Abstract: MINI-REVIEW Hydroxychloroquine is protective to the heart, not harmful: a systematic review C. C. Prodromos, T. Rumschlag and T. Perchyk Foundation for Orthopaedics and Regenerative Medicine, 1714 Milwaukee Ave, Glenview, IL, 60025, USA Abstract Hydroxychloroquine (HCQ) has been shown to be at least somewhat effective in treating patients with coronavirus disease 2019 (COVID-19). Recently the US Food and Drug Administration and Centers for Disease Control and Prevention warnings of fatal cardiac toxicity from torsades de pointes (TDP) arrhythmia from HCQ receipt have been made, notwithstanding the long safe provision of HCQ to treat lupus and rheumatoid arthritis. This has resulted in restricted access of HCQ for COVID-19 treatment. We hypothesized that HCQ and azithromycin have not been reported to cause significant acute cardiac arrhythmic mortality. We performed a literature search for the effects of HCQ and azithromycin on the heart. No TDP or related deaths were found to have been reported as a result of HCQ and azithromycin receipt in the peer-reviewed literature. On the contrary, HCQ and azithromycin were both found to substantially reduce cardiac mortality and also decrease thrombosis, arrhythmia and cholesterol in treated patients in recent peer-reviewed studies and meeting presentations. HCQ and azithromycin do not cause TDP cardiac mortality; rather, HCQ decreases cardiac events. HCQ should not be restricted in COVID-19 patients out of fear of cardiac mortality. © 2020 The Author. Published by Elsevier Ltd. Keywords: Azithromycin, COVID-19, hydroxychloroquine, SARS-CoV-2 Original Submission: 24 June 2020; Revised Submission: 13 August 2020; Accepted: 17 August 2020 Article published online: 20 August 2020 Corresponding author: C. C. Prodromos, Foundation for Orthopaedics and Regenerative Medicine, 1714 Milwaukee Ave, Glenview, IL 60025, USA. E-mail: research@ismoc.net