[Artigo] Of chloroquine and COVID-19
Recent publications have brought attention to the possible benefit of chloroquine, a broadly used antimalarial drug, in the treatment of patients infected by the novel emerged coronavirus (SARS-CoV-2) (Colson et al., 2020; Gao et al., 2020). The scientific community should consider this information in light of previous experiments with chloroquine in
the field of antiviral research.
The sulfate and phosphate salts of chloroquine have both been commercialised as antimalarial drugs. Hydroxychloroquine has also been used as an antimalarial, but in addition is now broadly used in autoimmune diseases such as lupus and rheumatoid arthritis. Of note, chloroquine and hydroxychloroquine are considered to be safe and side-effects are generally mild and transitory. However, the margin between the therapeutic and toxic dose is narrow and chloroquine poisoning has been associated with cardiovascular disorders that can be life-threatening (Frisk-Holmberg et al., 1983). Chloroquine and hydroxychloroquine use should therefore be subject to strict rules, and self-treatment is not recommended.
The in vitro antiviral activity of chloroquine has been identified since the late 1960’s (Inglot, 1969; Miller and Lenard, 1981; Shimizu et al., 1972) and the growth of many different viruses can be inhibited in cell culture by both chloroquine and hydroxychloroquine, including the SARS coronavirus (Keyaerts et al., 2004). Some evidence for activity in mice has been found for a variety of viruses, including human coronavirus OC43 (Keyaerts et al., 2009), enterovirus EV-A71 (Tan et al., 2018), Zika virus (Li et al., 2017) and influenza A H5N1 (Yan et al., 2013). However, chloroquine did not prevent influenza infection in a randomized, double-blind, placebo-controlled clinical trial (Paton et al., 2011), and had no effect on dengue-infecteds patient in a randomized controlled trial in Vietnam (Tricou et al., 2010). Chloroquine was also active ex vivo but not in vivo in the case of ebolavirus in mice (Dowall et al., 2015; Falzarano et al., 2015), Nipah (Pallister et al., 2009) and influenza virus (Vigerust and McCullers, 2007) in ferrets.
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