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Chloroquine, hydroxychloroquine and COVID-19.
T B Erickson1,2, P R Chai1,3,4,5, E W Boyer1,3
1Division of Medical Toxicology, Department of Emergency Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Toxicology Communications
|May 28, 2020
Summary
Chloroquine (CQ) and hydroxychloroquine (HCQ) have shown significant toxicity, including cardiac issues and seizures, with no proven benefit for COVID-19. Pediatric poisoning is a serious concern, necessitating caution with these antimalarial drugs.
Area of Science:
- Pharmacology
- Toxicology
- Infectious Diseases
Background:
- Antimalarials chloroquine (CQ) and hydroxychloroquine (HCQ) gained attention for potential COVID-19 treatment.
- Despite political promotion, these drugs possess significant toxicity and a narrow therapeutic window.
Purpose of the Study:
- To review the toxicity profile of chloroquine and hydroxychloroquine.
- To evaluate the scientific evidence regarding their use in COVID-19 treatment and prophylaxis.
Main Methods:
- Literature review of pharmacological and toxicological data.
- Analysis of clinical evidence and case reports concerning CQ/HCQ use and poisoning.
Main Results:
- CQ/HCQ poisoning can lead to myocardial depression, hypotension, arrhythmias, seizures, and severe pediatric toxicity.
- Cardiotoxicity manifests as ECG changes including QRS widening, heart block, and QT prolongation.
- Current evidence does not support the use of CQ/HCQ for COVID-19, highlighting risks over benefits.
Conclusions:
- CQ/HCQ present substantial risks, including severe cardiotoxicity and neurological effects.
- The use of CQ/HCQ for COVID-19 is not supported by scientific evidence and poses significant risks.
- Further investigation is required before any wider public distribution of these agents for COVID-19.
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