Use of aminoquinolines (Chloroquine and Hydroxychloroquine) in the treatment of COVID-19: a systematic review

Authors

DOI:

https://doi.org/10.33448/rsd-v10i12.20907

Keywords:

COVID-19; SARS-COV-2; Chloroquine; Hydroxychloroquine.

Abstract

The COVID-19 pandemic, caused by the SARS-COV-2 virus, is an infectious disease that to date there is no effective treatment to reduce patient mortality. Hydroxychloroquine (HCQ) and Chloroquine (CQ) are aminoquinoline-derived drugs used in the prevention and treatment of malaria. Initially, aminoquinolines were reported as effective in combating SARS-COV-2 due to their anti-inflammatory and antiviral effects, however, several studies were published in the literature, addressing their efficacy, leading to contradictory results. Furthermore, there is, to date, no concrete evidence to support their use, as well as, there is a small number of clinical trials that show evidence of the effectiveness of these drugs. Therefore, the present study aims to assess the effectiveness of HCQ and CQ in the treatment of patients with COVID-19, through a systematic review of the main articles involving patients with COVID-19 and the use of HCQ and CQ. A systematic review was performed based on a search in the PubMed and EMBASE databases to find articles that provide information on the efficacy and safety of formulations related to aminoquinolines in patients with SARS-CoV-2 pneumonia. The initial search identified a total of 162 articles, with 14 eligible, and 13 of these found no significant difference.

Author Biography

Tereza de Jesus Pinheiro Gomes Bandeira, Centro Universitário Christus

 

 

 

References

Abd-Elsalam, S., Esmail, E. S., Khalaf, M., Abdo, E. F., Medhat, M. A., Ghafar, M. S. A. E., Ahmed, O. A., Soliman, S., Serangawy, G. N. & Alboraie, M. (2020). Hydroxychloroquine in the treatment of COVID-19: a multicenter randomized controlled study. The American Journal of Tropical Medicine and Hygiene, 103(4), 1635-1639.

Abella, B. S., Jolkovsky, E. L., Biney, B. T., Uspal, J. E., Hyman, M. C., Frank, I., Hensley, S. E., Gill, S., Vogl, D. T., Maillard, I., Babushok, D. V., Huang, A. C., Nasta, S. D., Walsh, J. C., Wiletyo, E. P., Gimotty, P. A., Milone, M. C. & Amaravadi, R. K. (2021). Efficacy and safety of hydroxychloroquine vs placebo for pre-exposure SARS-CoV-2 prophylaxis among health care workers: a randomized clinical trial. JAMA Internal Medicine, 181(2), 195-202.

Borba, M. G. S., Val, F. F. A., Sampaio, V. S., Alexandre, M. A. A., Melo, G. C., Brito, M., Mourão, M. P. G., Brito-Sousa, J. D., Baía-da-Silva, D., Guerra, M. V. F., Hajjar, L. A., Pinto, R. C., Balieiro, A. A. S., Pacheco, A. G. F., Santos Júnior, J. D. O., Naveca, F. G., Xavier, M. S., Siqueira, A. M., Schwarzbold, A., ... Lacerda, M. V. G. (2020). 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 Network Open, 3(4), e208857.

Boulware, D. R., Pullen, M. F., Bangdiwala, A. S., Pastick, K. A., Lofgren, S. M., Okafor, E. C., Skipper, C. P., Nascene, A. A., Nicol, M. R., Abassi, M., Engen, N. W., Cheng, M. P., LaBar, D., Lother, S. A., MacKenzie, L. J., Drobot, G., Marten, N., Zarychanski, R., ... Hullsiek, K. H. (2020). A randomized trial of hydroxychloroquine as postexposure prophylaxis for Covid-19. New England Journal of Medicine, 383(6), 517-525.

Cavalcanti, A. B., Zampieri, F. G., Rosa, R. G, Azevedo, L. C. P., Veiga, V. C., Avezum, A., Damiani, L. P., Marcadenti, A., Kawano-Dourado, L., Lisboa, T., Junqueira, D. L. M., de Barros e Silva, P. G. M., Tramujas, L., Abreu-Silva, E. O., Larankeira, L. N., Soares, A. T., Echenique, L. S., Pereira, A. J., Freitas, F. G. R., … Berwanger, O. (2020). Hydroxychloroquine with or without Azithromycin in Mild-to-Moderate Covid-19. New England Journal of Medicine, 383(21), 2041-2052.

