Journal Summary of Chloroquine and Hydroxychloroquine

Coronavirus Apr 06, 2020

I wanted to check the scientific literature on these 2 drugs related to Wuhan, China Virus.

International Journal of Antimicrobial Agents - Hydroxychloroquine and azithromycin as a treatment of COVID-19: results of an open-label non-randomized clinical trial:

Despite its small sample size our survey shows that hydroxychloroquine treatment is significantly associated with viral load reduction/disappearance in COVID-19 patients and its effect is reinforced by azithromycin.

International Journal of Antimicrobial Agents - Chloroquine and hydroxychloroquine as available weapons to fight COVID-19 (Pre-proof, PDF):

There is a strong rationality for the use of chloroquine to treat infections with intracellular micro-organisms. Thus, malaria has been treated for several decades with this molecule. In addition, our team has used hydroxychloroquine for the first time for intracellular bacterial infections since 30 years to treat the intracellular bacterium Coxiella burnetii, the agent of Q fever, for which we have shown both in vitro and then in patients that this compound is the only one efficient for killing these intracellular pathogens. Since then, we have also shown the activity of hydroxychloroquine on Tropheryma whipplei, the agent of Whipple’s disease, which is another intracellular bacterium for which hydroxychloroquine has become a reference drug.
Indeed, following the in vitro results, 20 clinical studies were launched in several Chinese hospitals. The first results obtained from more than 100 patients showed the superiority of chloroquine compared with treatment of the control group in terms of reduction of exacerbation of [COVID-19] pneumonia, duration of symptoms and delay of viral clearance, all in the absence of severe side effects. This has led in China to include chloroquine in the recommendations regarding the prevention and treatment of COVID-19 pneumonia.

Clinical Infectious Diseases - 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):

Hydroxychloroquine (EC50=0.72 μM) was found to be more potent than chloroquine (EC50=5.47 μM) in vitro. Based on PBPK models results, a loading dose of 400 mg twice daily of hydroxychloroquine sulfate given orally, followed by a maintenance dose of 200 mg given twice daily for 4 days is recommended for SARS-CoV-2 infection, as it reached three times the potency of chloroquine phosphate when given 500 mg twice daily 5 days in advance.

Nature - Hydroxychloroquine, a less toxic derivative of chloroquine, is effective in inhibiting SARS-CoV-2 infection in vitro:

Other than its direct antiviral activity, HCQ [Hydroxychloroquine] is a safe and successful anti-inflammatory agent that has been used extensively in autoimmune diseases and can significantly decrease the production of cytokines and, in particular, pro-inflammatory factors. Therefore, in COVID-19 patients, HCQ may also contribute to attenuating the inflammatory response. In conclusion, our results show that HCQ can efficiently inhibit SARS-CoV-2 infection in vitro. In combination with its anti-inflammatory function, we predict that the drug has a good potential to combat the disease. This possibility awaits confirmation by clinical trials. We need to point out, although HCQ is less toxic than CQ, prolonged and overdose usage can still cause poisoning.

Now, these aren't without issues. And, more data is sure to come out. However, one must look at these and see some hope, right?