Is hydroxychloroquine beneficial for COVID-19 patients?
Review of the anti-inflammatory, antiviral, and protective vascular effects of CQ and HCQ, noting that HCQ may be preferable for COVID-19 due to fewer side effects.
Li et al., 8 Jul 2020, peer-reviewed, 8 authors.
Abstract: Li et al. Cell Death and Disease (2020)11:512
Cell Death & Disease
Is hydroxychloroquine beneﬁcial for COVID-19
Xing Li1, Ying Wang2, Patrizia Agostinis3, Arnold Rabson4, Gerry Melino
, Ernesto Carafoli6, Yufang Shi2,7 and
The outbreak of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2
(SARS-CoV-2) was ﬁrst reported in December 2019. As similar cases rapidly emerged around the world1–3, the World
Health Organization (WHO) declared a public health emergency of international concern on January 30, 2020 and
pronounced the rapidly spreading coronavirus outbreak as a pandemic on March 11, 20204. The virus has reached
almost all countries of the globe. As of June 3, 2020, the accumulated conﬁrmed cases reached 6,479,405 with more
than 383,013 deaths worldwide. The urgent and emergency care of COVID-19 patients calls for effective drugs, in
addition to the beneﬁcial effects of remdesivir5, to control the disease and halt the pandemic.
US FDA approved hydroxychloroquine (HCQ) and
chloroquine (CQ) for COVID-19 as an Emergency Use
Authorization (EUA) with cautions issued soon after
On March 28, 2020, the U.S. Food and Drug Administration (FDA) issued an EUA to allow hydroxychloroquine sulfate and chloroquine phosphate donated
to the Strategic National Stockpile (SNS) to be distributed
and used for hospitalized COVID-19 patients. In fact,
these two drugs have been used for decades for the
therapy and control of malaria and autoimmune diseases.
In Peru, the bark extracts of cinchona tree was used to
treat malaria and babesiosis started almost 400 years ago.
About 200 years ago quinine was found to be the key antimalaria compound in the bark. The analog of quinine, CQ
was made in 1934 and formally introduced into clinical
practice in the United States in 1947 for the prophylactic
treatment of malaria. In addition, CQ was also used to
Correspondence: Yufang Shi (firstname.lastname@example.org) or Erwei Sun (email@example.com)
Department of Rheumatology and Immunology, The Third Afﬁliated Hospital of
Southern Medical University, No. 183, Zhongshan Avenue West, Tianhe District,
Guangzhou, 510630 Guangdong, China
Shanghai Institute of Nutrition and Health, Shanghai Institutes for Biological
Sciences, Chinese Academy of Sciences, 320 Yueyang Road, 200031 Shanghai,
Full list of author information is available at the end of the article
Edited by R.A. Knight
treat rheumatoid arthritis, and lupus erythematosus. A
safer derivative HCQ was made in 1955. In 2017, there
were more than ﬁve million prescriptions of HCQ in the
United States, indicating that in the absence of other drug
interactions or special health conditions, HCQ should be
a relatively safe drug.
Preliminary studies have suggested HCQ may have
utility in ﬁghting COVID-196,7. Distinct possible effects
may be related to its function in the treatment of COVID19 patients: A. anti-virus, B. anti-inﬂammation, and C.
anti-thrombotic. As until now there have been no data
indicating HCQ has any immunity boosting effect, here
we will mainly discuss the anti-virus and antiinﬂammation effects. In in vitro assays, both CQ and
HCQ have been shown to possess antiviral activity against
various viruses, such as human immunodeﬁciency virus
(HIV), hepatitis A virus, hepatitis C virus, inﬂuenza A and
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