Pharmacological and cardiovascular perspectives on the treatment of COVID-19 with chloroquine derivatives.
Identifieur interne : 000B58 ( Main/Corpus ); précédent : 000B57; suivant : 000B59Pharmacological and cardiovascular perspectives on the treatment of COVID-19 with chloroquine derivatives.
Auteurs : Xiao-Lei Zhang ; Zhuo-Ming Li ; Jian-Tao Ye ; Jing Lu ; Lingyu Linda Ye ; Chun-Xiang Zhang ; Pei-Qing Liu ; Dayue D. DuanSource :
- Acta pharmacologica Sinica [ 1745-7254 ] ; 2020.
English descriptors
- KwdEn :
- Antiviral Agents (pharmacology), COVID-19 (MeSH), Cardiovascular Diseases (complications), Chloroquine (analogs & derivatives), Chloroquine (pharmacology), Chloroquine (therapeutic use), Coronavirus Infections (complications), Coronavirus Infections (drug therapy), Humans (MeSH), Pandemics (MeSH), Pneumonia, Viral (complications), Pneumonia, Viral (drug therapy).
- MESH :
- chemical , analogs & derivatives : Chloroquine.
- chemical , pharmacology : Antiviral Agents, Chloroquine.
- complications : Cardiovascular Diseases, Coronavirus Infections, Pneumonia, Viral.
- drug therapy : Coronavirus Infections, Pneumonia, Viral.
- chemical , therapeutic use : Chloroquine.
- COVID-19, Humans, Pandemics.
Abstract
The novel severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) causes coronavirus disease 2019 (COVID-19) and an ongoing severe pandemic. Curative drugs specific for COVID-19 are currently lacking. Chloroquine phosphate and its derivative hydroxychloroquine, which have been used in the treatment and prevention of malaria and autoimmune diseases for decades, were found to inhibit SARS-CoV-2 infection with high potency in vitro and have shown clinical and virologic benefits in COVID-19 patients. Therefore, chloroquine phosphate was first used in the treatment of COVID-19 in China. Later, under a limited emergency-use authorization from the FDA, hydroxychloroquine in combination with azithromycin was used to treat COVID-19 patients in the USA, although the mechanisms of the anti-COVID-19 effects remain unclear. Preliminary outcomes from clinical trials in several countries have generated controversial results. The desperation to control the pandemic overrode the concerns regarding the serious adverse effects of chloroquine derivatives and combination drugs, including lethal arrhythmias and cardiomyopathy. The risks of these treatments have become more complex as a result of findings that COVID-19 is actually a multisystem disease. While respiratory symptoms are the major clinical manifestations, cardiovascular abnormalities, including arrhythmias, myocarditis, heart failure, and ischemic stroke, have been reported in a significant number of COVID-19 patients. Patients with preexisting cardiovascular conditions (hypertension, arrhythmias, etc.) are at increased risk of severe COVID-19 and death. From pharmacological and cardiovascular perspectives, therefore, the treatment of COVID-19 with chloroquine and its derivatives should be systematically evaluated, and patients should be routinely monitored for cardiovascular conditions to prevent lethal adverse events.
DOI: 10.1038/s41401-020-00519-x
PubMed: 32968208
PubMed Central: PMC7509225
Links to Exploration step
pubmed:32968208Le document en format XML
<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Pharmacological and cardiovascular perspectives on the treatment of COVID-19 with chloroquine derivatives.</title><author><name sortKey="Zhang, Xiao Lei" sort="Zhang, Xiao Lei" uniqKey="Zhang X" first="Xiao-Lei" last="Zhang">Xiao-Lei Zhang</name><affiliation><nlm:affiliation>Laboratory of Pharmacology and Toxicology, School of Pharmaceutical Sciences, National and Local United Engineering Lab of Druggability and New Drug Evaluation, Guangdong Engineering Laboratory of Druggability and New Drug Evaluation, Guangdong Provincial Key Laboratory of New Drug Design and Evaluation, Sun Yat-sen University, Guangzhou, 510006, China.</nlm:affiliation></affiliation></author><author><name sortKey="Li, Zhuo Ming" sort="Li, Zhuo Ming" uniqKey="Li Z" first="Zhuo-Ming" last="Li">Zhuo-Ming Li</name><affiliation><nlm:affiliation>Laboratory of Pharmacology and Toxicology, School of Pharmaceutical Sciences, National and Local United Engineering Lab of Druggability and New Drug Evaluation, Guangdong Engineering Laboratory of Druggability and New Drug Evaluation, Guangdong Provincial Key Laboratory of New Drug Design and Evaluation, Sun Yat-sen University, Guangzhou, 510006, China.