chloroquine/hydroxychloroquine for COVID-19
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Clinical significance
- do not use chloroquine or hydroxychloroquine with or without azithromycin for treatment of COVID-19[1][2][3] or prophylaxis[12]
- chloroquine & hydroxychloroquine inhibit SARS CoV2 in vitro[4][5]
- chloroquine or hydroxychloroquine, with or without azithromycin, associated with increased risk of death in hospitalized COVID-19 patients (RR=2-3)[3][6]
- higher risk of ventricular arrhythmia during hospitalization[7] (6.1% for hydroxychloroquine, 4.3% for chloroquine vs 0.3% for controls)
- hydroxychloroquine arm within the Solidarity trial for COVID-19 halted by WHO May 25, 2020 due to safety concerns[8]
- hydroxychloroquine not associated with either significant increase or decrease in risk of composite end point of intubation or death[9]
- hydroxychloroquine not useful for COVID-19 in outpatient setting[3]
- hydroxychloroquine not useful for COVID-19 prophylaxis[10][12]
- FDA rescinded emergency use authorization of hydroxychloroquine to treat COVID-19 patients[11]
Additional terms
- chloroquine [chloroquine phosphate] (Aralen, Atabrine, Artrichin, Nivaquine, Cisplaquin, Quingamine, Avoclor, Chingaminum)
- COVID-19
- hydroxychloroquine (Plaquenil)
References
- ↑ 1.0 1.1 NIH Coronavirus Disease 2019 (COVID-19) Treatment Guidelines. Updated. April 21, 2020 https://covid19treatmentguidelines.nih.gov/
Alhazzani W et al. Surviving sepsis campaign: Guidelines on the management of critically ill adults with coronavirus disease 2019 (COVID-19). Crit Care Med 2020 Mar 27 https://journals.lww.com/ccmjournal/Abstract/9000/Surviving_Sepsis_Campaign__Guidelines_on_the.95707.aspx
Wilson KC et al. COVID-19: Interim guidance on management pending empirical evidence; from an American Thoracic Society-led international task force. 2020 Apr 3 https://www.thoracic.org/covid/covid-19-guidance.pdf
Bhimraj A et al. Infectious Diseases Society of America guidelines on the treatment and management of patients with COVID-19. 2020 Apr 11 https://www.idsociety.org/practice-guideline/covid-19-guideline-treatment-and-management - ↑ 2.0 2.1 AMA Morging Rounds. July 14, 2020
Sakoulas G, El Sahly H, Ellison RT III. Chloroquine and Hydroxychloroquine: Old Drugs in A New COVID-19 World. NEJM Journal Watch. April 24, 2020 Massachusetts Medical Society (subscription needed) http://www.jwatch.org
Guastalegname M, Vallone A Could Chloroquine /Hydroxychloroquine Be Harmful in Coronavirus Disease 2019 (COVID-19) Treatment? Clin Infect Dis. 2020 Mar 24. PMID: https://www.ncbi.nlm.nih.gov/pubmed/32211771
Yazdany J, Kim AHJ. Use of Hydroxychloroquine and Chloroquine During the COVID-19 Pandemic: What Every Clinician Should Know. Ann Intern Med. 2020 Mar 31. PMID: https://www.ncbi.nlm.nih.gov/pubmed/32232419 Free PMC Article https://annals.org/aim/fullarticle/2764199/use-hydroxychloroquine-chloroquine-during-covid-19-pandemic-what-every-clinician
Damle B, Vourvahis M, Wang E et al Clinical Pharmacology Perspectives on the Antiviral Activity of Azithromycin and Use in COVID-19. Clin Pharmacol Ther. 2020 Apr 17.Review. PMID: https://www.ncbi.nlm.nih.gov/pubmed/32302411
Sinha N, Balayla G. Hydroxychloroquine and covid-19. Postgrad Med J. 2020 Apr 15. PMID: https://www.ncbi.nlm.nih.gov/pubmed/32295814
Alia E, Grant-Kels JM. Does Hydroxychloroquine Combat COVID-19? A Timeline of Evidence. J Am Acad Dermatol. 2020 Apr 10. PMID: https://www.ncbi.nlm.nih.gov/pubmed/32283236 Free PMC Article - ↑ 3.0 3.1 3.2 3.3 Cavalcanti AB, Zampieri FG, Rosa RG et al Hydroxychloroquine with or without Azithromycin in Mild-to-Moderate Covid-19. N Engl J Med. July 23, 2020 PMID: https://www.ncbi.nlm.nih.gov/pubmed/32706953 https://www.nejm.org/doi/full/10.1056/NEJMoa2019014
Skipper CP et al. Hydroxychloroquine in nonhospitalized adults with early COVID-19: A randomized trial. Ann Intern Med 2020 Jul 16; PMID: https://www.ncbi.nlm.nih.gov/pubmed/32673060 Free PMC article. https://www.acpjournals.org/doi/10.7326/M20-4207
