Prophylaxis with Chloroquine and Hydroxychloroquine in Covid-19; A review

Since December 2019, an emerging virus called SARS-CoV-2 has spread in Wuhan, China, and has now become a global “pandemic” with the development of a disease called Covid-19. High emission capability and significant mortality of this disease indicate the need for immediate and effective attention to this issue. So far, many efforts have been made to introduce an effective treatment for Covid-19. Due to the contagiousness and high prevalence of the disease, chemoprophylaxis is a topic of discussion that is frequently asked by people and medical staff. The most suitable of the proposed drugs for this purpose are Chloroquine and Hydroxychloroquine which, besides anti-malarial and anti-inflammatory effects, have also antiviral effects. However, for introducing these drugs as prophylaxis, more evidence is needed.

In this study, the existing articles and studies on the use of Chloroquine and Hydroxychloroquine as an effective drug in the prevention of Covid-19 have been studied. References used in this review were identified through a search of PubMed and Google Scholar with keywords of “Hydroxychloroquine”, “Chloroquine”, “COVID-19”, “COVID 19”, “2019-nCoV”, “2019-CoV”, “coronavirus”, “ SARS-nCoV-2”, “antiviral”, and “prophylaxis”. Articles obtained from this search and relevant references were reviewed and included.

Available studies on the pharmacological effects of Chloroquine and Hydroxychloroquine on SARS-CoV-2 have been performed in the laboratory (In vitro). Till now, 5 clinical trials have been conducted in this field and their preliminary results will be published in the next few months. There are also different prophylactic doses suggested in existing studies.

Due to the lack of sufficient clinical evidence and the uncertainty about the dose required to create a prophylactic effect against the disease and due to possible complications, the use of these drugs for prophylaxis is not recommended until the first results of clinical studies are published and then approved by WHO, CDC and FDA. Sufficient attention should be paid to personal protective equipment.