Risk versus Benefit of Using Hydroxychloroquine to Treat Patients with COVID-19
Hydroxychloroquine (HCQ), also known by its trade name Plaquenil®, has been used for over 50 years as a treatment for malaria, systemic lupus erythematosus, and rheumatoid arthritis. As the COVID-19 pandemic emerged in the United States and globally in early 2020, HCQ began to garner attention as a...
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| Format: | Article |
| Language: | English |
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Wiley
2021-01-01
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| Series: | Canadian Journal of Infectious Diseases and Medical Microbiology |
| Online Access: | http://dx.doi.org/10.1155/2021/5942366 |
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| author | George G. Zhanel Michael A. Zhanel Kevin F. Boreskie Joseph P. Lynch James A. Karlowsky |
| author_facet | George G. Zhanel Michael A. Zhanel Kevin F. Boreskie Joseph P. Lynch James A. Karlowsky |
| author_sort | George G. Zhanel |
| collection | DOAJ |
| description | Hydroxychloroquine (HCQ), also known by its trade name Plaquenil®, has been used for over 50 years as a treatment for malaria, systemic lupus erythematosus, and rheumatoid arthritis. As the COVID-19 pandemic emerged in the United States and globally in early 2020, HCQ began to garner attention as a potential treatment and as prophylaxis against COVID-19. Preliminary data indicated that HCQ as well as chloroquine (CQ) possessed in vitro antiviral activity against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Early clinical data from China and France reported that HCQ and CQ were associated with viral load reduction and clinical improvement in patients with COVID-19 compared to control groups; however, an overwhelming number of randomized controlled trials, meta-analyses, and systematic reviews have since concluded that HCQ used alone, or in combination with azithromycin (AZ), provides no mortality or time-to-recovery benefit in hospitalized patients with COVID-19. Additionally, these same trials reported adverse events including cardiac, neuropsychiatric, hematologic, and hepatobiliary manifestations in patients with COVID-19 whom had been treated with HCQ. This review article summarizes the available data pertaining to the adverse events associated with HCQ use, alone or in combination with azithromycin, in patients with COVID-19 in order to fully assess the risk versus benefit of treating COVID-19 patients with these agents. The results of this review lead us to conclude that the risks of adverse events associated with HCQ use (with or without AZ) outweigh the potential clinical benefits and thus recommend against its use in the treatment or prevention of COVID-19. |
| format | Article |
| id | doaj-art-2e10e55bbd8a47eeb30ce80966dc8703 |
| institution | Kabale University |
| issn | 1712-9532 1918-1493 |
| language | English |
| publishDate | 2021-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Canadian Journal of Infectious Diseases and Medical Microbiology |
| spelling | doaj-art-2e10e55bbd8a47eeb30ce80966dc87032025-02-03T01:24:53ZengWileyCanadian Journal of Infectious Diseases and Medical Microbiology1712-95321918-14932021-01-01202110.1155/2021/59423665942366Risk versus Benefit of Using Hydroxychloroquine to Treat Patients with COVID-19George G. Zhanel0Michael A. Zhanel1Kevin F. Boreskie2Joseph P. Lynch3James A. Karlowsky4Department of Medical Microbiology/Infectious Diseases, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, CanadaDepartment of Medical Microbiology/Infectious Diseases, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, CanadaDepartment of Medical Microbiology/Infectious Diseases, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, CanadaDepartment of Medical Microbiology/Infectious Diseases, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, CanadaDepartment of Medical Microbiology/Infectious Diseases, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, CanadaHydroxychloroquine (HCQ), also known by its trade name Plaquenil®, has been used for over 50 years as a treatment for malaria, systemic lupus erythematosus, and rheumatoid arthritis. As the COVID-19 pandemic emerged in the United States and globally in early 2020, HCQ began to garner attention as a potential treatment and as prophylaxis against COVID-19. Preliminary data indicated that HCQ as well as chloroquine (CQ) possessed in vitro antiviral activity against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Early clinical data from China and France reported that HCQ and CQ were associated with viral load reduction and clinical improvement in patients with COVID-19 compared to control groups; however, an overwhelming number of randomized controlled trials, meta-analyses, and systematic reviews have since concluded that HCQ used alone, or in combination with azithromycin (AZ), provides no mortality or time-to-recovery benefit in hospitalized patients with COVID-19. Additionally, these same trials reported adverse events including cardiac, neuropsychiatric, hematologic, and hepatobiliary manifestations in patients with COVID-19 whom had been treated with HCQ. This review article summarizes the available data pertaining to the adverse events associated with HCQ use, alone or in combination with azithromycin, in patients with COVID-19 in order to fully assess the risk versus benefit of treating COVID-19 patients with these agents. The results of this review lead us to conclude that the risks of adverse events associated with HCQ use (with or without AZ) outweigh the potential clinical benefits and thus recommend against its use in the treatment or prevention of COVID-19.http://dx.doi.org/10.1155/2021/5942366 |
| spellingShingle | George G. Zhanel Michael A. Zhanel Kevin F. Boreskie Joseph P. Lynch James A. Karlowsky Risk versus Benefit of Using Hydroxychloroquine to Treat Patients with COVID-19 Canadian Journal of Infectious Diseases and Medical Microbiology |
| title | Risk versus Benefit of Using Hydroxychloroquine to Treat Patients with COVID-19 |
| title_full | Risk versus Benefit of Using Hydroxychloroquine to Treat Patients with COVID-19 |
| title_fullStr | Risk versus Benefit of Using Hydroxychloroquine to Treat Patients with COVID-19 |
| title_full_unstemmed | Risk versus Benefit of Using Hydroxychloroquine to Treat Patients with COVID-19 |
| title_short | Risk versus Benefit of Using Hydroxychloroquine to Treat Patients with COVID-19 |
| title_sort | risk versus benefit of using hydroxychloroquine to treat patients with covid 19 |
| url | http://dx.doi.org/10.1155/2021/5942366 |
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