46 citation statements)

References 39 publications

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“…The rst reports recommending HCQ as an effective treatment for SARS-CoV-2 infection have been under increased scrutiny due to questionable methodologies and outcomes [13,19,27,28]. Our results support the negative studies on the prophylaxis and e cacy of HCQ therapy.…”

Section: Discussionsupporting

confidence: 72%

The effect of hydroxychloroquine against SARS-CoV-2 infection in rheumatoid arthritis patients

Küçükakkaş

Aydın

2020

Preprint

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INTRODUCTION: The effectiveness of hydroxychloroquine in SARS-CoV-2 prophylaxis and treatment is still controversial. In this study, our aim is to investigate the potential effects of hydroxychloroquine therapy on patients with diagnosed with rheumatoid arthritis and a confirmed SARS-CoV-2 infection.METHOD: We included patients who were followed up with a diagnosis of rheumatoid arthritis and whose SARS-CoV-2 infection was confirmed. The patients were divided into two groups as those who previously used hydroxychloroquine and those who did not, and were compared in terms of clinical and laboratory data.RESULTS: Our study included 17 patients with adequate data (2 males, 15 females). The mean age of the patients was 57.2 ± 11.6 years. 7 (41.2%) patients were receiving hydroxychloroquine regularly for the last 6 months. When the effect of hydroxychloroquine on clinical and laboratory parameters of patients was examined, there was no significant difference between the groups of patients using and not using hydroxychloroquine. The patients using and not using hydroxychloroquine were compared for the presence of typical SARS-CoV-2 infection findings on computed tomography images, admission to the hospital and intensive care. No significant differences were observed between these two groups.CONCLUSIONS: Many studies on the effectiveness of hydroxychloroquine use in SARS-CoV-2 infection are still ongoing. Due to its importance in rheumatology practice, it is very important to clarify the position of hydroxychloroquine in SARS-CoV-2 therapy. Our findings suggest that having previously used hydroxychloroquine does not have any negative or positive effect on the infection.

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Section: Discussionsupporting

confidence: 72%

The effect of hydroxychloroquine against SARS-CoV-2 infection in rheumatoid arthritis patients

Küçükakkaş

Aydın

2020

Preprint

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“…This is in agreement with the other authors with similar findings of lack of literature in this regard. 28,29,30,46 The earliest nonempirical evidence came from China in form of report letter in which more than 100 patients with COVID pneumonia showed clinical improvement and changes in image findings on chloroquine administration. 43 It is pertinent to note that this letter was the brief report of ongoing many trials in various locations in China, neither it mentioned any specific data regarding interventions, study design, study population and outcome measures, nor any adverse events were discussed.…”

Section: Discussionmentioning

confidence: 99%

Review of Current Evidence of Hydroxychloroquine in Pharmacotherapy of COVID-19

Suranagi

Rehan

Goyal

2020

Preprint

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Purpose:The COVID-19 Pandemic has literally left the world breathless in the chase for Pharmacotherapy. With the vaccine approval likely more than a year away and novel drugs in early clinical trials, repurposing of existing drugs takes the center stage. A potential drug discussed both in geopolitical and global scientific community is hydroxychloroquine (HCQ). We intend to systematically weigh and analyze the existing evidence of HCQ in the light of published and pre-print data available so far. Methods: PubMed Ovid MEDLINE, EMBASE, Google scholar databases and official clinical trialRegistries of the United States, China, WHO ICTRP were electronically searched for studies for the use of HCQ in patients with COVID-19. Pre-proof article repositories like MedRxiv, BioRxiv, and ChemRxiv were also included in the search. The literature was critically appraised. Results:Total 71 articles were available as of 15 th April of which articles of relevance (three invitro studies, two open label non-randomized trials, two open label randomized control trials, one follow-up study, three reviews, ten short communications) and 88 clinical trials registered in three clinical trial registries were analyzed. HCQ seems to be efficient in inhibiting of SARS-CoV-2 in in-vitro cell lines; there is lack of strong evidence from human studies. Conclusions:The in-vitro cell culture based data of viral inhibition does not suffice for the use of hydroxychloroquine in the patients with COVID-19. Currently literature shows inadequate, low level evidence in human studies. Scarcity of safety and efficacy data warrants medical communities, health care agencies and governments across the world against the widespread use of HCQ in COVID-19 prophylaxis and treatment, until robust evidence becomes available.

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“…Chloroquine and hydroxychloroquine are viewed today as the most promising anti-COVID-19 drugs [71,72,78,79]. One could apprehend that melatonin would interfere with them because it was reported that the anti-malaria effectiveness of chloroquine was greatly increased by a melatonin antagonist, Luzindole, and/or bright light at night, which reduced melatonin production.…”

Section: Melatonin Can Be Utilized In Combinations With Drugs and Trementioning

confidence: 99%

Can melatonin reduce the severity of COVID-19 pandemic?

Shneider

Kudriavtsev

Vakhrusheva

2020

International Reviews of Immunology

147

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The current COVID-19 pandemic is one of the most devastating events in recent history. The virus causes relatively minor damage to young, healthy populations, imposing life-threatening danger to the elderly and people with diseases of chronic inflammation. Therefore, if we could reduce the risk for vulnerable populations, it would make the COVID-19 pandemic more similar to other typical outbreaks. Children don't suffer from COVID-19 as much as their grandparents and have a much higher melatonin level. Bats are nocturnal animals possessing high levels of melatonin, which may contribute to their high anti-viral resistance. Viruses induce an explosion of inflammatory cytokines and reactive oxygen species, and melatonin is the best natural antioxidant that is lost with age. The programmed cell death coronaviruses cause, which can result in significant lung damage, is also inhibited by melatonin. Coronavirus causes inflammation in the lungs which requires inflammasome activity. Melatonin blocks these inflammasomes. General immunity is impaired by anxiety and sleep deprivation. Melatonin improves sleep habits, reduces anxiety and stimulates immunity. Fibrosis may be the most dangerous complication after COVID-19. Melatonin is known to prevent fibrosis. Mechanical ventilation may be necessary but yet imposes risks due to oxidative stress, which can be reduced by melatonin. Thus, by using the safe over-the-counter drug melatonin, we may be immediately able to prevent the development of severe disease symptoms in coronavirus patients, reduce the severity of their symptoms, and/or reduce the immuno-pathology of coronavirus infection on patients' health after the active phase of the infection is over. ARTICLE HISTORY

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Role of Chloroquine and Hydroxychloroquine in the Treatment of COVID-19 Infection- A Systematic Literature Review

Cited by 42 publications

References 39 publications

The effect of hydroxychloroquine against SARS-CoV-2 infection in rheumatoid arthritis patients

The effect of hydroxychloroquine against SARS-CoV-2 infection in rheumatoid arthritis patients

Review of Current Evidence of Hydroxychloroquine in Pharmacotherapy of COVID-19

Can melatonin reduce the severity of COVID-19 pandemic?

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