Journey of Chloroquine/ Hydroxychloroquine in the management of COVID-19

Abstract

Chloroquine was discovered in 1934 and since then it is used as an antimalarial drug saving millions of lives. Chloroquine and its analogue Hydroxychloroquine possess pleotropic pharmacological actions and are of proven value in multiple conditions ranging from protozoal to autoimmune diseases. Advantage with these drugs is their well-documented tolerability profile. In Severe Acute Respiratory Syndrome Corona virus-2 (SARS-CoV-2), these drugs in vitro showed promising results working at multiple sites ranging from prevention of entry of the virus into human cells, halting the multiplication by altering the pH of internal organelles towards basic side and via exocytosis. These drugs also act as immunomodulators to prevent flare up of cytokines and interleukin cascade, thus preventing multiple organ dysfunction syndrome. In this review we trend the journey of these drugs, how high hopes were pinned to their use but they failed to show any mortality benefit in hospitalized patients. However, still certain studies are underway to explore their role in prophylaxis or otherwise. Medline, Medscape, EMBASE, Cochrane database, Scopus and clinicaltrials.gov were searched using terms like “SARS-CoV-2”, “COVID-19”, “Chloroquine” and “Hydroxychloroquine”.