GY48LS6

Статус Emergency use authorization (EUA) FDA отозван 15 июня 2020 г.

Mechanisms may include inhibition of viral enzymes or processes such as viral DNA and RNA polymerase, viral protein glycosylation, virus assembly, new virus particle transport, and virus release. Other mechanisms may also involve ACE2 cellular receptor inhibition, acidification at the surface of the cell membrane inhibiting fusion of the virus, and immunomodulation of cytokine release.

Pre-clinical data in vitro suggest chloroquine has activity has activity against SARS-CoV-2.

There have been reports of potential benefit in inhibiting the exacerbation of pneumonia patients with SARS-CoV-2 infection; however, specific data are not available.

Some protocols include recommendations for use.

Additional data regarding clinical efficacy for COVID-19 are being evaluated.

Safety Concerns:

• Risk of cardiac arrhythmias (e.g., QT prolongation)
• Risk of retinal damage, especially with long term use
• Caution in patients with G6PD deficiency
• Caution in diabetics
• Significant drug interactions

Mayla Gabriela Silva Borba, Fernando de Almeida Val, et al. Chloroquine diphosphate in two different dosages as adjunctive therapy of hospitalized patients with severe respiratory syndrome in the context of coronavirus (SARS-CoV-2) infection: Preliminary safety results of a randomized, double-blinded, phase IIb clinical trial (CloroCovid-19 Study). April 16, 2020. DOI: 10.1101/2020.04.07.20056424v2.

Kome Gbinigie and Kerstin Frie. Should chloroquine and hydroxychloroquine be used to treat COVID-19? A rapid review. BJGP Open 7 April 2020; DOI: https://doi.org/10.3399/bjgpopen20X101069

Food and Drug Administration (FDA). Fact sheet for health care providers: emergency use authorization (EUA) of chloroquine phosphate supplied from the strategic national stockpile for treatment of COVID-19 in certain hospitalized patients.

Devaux CA, Rolain JM, Colson P, Raoult D. New insights on the antiviral effects of chloroquine against coronavirus: what to expect for COVID-19? Int J Antimicrob Agents. 2020 Mar 11:105938. doi: 10.1016/j.ijantimicag.2020.105938. 

Cortegiani A, Ingoglia G, Ippolito M, et al. A systematic review on the efficacy and safety of chloroquine for the treatment of COVID-19. J Crit Care 2020 Mar 10. PMID: 32173110.

Colson P, Rolain J, Lagier J, et al. Chloroquine and hydroxychloroquine as available weapons to fight COVID-19. Int J Antimicrob Agents 2020. PMID: 32145363.

Gao J, T Zhenxue, Yang X. Breakthrough: Chloroquine phosphate has shown apparent efficacy in treatment of COVID-19 associated pneumonia in clinical studies. Biosci Trends 2020;14(1):72-73. PMID: 32074550.

Wang M, Cao R, Zhang L, et al. Remdesivir and chloroquine effectively inhibit the recently emerged novel coronavirus (2019-nCoV) in vitro. Cell Research 2020;30:269–271. PMID: 32020029.

Italian Society of Infectious and Tropical Diseases. Handbook for the care of people with disease-COVI 19. Edition 2.0, March 13, 2020.

Savarino A, Trani LD, Donatelli I, et al. New insights into the antiviral effects of chloroquine. The Lancet 2006;6:67-9. PMID: 16439323.

Barnard DL, Day CW, Bailey K, et al. Evaluation of immunomodulators, interferons and known in vitro SARS-coV inhibitors for inhibition of SARS-coV replication in BALB/c mice. Antivir Chem Chemother. 2006;17(5):275-84.