ABSTRACT
The new type of coronavirus pneumonia (COVID-19) is raging around the world, and the number of diagnoses and deaths continues to rise, and there is still no specific treatment drug. Chloroquine is a traditional medicine for the treatment of malaria and autoimmune diseases. It has shown initial efficacy in the treatment of COVID-19 and has attracted much attention. Hydroxychloroquine is a derivative of chloroquine, and its clinical drug safety is higher than that of chloroquine. It is listed by the World Health Organization as one of the 4 candidate trial drugs for the treatment of COVID-19 , Has also been included in the trial of the sixth and seventh editions of the COVID-19 treatment plan by the National Health Commission of China. However, the clinical efficacy of chloroquine and hydroxychloroquine in the treatment of COVID-19 is still very controversial, and sufficient Clinical data supports its use as a recommended drug for the treatment of COVID-19. In order to have a clearer understanding of chloroquine and hydroxychloroquine, this article briefly summarizes the pathological changes and treatment options of COVID-19, focusing on the efficacy of hydroxychloroquine in clinical trials and an in-depth analysis The potential causes and possible mechanisms of the different results of hydroxychloroquine in clinical trials, and the potential therapeutic effects of anisodamine and the antiviral drug remdesivir and psychological interventions are discussed, which are important for the rationalization of COVID-19 treatment options Reference value.
ABSTRACT
The novel severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) causes coronavirus disease 2019 (COVID-19) and an ongoing severe pandemic. Curative drugs specific for COVID-19 are currently lacking. Chloroquine phosphate and its derivative hydroxychloroquine, which have been used in the treatment and prevention of malaria and autoimmune diseases for decades, were found to inhibit SARS-CoV-2 infection with high potency in vitro and have shown clinical and virologic benefits in COVID-19 patients. Therefore, chloroquine phosphate was first used in the treatment of COVID-19 in China. Later, under a limited emergency-use authorization from the FDA, hydroxychloroquine in combination with azithromycin was used to treat COVID-19 patients in the USA, although the mechanisms of the anti-COVID-19 effects remain unclear. Preliminary outcomes from clinical trials in several countries have generated controversial results. The desperation to control the pandemic overrode the concerns regarding the serious adverse effects of chloroquine derivatives and combination drugs, including lethal arrhythmias and cardiomyopathy. The risks of these treatments have become more complex as a result of findings that COVID-19 is actually a multisystem disease. While respiratory symptoms are the major clinical manifestations, cardiovascular abnormalities, including arrhythmias, myocarditis, heart failure, and ischemic stroke, have been reported in a significant number of COVID-19 patients. Patients with preexisting cardiovascular conditions (hypertension, arrhythmias, etc.) are at increased risk of severe COVID-19 and death. From pharmacological and cardiovascular perspectives, therefore, the treatment of COVID-19 with chloroquine and its derivatives should be systematically evaluated, and patients should be routinely monitored for cardiovascular conditions to prevent lethal adverse events.