Is There a Future for Hydroxychloroquine/chloroquine in Prevention of SARS-CoV-2 Infection (COVID-19)?

In a recent article, Spinelli et al discussed a potential role of antimalarials in prevention of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection and suggest that, waiting for supportive data from clinical trials, the scientific community is moving towards pre-emptive use of chloroquine (CQ) and hydroxychloroquine (HCQ).1 During pandemic of COVID-19, physicians face an imperative to use the drugs with unproven clinical efficacy and at best only moderate activity against SARS-CoV-2 (CQ and HCQ among them) in an attempt to save lives of patients with severe viral pneumonia complicated by acute respiratory distress syndrome. Several reports from China showed that both CQ and HCQ can block viral replication in vitro,2 3 whereas a small non-randomised trial from Gautret et al found HCQ to have a promising efficacy in enhancing viral clearance.4 These preliminary data resulted in a widespread use of antimalarials to treat COVID-19 and prompted US President Donald Trump to tout HCQ as ‘one of the biggest game-changers in the history of medicine’. However, recent evidence suggests that it might be …