</nlm:affiliation></affiliation></author><author><name sortKey="Ye, Jian Tao" sort="Ye, Jian Tao" uniqKey="Ye J" first="Jian-Tao" last="Ye">Jian-Tao Ye</name><affiliation><nlm:affiliation>Laboratory of Pharmacology and Toxicology, School of Pharmaceutical Sciences, National and Local United Engineering Lab of Druggability and New Drug Evaluation, Guangdong Engineering Laboratory of Druggability and New Drug Evaluation, Guangdong Provincial Key Laboratory of New Drug Design and Evaluation, Sun Yat-sen University, Guangzhou, 510006, China.</nlm:affiliation></affiliation></author><author><name sortKey="Lu, Jing" sort="Lu, Jing" uniqKey="Lu J" first="Jing" last="Lu">Jing Lu</name><affiliation><nlm:affiliation>Laboratory of Pharmacology and Toxicology, School of Pharmaceutical Sciences, National and Local United Engineering Lab of Druggability and New Drug Evaluation, Guangdong Engineering Laboratory of Druggability and New Drug Evaluation, Guangdong Provincial Key Laboratory of New Drug Design and Evaluation, Sun Yat-sen University, Guangzhou, 510006, China.</nlm:affiliation></affiliation></author><author><name sortKey="Ye, Lingyu Linda" sort="Ye, Lingyu Linda" uniqKey="Ye L" first="Lingyu Linda" last="Ye">Lingyu Linda Ye</name><affiliation><nlm:affiliation>Center for Phenomics of Traditional Chinese Medicine of the Affiliated Traditional Chinese Medicine Hospital, Southwest Medical University, Luzhou, 646000, China.</nlm:affiliation></affiliation></author><author><name sortKey="Zhang, Chun Xiang" sort="Zhang, Chun Xiang" uniqKey="Zhang C" first="Chun-Xiang" last="Zhang">Chun-Xiang Zhang</name><affiliation><nlm:affiliation>Institute of Cardiovascular Research and the Affiliated Hospital, Southwest Medical University, Luzhou, 646000, China.</nlm:affiliation></affiliation></author><author><name sortKey="Liu, Pei Qing" sort="Liu, Pei Qing" uniqKey="Liu P" first="Pei-Qing" last="Liu">Pei-Qing Liu</name><affiliation><nlm:affiliation>Laboratory of Pharmacology and Toxicology, School of Pharmaceutical Sciences, National and Local United Engineering Lab of Druggability and New Drug Evaluation, Guangdong Engineering Laboratory of Druggability and New Drug Evaluation, Guangdong Provincial Key Laboratory of New Drug Design and Evaluation, Sun Yat-sen University, Guangzhou, 510006, China. liupq@mail.sysu.edu.cn.</nlm:affiliation></affiliation></author><author><name sortKey="Duan, Dayue D" sort="Duan, Dayue D" uniqKey="Duan D" first="Dayue D" last="Duan">Dayue D. Duan</name><affiliation><nlm:affiliation>Center for Phenomics of Traditional Chinese Medicine of the Affiliated Traditional Chinese Medicine Hospital, Southwest Medical University, Luzhou, 646000, China. dduan@swmu.edu.cn.</nlm:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2020">2020</date><idno type="RBID">pubmed:32968208</idno><idno type="pmid">32968208</idno><idno type="doi">10.1038/s41401-020-00519-x</idno><idno type="pmc">PMC7509225</idno><idno type="wicri:Area/Main/Corpus">000B58</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Corpus" wicri:corpus="PubMed">000B58</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Pharmacological and cardiovascular perspectives on the treatment of COVID-19 with chloroquine derivatives.</title><author><name sortKey="Zhang, Xiao Lei" sort="Zhang, Xiao Lei" uniqKey="Zhang X" first="Xiao-Lei" last="Zhang">Xiao-Lei Zhang</name><affiliation><nlm:affiliation>Laboratory of Pharmacology and Toxicology, School of Pharmaceutical Sciences, National and Local United Engineering Lab of Druggability and New Drug Evaluation, Guangdong Engineering Laboratory of Druggability and New Drug Evaluation, Guangdong Provincial Key Laboratory of New Drug Design and Evaluation, Sun Yat-sen University, Guangzhou, 510006, China.</nlm:affiliation></affiliation></author><author><name sortKey="Li, Zhuo Ming" sort="Li, Zhuo Ming" uniqKey="Li Z" first="Zhuo-Ming" last="Li">Zhuo-Ming Li</name><affiliation><nlm:affiliation>Laboratory of Pharmacology and Toxicology, School of Pharmaceutical Sciences, National and Local United Engineering Lab of Druggability and New Drug Evaluation, Guangdong Engineering Laboratory of Druggability and New Drug Evaluation, Guangdong Provincial Key Laboratory of New Drug Design and Evaluation, Sun Yat-sen University, Guangzhou, 510006, China.</nlm:affiliation></affiliation></author><author><name sortKey="Ye, Jian Tao" sort="Ye, Jian Tao" uniqKey="Ye J" first="Jian-Tao" last="Ye">Jian-Tao Ye</name><affiliation><nlm:affiliation>Laboratory of Pharmacology and Toxicology, School of Pharmaceutical Sciences, National and Local United Engineering Lab of Druggability and New Drug Evaluation, Guangdong Engineering Laboratory of Druggability and New Drug Evaluation, Guangdong Provincial Key Laboratory of New Drug Design and Evaluation, Sun Yat-sen University, Guangzhou, 510006, China.