The global spread of COVID-19 has claimed many lives. This SARS-CoV-2 . respiratory tract disease induced by, The WHO proposed taking preventive measures, but at the same time required officials to conduct clinical trials for drugs that are effective against the coronavirus. However, fewer patients have access to clinical trials and it takes longer to investigate and finish all clinical trials. Therefore, only hit and trial method is applied in situations where patients not covered under clinical trial section are provided with unproven drugs ,
When no specific drug was available to treat the disease, the US FDA did not approve anti-malarial drugs such as hydroxychloroquine and chloroquine. The Emergency Use Authority (EUA) permits the use of anti-malarial drugs; Although there have been no trials of both drugs, they have fewer side effects. US President Donald Trump also agreed to use these drugs and it is exported from India. The drug dropped out of the placebo-controlled clinical trial, the double-blind approval trial, which is why it became debatable. ,
Studies in China show that hydroxychloroquine has the ability to inhibit the invasion of the coronavirus into the lungs. Similarly, France touted this drug as a promising treatment. The virus has infected 1.3 million people and needs to be taken seriously. Dr. Anthony Fauci, a specialist in infectious diseases, began, I would have two words: ‘second opinion’. He also noted that more testing is needed for these drugs, especially for patients with a history of heart disease or heart failure taking antidepressants. ,
mechanism of action
Chloroquine was previously used to treat malaria, but it also has activity against COVID-19. Depending on the type of microorganism, it has different mechanisms of action. It acts by inhibiting the replication of intracellular pathogens. It was analyzed that chloroquine has anti-inflammatory and antiviral activities against coronavirus. It resists infection by interfering with the glycosylation process of cellular receptors present in SARS-CoV and also increases the endosomal pH.[3,5],
The quinone reductase-2 enzyme is involved in the biosynthesis of sialic acid, chloroquine inhibits such an enzyme and leads to the death of microorganisms. In addition, chloroquine is a potential antiviral drug as it activates autophagosomes that break down the SARS-CoV-2 spike protein by transformation into lysosomes, and inhibits cathepsins. It also acts by interfering with the glycosylation receptor and is not able to bind with ACE2 receptors and prevents SARS-CoV-2 from binding to the target cells of the lungs. Thus, chloroquine is intended to be used against coronavirus ,
The structure and mechanism of action of hydroxychloroquine is similar to that of chloroquine but at the terminal hydroxychloroquine (HCQ) an additional hydroxy group is present. Both act as weak bases and cause acidic changes in pH which makes it effective against viruses. But it is more potent than chloroquine because it is less permeable to the blood–brain barrier, and clearance occurs through the retina and therefore has fewer side effects than chloroquine. ,
The side effects of HCQ and chloroquine are relatively less as compared to other drugs as well as cost-effective therapy, which is why it is used to control such outbreaks. In addition, some trials are underway to check the effectiveness of the drugs against COVID 19. Researchers are looking for any form of resistance by the virus.
HCQ and chloroquine are further studies to learn about the resistance through different types of the virus. While chemoprophylaxis is still unknown, it is also important to know whether drugs can stop the transmission of the virus, especially to doctors, nurses and other healthcare workers. Another area that needs to be analyzed is diabetics who are already on HCQ therapy, whether there is a glycemic effect, CVS inappropriately functioning, and viral load. However, the drug is approved for prescription
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- Divided on antimalarial for regulators. COVID-19. Retrieved on 12/4/2020. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30817-5/fulltext.
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- Things to know about hydroxychloroquine, the ‘unproven’ coronavirus drug? Retrieved on 12/4/2020. https://www.business-standard.com/article/health/hydroxychloroquine-use-in-coronavirus-treatment-hydroxychloroquine-tablets-side-effects-price-explained-120040701280_1.html.
- Smith, T., Bushek, J. COVID-19 drug therapy. Retrieved on 13/4/2020. Elseveir.https://www.elsevier.com/__data/assets/pdf_file/0007/988648/COVID-19-Drug-Therapy_Mar-2020.pdf