Rheumatologists Weigh In On Hydroxychloroquine and COVID-19

Attempts to repurpose hydroxychloroquine as a treatment for additional indications, including COVID-19, are a testament to the drug—regardless of whether it is successful, rheumatologists concluded in a new review.

The review, titled “Hydroxychloroquine and COVID-19: a Rheumatologist’s Take on the Lessons Learned” and published in Current Allergy and Asthma Reports, discusses the history of the hydroxychloroquine drug, as well as its uses in rheumatology and as an antiviral before and during the COVID-19 era.

Hydroxychloroquine has become a “mainstay” in treating rheumatic disease, according to the authors, citing its success for patients with systemic lupus erythematosus (SLE), who experience increased survival as well as fewer and less severe disease flares. Among patients with rheumatic diseases aside from SLE, patients taking the drug experience improvements in certain cardiovascular outcomes. It has also been studied for its efficacy in treating HIV and influenza, with studies yielding conflicting results.

During the 2002 severe acute respiratory syndrome (SARS) pandemic, caused by the SARS coronavirus (SARS-CoV), a study found that chloroquine may be effective during the pre- and early post-infection stages. However, research into SARS-CoV slowed down significantly when the pandemic settled down in 2003.

The COVID-19 pandemic, however, has yet to be contained, so the question of using hydroxychloroquine as a possible treatment once again arose, according to the study authors. And while “anecdotal evidence” as well as non-controlled and non-peer-reviewed studies appeared to support the drug’s use as a COVID-19 therapy, “multiple randomized controlled trials have now demonstrated that hydroxychloroquine is not effective in preventing or treating COVID-19 infection in vivo.”

“Hydroxychloroquine remains a drug with an ever-expanding number of underlying mechanisms,” the rheumatologists wrote in their conclusion. “Reappropriation of hydroxychloroquine to treat other disease states like COVID-19, irrespective of whether or not it is deemed a triumph, furthers our appreciation for hydroxychloroquine and how it works, underscoring the importance of ongoing research.”