Hydroxychloroquine and chloroquine: a potential and controversial treatment for COVID-19
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Online ISSN 1976-3786 Print ISSN 0253-6269
REVIEW
Hydroxychloroquine and chloroquine: a potential and controversial treatment for COVID‑19 Li Zou1 · Lijun Dai1 · Xingyu Zhang1 · Zhaohui Zhang1 · Zhentao Zhang1
Received: 6 May 2020 / Accepted: 26 July 2020 © The Pharmaceutical Society of Korea 2020
Abstract A novel coronavirus, later named SARS-CoV-2, was first reported in China in December 2019 and subsequently widely identified in the United States, Japan, South Korea, France, India, and other countries. The disease caused by SARS-CoV-2 infection was called COVID-19. The high fatality and morbidity rates of COVID-19 make it the third largest global epidemic in this century. However, there are currently no approved antiviral drugs for the COVID-19 treatment. Recently, two old antimalarial drugs, hydroxychloroquine and chloroquine, have been found to exert anti-SARS-CoV-2 effects both in vitro and in vivo. Preliminary clinical evidence suggests these drugs may have an effect on the treatment of COVID-19. Herein, we review the pharmacokinetics characteristics and antiviral effects of these drugs, in addition to their side effects and clinical evidence of their use for the COVID-19 treatment. Keywords Hydroxychloroquine · Chloroquine · COVID19 · SARS-CoV-2 · Treatment
Introduction In December 2019, unexplained pneumonia cases were reported in Wuhan, China, which was later confirmed to be caused by a novel coronavirus identified as SARS-CoV-2. The clinical symptoms caused by this novel coronavirus * Zhaohui Zhang [email protected] * Zhentao Zhang [email protected] 1
Department of Neurology, Renmin Hospital of Wuhan University, Wuhan 430060, China
were named as coronavirus disease 2019 (COVID-19) by World Health Organization (WHO). SARS-CoV-2 is a β-coronavirus and its genomic sequence is 96.2% identical to that of Bat-SARSs-CoV RaTG13 and 79.5% identical to that of SARS-CoV. Based on the sequencing results and evolutionary analysis of the viral genome, bats are suspected to be the natural hosts of SARS-CoV-2, while the intermediate host is unknown. Previous studies have shown that SARSCoV-2, like SARS-CoV, can infect human cells that express angiotensin-converting enzyme 2 (ACE2) (Guo et al. 2020). The most common symptoms of COVID-19 patients include fever, cough, fatigue, and myalgia. However, the disease can evolve in some cases and patients begin to experience dyspnea, shock, multiple organ damage and may even die (Huang et al. 2020; Wang et al. 2020a; Zhang et al. 2020). COVID-19 is reported to be transmitted from person to person through respiratory droplets or by direct contact with infected patients. Although virus particles have been detected in feces, there is no clear evidence that the virus can be transmitted through the digestive tract (Adhikari et al. 2020). Studies estimate that the basic reproduction number (R0) of SARS-CoV-2 is about 2.2, but it can vary from 1.4 to 6.5 (Adhikari et al. 2020; Guo et al. 2020; Imai et al. 2020; Shen et al. 2020). As of April 30, 3,172,185 cases hav
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