Abstract: Li et al. Cell Death and Disease (2020)11:512 https://doi.org/10.1038/s41419-020-2721-8 Cell Death & Disease PERSPECTIVE Open Access Is hydroxychloroquine beneficial for COVID-19 patients? Xing Li1, Ying Wang2, Patrizia Agostinis3, Arnold Rabson4, Gerry Melino Erwei Sun1,8 5 , Ernesto Carafoli6, Yufang Shi2,7 and 1234567890():,; 1234567890():,; 1234567890():,; 1234567890():,; Abstract 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 (yfshi@suda.edu.cn) or Erwei Sun (sunew@smu.edu.cn) 1 Department of Rheumatology and Immunology, The Third Affiliated Hospital of Southern Medical University, No. 183, Zhongshan Avenue West, Tianhe District, Guangzhou, 510630 Guangdong, China 2 Shanghai Institute of Nutrition and Health, Shanghai Institutes for Biological Sciences, Chinese Academy of Sciences, 320 Yueyang Road, 200031 Shanghai, China 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 B..