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Chloroquine to fight COVID-19: A consideration of mechanisms and adverse effects?
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  • Xiping Zhan,
  • Sharon Dowell,
  • Ying Shen,
  • Dexter Lee
Xiping Zhan
Howard University College of Medicine
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Sharon Dowell
Howard University Hospital
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Ying Shen
Zhejiang University School of Medicine
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Dexter Lee
Howard University College of Medicine
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The COVID-19 outbreak emerged in December 2019 and has rapidly become a global pandemic. A great deal of effort has been made to find effective drugs against this disease. Chloroquine (CQ) and hydroxychloroquine (HCQ) have demonstrated great promise in treating COVID-19. CQ/HCQ have been used to prevent and treat malaria and are efficacious anti-inflammatory agents in rheumatoid arthritis and systemic lupus erythematosus. These drugs have potential broad-spectrum antiviral properties, and have been widely adopted for COVID-19 treatment and clinical trials. In this review, we re-evaluated the treatment outcomes and current hypothesis for the working mechanism of CQ/HCQ as COVID-19 therapy with a special focus on disruption of Ca2+ pathways. The potential toxicity is also cautioned for its action on Ca2+ and hyperpolarization-activated cyclic nucleotide-gated channels in cardiac myocytes and neuronal cells. We propose that intracellular calcium homeostasis is an alternative mechanism for CQ/HCQ pharmacology, which should be considered when evaluating the risks and benefits of therapy in these patients.

Peer review status:Published

Sep 2020Published in Heliyon volume 6 issue 9 on pages e04900. 10.1016/j.heliyon.2020.e04900