Safety and Efficacy of Chloroquine/Hydroxychloroquine in SARS-CoV-2 Infection

Abstract

This work summarizes the available evidence of the use of chloroquine/hydroxychloroquine (CQ/HCQ) in SARS-CoV-2 infection. Most of the published works indicate CQ/HCQ is likely effective against SARS-CoV-2 infection, almost 100% in prophylaxis and mild-medium severity cases and 60% in late infection cases. The percentage of positive works is larger if those works conducted under a probable conflict of interest are excluded from the list. Despite this overwhelming evidence from independent studies, the use of CQ/HCQ is currently limited or prevented in many western countries, based on a very singular examination of the science. The case of a work published in late May 2020, despite being openly defective and then retracted, prompted the World Health Organization (WHO) to ban the use of CQ/HCQ. This position has not yet rectified, thanks to the results of the not less questionable RECOVERY trial, where very sick patients were administered more than double the dose, over more than double the time, recommended for asymptomatic patients in current protocols of other countries, where CQ/HCQ are used for asymptomatic and mild but not severe pneumonia critically ill patients. While the case fatality rate does not depend only on therapies, it is finally shown based on the number of cases and fatalities per million and the case fatality rate as the western countries enforcing the ban on CQ/HCQ did not perform better, but much worse, than other countries, also because of therapies.