Chen, Z., Hu, J., Zhang, Z., Jiang, S., Han, S., Yan, D., Zhuang, R., Hu, B., Zhang, Z. (2020). Efficacy of hydroxychloroquine in patients with COVID-19: results of a randomized clinical trial. Medrxiv, Cold Spring Harbor Laboratory. doi:http://dx.doi.org/10.1101/2020.03.22.20040758.

Conselho Nacional de Saúde. (2021). CNS pede que Ministério da Saúde retire publicações sobre tratamento precoce para Covid-19. http://conselho.saude.gov.br/ultimas-noticias-cns/1570-cns-pede-que-ministerio-da-saude-retire-publicacoes-sobre-tratamento-precoce-para-covid-19.

Cortegiani, A., Ingoglia, G., Ippolito, M., Giarratano, A., & Einav, S. (2020). A systematic review on the efficacy and safety of chloroquine for the treatment of COVID-19. Journal of Critical Care, 57, 279–283. doi:https://doi.org/10.1016/j.jcrc.2020.03.005.

Devaux, C. A., Rolain, J.-M. & Raoult, D. (2020). ACE2 receptor polymorphism: Susceptibility to SARS-CoV-2, hypertension, multi-organ failure, and COVID-19 disease outcome. J. Microbiol. Immunol. Infect. 53, 425–435. doi:https://doi.org/10.1016/j.jmii.2020.04.015.

Franco, J. V. A. (2020). La hidroxicloroquina no reduciría la portación viral del nuevo coronavirus (COVID-19). Evidencia, actualización en la práctica ambulatoria, 23(1), e002051.

Gautret, P., Lagier, J.-C., Parola, P., Hoang, V. T., Meddeb, L., Sevestre, J., Mailhe, M., Doudier, B., Aubry, C., Amrane, S., Seng, P., Hocquart, M., Eldin, C., Finance, J., Vieira, V. E., Tissot-Dupont, H. T., Honoré, S., Stein, A., Million, M., … Raoult, D. (2020). Clinical and microbiological effect of a combination of hydroxychloroquine and azithromycin in 80 COVID-19 patients with at least a six-day follow up: a pilot observational study. Travel medicine and infectious disease, 34, e101663.

Geleris, J., Sun, Y., Platt, J., Zucker, J., Baldwin, M., Hripcsak, G., Labella, A., Manson, D. K., Kubin, C., Barr, G., Sobieszczyk, M. E. & Schluger, N. W. (2020). Observational Study of Hydroxychloroquine in Hospitalized Patients with Covid-19. New England Journal of Medicine, 382(25), 2411-2418. doi:https://doi.org/10.1056/NEJMoa2012410.

Ghazy, R. M., Almaghraby, A., Shaaban, R., Kamal, A., Beshir, H., Moursi, A., Ramadan, A. & Taha, S. H. N.. (2020). A systematic review and meta-analysis on chloroquine and hydroxychloroquine as monotherapy or combined with azithromycin in COVID-19 treatment. Scientific reports, 10(1), 1-18.

Horby, P., Mafham, M., Linsell, L., Bell, J. L. Staplin, N., Emberson, J. R., Wiselka, M., Ustianowski, A., Elmahi, E., Prudon, B., Whitehouse, A., Felton, T., Williams, J., Faccenda, J., Underwood, J., Baillie, J. K., Chappell, L., Faust, S. N., Jaki, T., … Landray, M. J. (2020). Effect of Hydroxychloroquine in Hospitalized Patients with COVID-19: Preliminary results from a multi-centre, randomized, controlled trial. MedRxiv. doi:https://doi.org/10.1101/2020.07.15.20151852.

Huang, M., Tang, T., Pengfei, P., Li, M., Ma, R., Lu, J., Shu, J., You, Y., Chen, B., Liang, J., Hong, Z., Chen, H., Kong, L., Qin, D., Pei, D., Xia, J., Jiang, S. & Shan, H. (2020). Treating COVID-19 with chloroquine. Journal of Molecular Cell Biology, 12(4), 322-325.

