Hydroxychloroquine: a comprehensive review and its controversial role in coronavirus disease 2019

Hydroxychloroquine, initially used as an antimalarial, is used as an immunomodulatory and anti-inflammatory agent for the management of autoimmune and rheumatic diseases such as systemic lupus erythematosus. Lately, there has been interest in its potential efficacy against severe acute respiratory s...

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Main Authors: Pankaj Bansal, Amandeep Goyal, Austin Cusick, Shubham Lahan, Harpal S. Dhaliwal, Poonam Bhyan, Pradnya Brijmohan Bhattad, Fawad Aslam, Sagar Ranka, Tarun Dalia, Lovely Chhabra, Devang Sanghavi, Bhavin Sonani, John M. Davis
Format: Article
Language:English
Published: Taylor & Francis Group 2021-01-01
Series:Annals of Medicine
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Online Access:https://www.tandfonline.com/doi/10.1080/07853890.2020.1839959
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author Pankaj Bansal
Amandeep Goyal
Austin Cusick
Shubham Lahan
Harpal S. Dhaliwal
Poonam Bhyan
Pradnya Brijmohan Bhattad
Fawad Aslam
Sagar Ranka
Tarun Dalia
Lovely Chhabra
Devang Sanghavi
Bhavin Sonani
John M. Davis
author_facet Pankaj Bansal
Amandeep Goyal
Austin Cusick
Shubham Lahan
Harpal S. Dhaliwal
Poonam Bhyan
Pradnya Brijmohan Bhattad
Fawad Aslam
Sagar Ranka
Tarun Dalia
Lovely Chhabra
Devang Sanghavi
Bhavin Sonani
John M. Davis
author_sort Pankaj Bansal
collection DOAJ
description Hydroxychloroquine, initially used as an antimalarial, is used as an immunomodulatory and anti-inflammatory agent for the management of autoimmune and rheumatic diseases such as systemic lupus erythematosus. Lately, there has been interest in its potential efficacy against severe acute respiratory syndrome coronavirus 2, with several speculated mechanisms. The purpose of this review is to elaborate on the mechanisms surrounding hydroxychloroquine. The review is an in-depth analysis of the antimalarial, immunomodulatory, and antiviral mechanisms of hydroxychloroquine, with detailed and novel pictorial explanations. The mechanisms of hydroxychloroquine are related to potential cardiotoxic manifestations and demonstrate potential adverse effects when used for coronavirus disease 2019 (COVID-19). Finally, current literature associated with hydroxychloroquine and COVID-19 has been analyzed to interrelate the mechanisms, adverse effects, and use of hydroxychloroquine in the current pandemic. Currently, there is insufficient evidence about the efficacy and safety of hydroxychloroquine in COVID-19.KEY MESSAGESHCQ, initially an antimalarial agent, is used as an immunomodulatory agent for managing several autoimmune diseases, for which its efficacy is linked to inhibiting lysosomal antigen processing, MHC-II antigen presentation, and TLR functions.HCQ is generally well-tolerated although severe life-threatening adverse effects including cardiomyopathy and conduction defects have been reported.HCQ use in COVID-19 should be discouraged outside clinical trials under strict medical supervision.
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spelling doaj-art-cf3273e9cd1549ca80ecaab7362d08f72025-08-20T03:44:04ZengTaylor & Francis GroupAnnals of Medicine0785-38901365-20602021-01-0153111713410.1080/07853890.2020.1839959Hydroxychloroquine: a comprehensive review and its controversial role in coronavirus disease 2019Pankaj Bansal0Amandeep Goyal1Austin Cusick2Shubham Lahan3Harpal S. Dhaliwal4Poonam Bhyan5Pradnya Brijmohan Bhattad6Fawad Aslam7Sagar Ranka8Tarun Dalia9Lovely Chhabra10Devang Sanghavi11Bhavin Sonani12John M. Davis13Mayo Clinic Health System, Eau Claire, WI, USAUniversity of Kansas Medical Center, Kansas City, KS, USAOhio University Heritage College of Osteopathic Medicine, Athens, OH, USAUniversity College of Medical Sciences, New Delhi, IndiaChristian Medical College and Hospital, Ludhiana, IndiaCape Fear Valley Hospital, Fayetteville, NC, USAEast Tennessee State University, Johnson City, TN, USAMayo Clinic, Scottsdale, AZ, USA, USAUniversity of Kansas Medical Center, Kansas City, KS, USAUniversity of Kansas Medical Center, Kansas City, KS, USAHeartland Regional Medical Center, Southern IL University, Carbondale, IL, USAMayo Clinic, Jacksonville, FL, USAHSHS St John’s Hospital, Springfield, IL, USAMayo Clinic, Rochester, MN, USAHydroxychloroquine, initially used as an antimalarial, is used as an immunomodulatory and anti-inflammatory agent for the management of autoimmune and rheumatic diseases such as systemic lupus erythematosus. Lately, there has been interest in its potential efficacy against severe acute respiratory syndrome coronavirus 2, with several speculated mechanisms. The purpose of this review is to elaborate on the mechanisms surrounding hydroxychloroquine. The review is an in-depth analysis of the antimalarial, immunomodulatory, and antiviral mechanisms of hydroxychloroquine, with detailed and novel pictorial explanations. The mechanisms of hydroxychloroquine are related to potential cardiotoxic manifestations and demonstrate potential adverse effects when used for coronavirus disease 2019 (COVID-19). Finally, current literature associated with hydroxychloroquine and COVID-19 has been analyzed to interrelate the mechanisms, adverse effects, and use of hydroxychloroquine in the current pandemic. Currently, there is insufficient evidence about the efficacy and safety of hydroxychloroquine in COVID-19.KEY MESSAGESHCQ, initially an antimalarial agent, is used as an immunomodulatory agent for managing several autoimmune diseases, for which its efficacy is linked to inhibiting lysosomal antigen processing, MHC-II antigen presentation, and TLR functions.HCQ is generally well-tolerated although severe life-threatening adverse effects including cardiomyopathy and conduction defects have been reported.HCQ use in COVID-19 should be discouraged outside clinical trials under strict medical supervision.https://www.tandfonline.com/doi/10.1080/07853890.2020.1839959HydroxychloroquineCOVID-19cardiotoxicitymechanism of action
spellingShingle Pankaj Bansal
Amandeep Goyal
Austin Cusick
Shubham Lahan
Harpal S. Dhaliwal
Poonam Bhyan
Pradnya Brijmohan Bhattad
Fawad Aslam
Sagar Ranka
Tarun Dalia
Lovely Chhabra
Devang Sanghavi
Bhavin Sonani
John M. Davis
Hydroxychloroquine: a comprehensive review and its controversial role in coronavirus disease 2019
Annals of Medicine
Hydroxychloroquine
COVID-19
cardiotoxicity
mechanism of action
title Hydroxychloroquine: a comprehensive review and its controversial role in coronavirus disease 2019
title_full Hydroxychloroquine: a comprehensive review and its controversial role in coronavirus disease 2019
title_fullStr Hydroxychloroquine: a comprehensive review and its controversial role in coronavirus disease 2019
title_full_unstemmed Hydroxychloroquine: a comprehensive review and its controversial role in coronavirus disease 2019
title_short Hydroxychloroquine: a comprehensive review and its controversial role in coronavirus disease 2019
title_sort hydroxychloroquine a comprehensive review and its controversial role in coronavirus disease 2019
topic Hydroxychloroquine
COVID-19
cardiotoxicity
mechanism of action
url https://www.tandfonline.com/doi/10.1080/07853890.2020.1839959
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