Chloroquine (CQ) and Hydroxychloroquine (HCQ) are highly prescribed as medications for COVID-19 infection, although no robust or convincing data has yet been published about their efficacy in COVID-19 patients. Therefore, risk and benefit assessment is necessary for deciding to prescribe these drugs in COVID-19 patients in hospital settings. We systematically searched from the MEDLINE Database, investigating the benefits and risks of HCQ and CQ among COVID-19 patients. All records were searched using the search terms Hydroxychloroquine, Chloroquine, COVID-19, and SARS-CoV-2. The selection criteria include all clinical trials and observational studies. We found 11 records on benefits and 7 records on risks of HCQ and CQ in COVID-19 patients after following inclusion and exclusion criteria. Clinical trial and observational studies have shown that HCQ is very limited, particularly in reducing mortality or proving clinical improvement. Similarly, seven observational studies have estimated the cardiac event in the use of HCQ or CQ in COVID-19. Even though there was no increase in death, these studies reported an increased risk of prolonging QT-interval in high proportion and other cardiac events such as arrhythmia, torsade de pointes, and conduction block. We conclude that the beneficial effect of HCQ and CQ in COVID-19 remains very limited. However, both medications have independently been shown to increase the risk for QT-interval prolongation, drug-induced torsades de pointes/TdP (a form of polymorphic ventricular tachycardia), and drug-induced other cardiac events in other populations. Copyright © 2020 THE AUTHOR(S).
Narrative review: Risk-benefit analysis of hydroxychloroquine and chloroquine treatment in COVID-19