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Review
. 2020;6(5):203-211.
doi: 10.1007/s40495-020-00231-8. Epub 2020 Aug 24.

Hydroxychloroquine in COVID-19: Potential Mechanism of Action Against SARS-CoV-2

Sairaj Satarker #  1 , Tejas Ahuja #  1 , Madhuparna Banerjee  1 , Vignesh Balaji E  1 , Shagun Dogra  1 , Tushar Agarwal  1 , Madhavan Nampoothiri #  1
Affiliations
Review

Hydroxychloroquine in COVID-19: Potential Mechanism of Action Against SARS-CoV-2

Sairaj Satarker et al. Curr Pharmacol Rep. 2020.

Abstract

Purpose of review: The rapid spread of virus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has turned out to be a global emergency. Symptoms of this viral infection, coronavirus disease 2019 (COVID-19), include mild infections of the upper respiratory tract, viral pneumonia, respiratory failure, multiple organ failure and death. Till date, no drugs have been discovered to treat COVID-19 patients, and therefore, a considerable amount of interest has been shown in repurposing the existing drugs.

Recent findings: Out of these drugs, chloroquine (CQ) and hydroxychloroquine (HCQ) have demonstrated positive results indicating a potential antiviral role against SARS-CoV-2. Its mechanism of action (MOA) includes the interference in the endocytic pathway, blockade of sialic acid receptors, restriction of pH mediated spike (S) protein cleavage at the angiotensin-converting enzyme 2 (ACE2) binding site and prevention of cytokine storm. Unfortunately, its adverse effects like gastrointestinal complications, retinopathy and QT interval prolongation are evident in treated COVID-19 patients. Yet, multiple clinical trials have been employed in several countries to evaluate its ability in turning into a needed drug in this pandemic.

Summary: This review attempts to summarize the MOA of CQ/HCQ and its side effects. The existing literature hints that till date, the role of CQ/HCQ in COVID-19 may be sceptical, and further studies are warranted for obtaining a therapeutic option that could be effectively used across the world to rise out from this pandemic.

Keywords: COVID-19; Coronavirus; Hydroxychloroquine; Pandemic; QT prolongation; SARS-CoV-2.

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Conflict of interest statement

Conflict of InterestThe authors declare that they have no conflict of interests.

Figures

Fig. 1
Fig. 1
The role of CQ/HCQ in inhibition of ACE2 glycosylation, conversion of early endosome into late endosome and formation of autophagosome
Fig. 2
Fig. 2
The role of HCQ in prevention of cytokine storm via inhibition of antigen processing and TLR receptor binding in antigen-presenting cells (APCs)
Fig. 3
Fig. 3
The role of HCQ in prevention of cytokine storm via inhibition of cGAS mediated release of proinflammatory cytokines
Fig. 4
Fig. 4
Summary of side effects exhibited by CQ/HCQ
See this image and copyright information in PMC

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