Schluger NW. The saga of hydroxychloroquine and COVID-19: A cautionary tale. Ann Intern Med 2020 Jul 16; [e-pub]. PMID: https://www.ncbi.nlm.nih.gov/pubmed/32673059 Free PMC article https://www.acpjournals.org/doi/10.7326/M20-5041 - ↑ 4.0 4.1 Wang M, Cao R, Zhang L et al Remdesivir and chloroquine effectively inhibit the recently emerged novel coronavirus (2019-nCoV) in vitro. Cell Res. 2020 Mar;30(3):269-271. PMID: https://www.ncbi.nlm.nih.gov/pubmed/32020029 Free PMC Article
- ↑ 5.0 5.1 Yao X,Ye F Zhang M et al In Vitro Antiviral Activity and Projection of Optimized Dosing Design of Hydroxychloroquine for the Treatment of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). Clinical Infectious Diseases. March 2020 https://academic.oup.com/cid/advance-article-abstract/doi/10.1093/cid/ciaa237/5801998
Lecrubier A COVID-19: Could Hydroxychloroquine Really Be the Answer? Medscape. March 18, 2020 https://www.medscape.com/viewarticle/927033
Chen Z, Hu J, Zhang Z et al Efficacy of hydroxychloroquine in patients with COVID-19: results of a randomized clinical trial. Unreviewed manuscript. April 1, 2020 https://www.medrxiv.org/content/10.1101/2020.03.22.20040758v2.full.pdf - ↑ 6.0 6.1 Susman E HCQ Linked to Harm in Cancer Patients Combination with azithromycin associated with three-fold risk of mortality, registry study shows. MedPage Today May 28, 2020 https://www.medpagetoday.com/meetingcoverage/asco/86738
Warner J, et al Clinical impact of COVID-19 on patients with cancer: Data from the COVID-19 and Cancer Consortium (CCC19). American Society of Clinical Oncology ASCO 2020; Abstract LBA110. - ↑ 7.0 7.1 Borba MGS, Val FFA, Sampaio VS et al Effect of High vs Low Doses of Chloroquine Diphosphate as Adjunctive Therapy for Patients Hospitalized With Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Infection. A Randomized Clinical Trial. JAMA Netw Open. 2020;3(4.23):e208857 PMID: https://www.ncbi.nlm.nih.gov/pubmed/32330277 https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2765270
Fihn SD, Perencevich E, Bradley SM Caution Needed on the Use of Chloroquine and Hydroxychloroquine for Coronavirus Disease 2019. JAMA Netw Open. 2020;3(4.23):e209035 PMID: https://www.ncbi.nlm.nih.gov/pubmed/32330276 https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2765269 - ↑ 8.0 8.1 Reuters. May 25, 2020 Clinical trial of hydroxychloroquine in COVID-19 patients paused-WHO. https://www.msn.com/en-us/news/world/clinical-trial-of-hydroxychloroquine-in-covid-19-patients-paused-who/ar-BB14zn1l
- ↑ 9.0 9.1 Geleris J, Sun Y, Platt J et al Observational Study of Hydroxychloroquine in Hospitalized Patients with Covid-19. N Engl J Med. May 7, 2019 PMID: https://www.ncbi.nlm.nih.gov/pubmed/32379955 https://www.nejm.org/doi/full/10.1056/NEJMoa2012410
- ↑ 10.0 10.1 Boulware DR, Pullen MF, Bangdiwala AS et al A Randomized Trial of Hydroxychloroquine as Postexposure Prophylaxis for Covid-19. N Engl J Med. June 3, 2020 PMID: https://www.ncbi.nlm.nih.gov/pubmed/32492293 https://www.nejm.org/doi/full/10.1056/NEJMoa2016638
Cohen MS Hydroxychloroquine for the Prevention of Covid-19 - Searching for Evidence N Engl J Med. June 3, 2020 PMID: https://www.ncbi.nlm.nih.gov/pubmed/32492298 https://www.nejm.org/doi/full/10.1056/NEJMe2020388
Abella BS, Jolkovsky EL, Biney BT et al Efficacy and Safety of Hydroxychloroquine vs Placebo for Pre-exposure SARS-CoV-2 Prophylaxis Among Health Care Workers. A Randomized Clinical Trial. JAMA Intern Med. Published online September 30, 2020 PMID: https://www.ncbi.nlm.nih.gov/pubmed/33001138 https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2771265 - ↑ 11.0 11.1 Walker M HCQ No Longer Approved Even a Little for COVID-19 - Study after study showed no benefit, and now the FDA has had enough MedPage Today. June 15, 2020 https://www.medpagetoday.com/infectiousdisease/covid19/87066
- ↑ 12.0 12.1 12.2 Lamontagne F, Agoritsas T, Siemieniuk R et al A living WHO guideline on drugs to prevent covid-19. Hydroxychloroquine. BMJ 2021;372:n526 https://www.bmj.com/content/372/bmj.n526