ABSTRACT
BackgroundEffective therapies are urgently needed for the SARS-CoV-2 pandemic. Chloroquine has been proved to have antiviral effect against coronavirus in vitro. In this study, we aimed to assess the efficacy and safety of chloroquine with different doses in COVID-19. MethodIn this multicenter prospective observational study, we enrolled patients older than 18 years old with confirmed SARS-CoV-2 infection excluding critical cases from 12 hospitals in Guangdong and Hubei Provinces. Eligible patients received chloroquine phosphate 500mg, orally, once (half dose) or twice (full dose) daily. Patients treated with non-chloroquine therapy were included as historical controls. The primary endpoint is the time to undetectable viral RNA. Secondary outcomes include the proportion of patients with undetectable viral RNA by day 10 and 14, hospitalization time, duration of fever, and adverse events. ResultsA total of 197 patients completed chloroquine treatment, and 176 patients were included as historical controls. The median time to achieve an undetectable viral RNA was shorter in chloroquine than in non-chloroquine (absolute difference in medians -6.0 days; 95% CI -6.0 to -4.0). The duration of fever is shorter in chloroquine (geometric mean ratio 0.6; 95% CI 0.5 to 0.8). No serious adverse events were observed in the chloroquine group. Patients treated with half dose experienced lower rate of adverse events than with full dose. ConclusionsAlthough randomised trials are needed for further evaluation, this study provides evidence for safety and efficacy of chloroquine in COVID-19 and suggests that chloroquine can be a cost-effective therapy for combating 102 the COVID-19 pandemic.
ABSTRACT
In recent years,researches on drugs concentrated in the ecosystem have become a hot topic. Environmental pharmacology is a new subject studying the source and fate of drugs in the environment. It is found that a lot of pharmaceuticals and pharmaceutically active compounds are released into the environment by the pharmaceutical industry,hospitals and agricultured activities. Drugs in the environment not only affect the ecosystem,which leads to bacterial resistance,but also affect the balance of flora in the biofilm. Furthermore,such drugs may induce epigenetic changes, which may leave to the body vulnerable to diseases. The enrichment of endocrine disruptors can inter?fere with the growth and function of the human reproductive system. China is becoming concerned about environmental drugs. The development of environmental pharmacology can help clarify the interac?tions between drugs and the environment while contributing to public health and food safety in China.
