Hydroxychloroquine in COVID-19: Potential Mechanism of Action Against SARS-CoV-2
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COVID-19 (ATY LAU AND A KONG, SECTION EDITORS)
Hydroxychloroquine in COVID-19: Potential Mechanism of Action Against SARS-CoV-2 Sairaj Satarker 1 & Tejas Ahuja 1 & Madhuparna Banerjee 1 & Vignesh Balaji E 1 & Shagun Dogra 1 & Tushar Agarwal 1 & Madhavan Nampoothiri 1
# The Author(s) 2020
Abstract Purpose of Review The rapid spread of virus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has turned out to be a global emergency. Symptoms of this viral infection, coronavirus disease 2019 (COVID-19), include mild infections of the upper respiratory tract, viral pneumonia, respiratory failure, multiple organ failure and death. Till date, no drugs have been discovered to treat COVID-19 patients, and therefore, a considerable amount of interest has been shown in repurposing the existing drugs. Recent Findings Out of these drugs, chloroquine (CQ) and hydroxychloroquine (HCQ) have demonstrated positive results indicating a potential antiviral role against SARS-CoV-2. Its mechanism of action (MOA) includes the interference in the endocytic pathway, blockade of sialic acid receptors, restriction of pH mediated spike (S) protein cleavage at the angiotensinconverting enzyme 2 (ACE2) binding site and prevention of cytokine storm. Unfortunately, its adverse effects like gastrointestinal complications, retinopathy and QT interval prolongation are evident in treated COVID-19 patients. Yet, multiple clinical trials have been employed in several countries to evaluate its ability in turning into a needed drug in this pandemic. Summary This review attempts to summarize the MOA of CQ/HCQ and its side effects. The existing literature hints that till date, the role of CQ/HCQ in COVID-19 may be sceptical, and further studies are warranted for obtaining a therapeutic option that could be effectively used across the world to rise out from this pandemic. Keywords COVID-19 . Hydroxychloroquine . SARS-CoV-2 . Coronavirus . Pandemic . QT prolongation
Introduction What was then an unknown cause of respiratory ailments in the patients of Wuhan, China, the disease has now grown into a lethal threat to mankind in the form of a pandemic. The World Health Organization (WHO) had declared it as a public health emergency of international concern on 31 January 2020 [1]. Initially referred to as the 2019 novel coronavirus (2019 nCoV) [2–4] and controversially the Wuhan virus [5–7], it was Sairaj Satarker, Tejas Ahuja and Madhavan Nampoothiri contributed equally to this work. This article is part of the Topical Collection on Covid-19 * Madhavan Nampoothiri [email protected] 1
Department of Pharmacology, Manipal College of Pharmaceutical Sciences, Manipal Academy of Higher Education, Manipal 576104, India
later officially named by WHO as the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that is responsible for causing coronavirus disease 2019 (COVID-19) on 11 February 2020 [8]. The SARS-CoV-2 belongs to Betacoronavirus genera of the Coronaviridae family, which, along with the Alphacoronavirus, are known to infect mam
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