Lyngbakken, M. N., Berdal, J.-E., Eskesen, A., Kvale, D., Olsen, I. C., Rueegg, C. S., Rangberg, A., Jonassen, C. M., Omland, T., Røsjø, H. & Dalgard, O. (2020). A pragmatic randomized controlled trial reports lack of efficacy of hydroxychloroquine on coronavirus disease 2019 viral kinetics. Nature Communications, 11(1), 1-6.

Mitjà, O., Corbacho-Monné, M., Ubals, M., Tebe, C., Peñafiel, J.,Tobias, A., Ballana, E., Alemany, A., Riera-Martí, N., Pérez, C. A., Suñer C., Laporte, P., Admella, P., Mitjà, J., Clua, M., Bertran, L., Sarquella, M., Gavilán, S., Ara, J., … Vall-Mayans, M. (2020). Hydroxychloroquine for early treatment of adults with mild Covid-19: a randomized-controlled trial. Clinical Infectious Diseases. doi:https://doi.org/10.1093/cid/ciaa1009.

Recovery Collaborative Group. (2021). Dexamethasone in hospitalized patients with Covid-19. New England Journal of Medicine, 384(8), 693-704.

Savarino, A., Di Trani, L., Donatelli, I., Cauda, R. & Cassone, A. (2006). New insights into the antiviral effects of chloroquine. Lancet Infect. Dis. 6, 67–69.

Skipper, C. P., Pastick, K. A., Engen, N. W., Bangdiwala, A. S., Abassi, M., Lofgren, S. M., Williams, D. A., Okafor, E. C., Pullen, M. F., Nicol, M. R., Nascene, A. A., Hullsiek, K. H., Cheng, M. P., Luke, D., Lother, S. A., MacKenzie, L. J., Drobot, G., Kelly, L. E., Schwartz, I. S, … Boulware, D. R. (2020). Hydroxychloroquine in nonhospitalized adults with early COVID-19: a randomized trial. Annals of Internal Medicine, 173(8), 623-631.

Tang, W., Cao, Z., Han, M., Wang, Z., Chen, J., Sun, W., Wu, Y., Xiao, W., Liu, S., Chen, E., Chen, W., Wang, X., Yang, J., Lin, J., Zhao, Q., Yan, Y., Xie, Z., Li, D., Yang, Y., … Xie, Q. (2020). Hydroxychloroquine in patients with mainly mild to moderate coronavirus disease 2019: open label, randomised controlled trial. The BMJ, 369, 1-11. doi: https://doi.org/10.1136/bmj.m1849.

Thomas, J., Kneale, D., Mckenzie, J.E., Brennan, S.E. & Bhaumik S. (Eds.). (2019). Cochrane Handbook for Systematic Reviews of Interventions version 6.0 (Chap. 2). www.training.cochrane.org/handbook.

UNA-SUS (2021). Organização Mundial de Saúde declara pandemia do novo coronavírus. https://www.unasus.gov.br/noticia/organizacao-mundial-de-saude-declara-pandemia-de-coronavirus.

WHO. (2020). Coronavirus disease 2019 (COVID-19), Situation report 85. https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200414-sitrep-85-covid-19.pdf?sfvrsn=7b8629bb_4.

WHO. (2021). Weekly Operational Update on COVID-19, Issue No. 59. https://www.who.int/publications/m/item/weekly-operational-update-on-covid-19---14-june-2021.

Yan, Y., Zou, Z., Sun, Y., Li, X., Xu, K.-F., Yuquan, W., Jin, N. & Jiang, C. (2013). Anti-malaria drug chloroquine is highly effective in treating avian influenza A H5N1 virus infection in an animal model. Cell Research, 23, 300–302.

Published

01/10/2021

How to Cite

LIMA, L. V. A.; SANTOS, F. S. .; ALVES, N. A.; ALVES, S. S.; MELO, I. M. D. de; BANDEIRA, T. de J. P. G. Use of aminoquinolines (Chloroquine and Hydroxychloroquine) in the treatment of COVID-19: a systematic review. Research, Society and Development, [S. l.], v. 10, n. 12, p. e569101220907, 2021. DOI: 10.33448/rsd-v10i12.20907. Disponível em: https://rsdjournal.org/index.php/rsd/article/view/20907. Acesso em: 25 nov. 2024.

Issue

Section

Health Sciences