Chloroquine, hydroxychloroquine and COVID-19
The media have featured the antimalarials chloroquine (CQ) and hydroxychloroquine (HCQ) to treat coronavirus (COVID-19). Political leaders have touted their use and recommended availability to the public. These anti-inflammatory agents have substantial human toxicity with a narrow therapeutic window...
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| Format: | Article |
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Informa UK Limited
2020
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| Online Access: | https://hdl.handle.net/1721.1/125584 |
| _version_ | 1826195060814774272 |
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| author | Erickson, T. B. Chai, P. R. Boyer, E. W. |
| author2 | Koch Institute for Integrative Cancer Research at MIT |
| author_facet | Koch Institute for Integrative Cancer Research at MIT Erickson, T. B. Chai, P. R. Boyer, E. W. |
| author_sort | Erickson, T. B. |
| collection | MIT |
| description | The media have featured the antimalarials chloroquine (CQ) and hydroxychloroquine (HCQ) to treat coronavirus (COVID-19). Political leaders have touted their use and recommended availability to the public. These anti-inflammatory agents have substantial human toxicity with a narrow therapeutic window. CQ and HCQ poisoning cause myocardial depression and profound hypotension due to vasodilation. Bradycardia and ventricular escape rhythms arise from impaired myocardial automaticity and conductivity due to sodium and potassium channel blockade. With cardiotoxicity, ECGs may show widened QRS, atrioventricular heart block and QT interval prolongation. CQ may also cause seizures, often refractory to standard treatment. Of concern is pediatric poisoning, where 1-2 pills of CQ or HCQ can cause serious and potentially fatal toxicity in a toddler. The treatment of CQ/HCQ poisoning includes high-dose intravenous diazepam postulated to have positive ionotropic and antidysrhythmic properties that may antagonize the cardiotoxic effects of CQ. Infusions of epinephrine titrated to treat unstable hypotension, as well as potassium for severe hypokalemia may be required. Current scientific evidence does not support treatment or prophylactic use of these agents for COVID-19 disease. Regulatory and public health authorities recognize that CQ/HCQ may offer little clinical benefit and only add risk requiring further investigation before wider public distribution. |
| first_indexed | 2024-09-23T10:06:42Z |
| format | Article |
| id | mit-1721.1/125584 |
| institution | Massachusetts Institute of Technology |
| last_indexed | 2024-09-23T10:06:42Z |
| publishDate | 2020 |
| publisher | Informa UK Limited |
| record_format | dspace |
| spelling | mit-1721.1/1255842022-09-26T15:47:06Z Chloroquine, hydroxychloroquine and COVID-19 Erickson, T. B. Chai, P. R. Boyer, E. W. Koch Institute for Integrative Cancer Research at MIT The media have featured the antimalarials chloroquine (CQ) and hydroxychloroquine (HCQ) to treat coronavirus (COVID-19). Political leaders have touted their use and recommended availability to the public. These anti-inflammatory agents have substantial human toxicity with a narrow therapeutic window. CQ and HCQ poisoning cause myocardial depression and profound hypotension due to vasodilation. Bradycardia and ventricular escape rhythms arise from impaired myocardial automaticity and conductivity due to sodium and potassium channel blockade. With cardiotoxicity, ECGs may show widened QRS, atrioventricular heart block and QT interval prolongation. CQ may also cause seizures, often refractory to standard treatment. Of concern is pediatric poisoning, where 1-2 pills of CQ or HCQ can cause serious and potentially fatal toxicity in a toddler. The treatment of CQ/HCQ poisoning includes high-dose intravenous diazepam postulated to have positive ionotropic and antidysrhythmic properties that may antagonize the cardiotoxic effects of CQ. Infusions of epinephrine titrated to treat unstable hypotension, as well as potassium for severe hypokalemia may be required. Current scientific evidence does not support treatment or prophylactic use of these agents for COVID-19 disease. Regulatory and public health authorities recognize that CQ/HCQ may offer little clinical benefit and only add risk requiring further investigation before wider public distribution. National Institutes of Health (Grant K23DA044874) 2020-05-29T16:11:08Z 2020-05-29T16:11:08Z 2020-01 Article http://purl.org/eprint/type/JournalArticle 2473-4306 https://hdl.handle.net/1721.1/125584 Erickson, T. B. et al. "Chloroquine, hydroxychloroquine and COVID-19." Toxicology Communications 4, 1 (January 2020): 40-42 © 2020 The Author(s) 10.1080/24734306.2020.1757967 Toxicology Communications Creative Commons Attribution-Noncommercial-Share Alike http://creativecommons.org/licenses/by-nc-sa/4.0/ application/pdf Informa UK Limited PMC |
| spellingShingle | Erickson, T. B. Chai, P. R. Boyer, E. W. Chloroquine, hydroxychloroquine and COVID-19 |
| title | Chloroquine, hydroxychloroquine and COVID-19 |
| title_full | Chloroquine, hydroxychloroquine and COVID-19 |
| title_fullStr | Chloroquine, hydroxychloroquine and COVID-19 |
| title_full_unstemmed | Chloroquine, hydroxychloroquine and COVID-19 |
| title_short | Chloroquine, hydroxychloroquine and COVID-19 |
| title_sort | chloroquine hydroxychloroquine and covid 19 |
| url | https://hdl.handle.net/1721.1/125584 |
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