Hydroxychloroquine and azithromycin as a treatment of COVID-19

Excerpt

Since the emerging of the new coronavirus disease (COVID-19) with its staggering worldwide morbidity and mortality, the scientific community has been placed under extraordinary pressure to find safe and effective treatments, pending the availability of a vaccine. Some authors have focused their attention on the use of hydroxychloroquine, currently used in the prevention and treatment of malaria and chronic inflammatory diseases (lupus erythematosus and rheumatoid arthritis). Preclinical data suggest that hydroxychloroquine has in vitro antiviral activity blocking the entry of the virus into cells, decreasing pH within cells and attenuating cytokine production; this in vitro effect was promising against a bunch of virus (dengue, HIV, chikungunya, Ebola, SARS, and MERS) and recently, scientists have demonstrated its efficacy also against SARS-CoV-2 [1, 2]. The in vivo efficacy of hydroxychloroquine has not yet been assessed, even if several trials are ongoing (ex. trial ORCHID, NCT 04332991) [3]. Despite the lack of standardized evidences, hydroxychloroquine has been adopted by clinicians worldwide in the treatment, and in some cases, even in the prevention of patients with SARS-CoV-2 and it is still used even if some recent observational studies have confuted its usefulness [4]. The Chinese National guidelines and the US Food and Drug Administration for emergency uses have both recommended the off-label adoption of hydroxychloroquine in the treatment of COVID-19. …