key: cord-0858898-de976ftr authors: Paliani, Ugo; Cardona, Andrea title: COVID-19 and hydroxychloroquine: is the wonder drug failing? date: 2020-06-04 journal: Eur J Intern Med DOI: 10.1016/j.ejim.2020.06.002 sha: a339d44e43eff2df2a48f03adfbb9933d679c6d8 doc_id: 858898 cord_uid: de976ftr nan The absence of an effective treatment against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has led clinicians to redirect drugs that are known to be effective for other medical conditions to the treatment of Covid-19. Chloroquine and hydroxychloroquine are widely used in the treatment of malaria and rheumatic diseases, and they have been suggested as effective treatments for Covid-19 on the grounds of both anti-inflammatory and antiviral effects [1] [2] [3] [4] . Mounting data suggest that Covid-19 is burdened by a higher risk of arrhythmic events, with important implications for survival 5 . Hydroxychloroquine, with or without a second-generation macrolide, has also been advocated despite limited evidence for its effectiveness and known detrimental effect of prolongation of the QT interval, which could be a mechanism that predisposes to ventricular arrhythmias [6] [7] [8] Design and synthesis of hydroxyferroquine derivatives with antimalarial and antiviral activities Mechanism of action of hydroxychloroquine as an antirheumatic drug New insights on the antiviral effects of chloroquine against coronavirus: What to expect for covid-19? Structural and molecular modelling studies reveal a new mechanism of action of chloroquine and hydroxychloroquine against sars-cov-2 infection Cardiovascular considerations for patients, health care workers, and health systems during the covid-19 pandemic Hydroxychloroquine and azithromycin as a treatment of covid-19: Results of an open-label non-randomized clinical trial Azithromycin and the risk of cardiovascular death Urgent guidance for navigating and circumventing the qtc-prolonging and torsadogenic potential of possible pharmacotherapies for coronavirus disease 19 (covid-19) Possible consequences of a shortage of hydroxychloroquine for patients with systemic lupus erythematosus amid the covid-19 pandemic Hydroxychloroquine or chloroquine with or without a macrolide for treatment of covid-19: A multinational registry analysis. The Lancet Observational study of hydroxychloroquine in hospitalized patients with covid-19 Association of treatment with hydroxychloroquine or azithromycin with in-hospital mortality in patients with covid-19 in new york state Clinical efficacy of hydroxychloroquine in patients with covid-19 pneumonia who require oxygen: Observational comparative study using routine care data Risk of qt interval prolongation associated with use of hydroxychloroquine with or without concomitant azithromycin among hospitalized patients testing positive for coronavirus disease 2019 (covid-19)