</nlm:affiliation></affiliation></author><author><name sortKey="Lu, Jing" sort="Lu, Jing" uniqKey="Lu J" first="Jing" last="Lu">Jing Lu</name><affiliation><nlm:affiliation>Laboratory of Pharmacology and Toxicology, School of Pharmaceutical Sciences, National and Local United Engineering Lab of Druggability and New Drug Evaluation, Guangdong Engineering Laboratory of Druggability and New Drug Evaluation, Guangdong Provincial Key Laboratory of New Drug Design and Evaluation, Sun Yat-sen University, Guangzhou, 510006, China.</nlm:affiliation></affiliation></author><author><name sortKey="Ye, Lingyu Linda" sort="Ye, Lingyu Linda" uniqKey="Ye L" first="Lingyu Linda" last="Ye">Lingyu Linda Ye</name><affiliation><nlm:affiliation>Center for Phenomics of Traditional Chinese Medicine of the Affiliated Traditional Chinese Medicine Hospital, Southwest Medical University, Luzhou, 646000, China.</nlm:affiliation></affiliation></author><author><name sortKey="Zhang, Chun Xiang" sort="Zhang, Chun Xiang" uniqKey="Zhang C" first="Chun-Xiang" last="Zhang">Chun-Xiang Zhang</name><affiliation><nlm:affiliation>Institute of Cardiovascular Research and the Affiliated Hospital, Southwest Medical University, Luzhou, 646000, China.</nlm:affiliation></affiliation></author><author><name sortKey="Liu, Pei Qing" sort="Liu, Pei Qing" uniqKey="Liu P" first="Pei-Qing" last="Liu">Pei-Qing Liu</name><affiliation><nlm:affiliation>Laboratory of Pharmacology and Toxicology, School of Pharmaceutical Sciences, National and Local United Engineering Lab of Druggability and New Drug Evaluation, Guangdong Engineering Laboratory of Druggability and New Drug Evaluation, Guangdong Provincial Key Laboratory of New Drug Design and Evaluation, Sun Yat-sen University, Guangzhou, 510006, China. liupq@mail.sysu.edu.cn.</nlm:affiliation></affiliation></author><author><name sortKey="Duan, Dayue D" sort="Duan, Dayue D" uniqKey="Duan D" first="Dayue D" last="Duan">Dayue D. Duan</name><affiliation><nlm:affiliation>Center for Phenomics of Traditional Chinese Medicine of the Affiliated Traditional Chinese Medicine Hospital, Southwest Medical University, Luzhou, 646000, China. dduan@swmu.edu.cn.</nlm:affiliation></affiliation></author></analytic><series><title level="j">Acta pharmacologica Sinica</title><idno type="eISSN">1745-7254</idno><imprint><date when="2020" type="published">2020</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Antiviral Agents (pharmacology)</term><term>COVID-19 (MeSH)</term><term>Cardiovascular Diseases (complications)</term><term>Chloroquine (analogs & derivatives)</term><term>Chloroquine (pharmacology)</term><term>Chloroquine (therapeutic use)</term><term>Coronavirus Infections (complications)</term><term>Coronavirus Infections (drug therapy)</term><term>Humans (MeSH)</term><term>Pandemics (MeSH)</term><term>Pneumonia, Viral (complications)</term><term>Pneumonia, Viral (drug therapy)</term></keywords><keywords scheme="MESH" type="chemical" qualifier="analogs & derivatives" xml:lang="en"><term>Chloroquine</term></keywords><keywords scheme="MESH" type="chemical" qualifier="pharmacology" xml:lang="en"><term>Antiviral Agents</term><term>Chloroquine</term></keywords><keywords scheme="MESH" qualifier="complications" xml:lang="en"><term>Cardiovascular Diseases</term><term>Coronavirus Infections</term><term>Pneumonia, Viral</term></keywords><keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>Coronavirus Infections</term><term>Pneumonia, Viral</term></keywords><keywords scheme="MESH" type="chemical" qualifier="therapeutic use" xml:lang="en"><term>Chloroquine</term></keywords><keywords scheme="MESH" xml:lang="en"><term>COVID-19</term><term>Humans</term><term>Pandemics</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">The novel severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) causes coronavirus disease 2019 (COVID-19) and an ongoing severe pandemic. Curative drugs specific for COVID-19 are currently lacking. Chloroquine phosphate and its derivative hydroxychloroquine, which have been used in the treatment and prevention of malaria and autoimmune diseases for decades, were found to inhibit SARS-CoV-2 infection with high potency in vitro and have shown clinical and virologic benefits in COVID-19 patients. Therefore, chloroquine phosphate was first used in the treatment of COVID-19 in China. Later, under a limited emergency-use authorization from the FDA, hydroxychloroquine in combination with azithromycin was used to treat COVID-19 patients in the USA, although the mechanisms of the anti-COVID-19 effects remain unclear. Preliminary outcomes from clinical trials in several countries have generated controversial results. The desperation to control the pandemic overrode the concerns regarding the serious adverse effects of chloroquine derivatives and combination drugs, including lethal arrhythmias and cardiomyopathy. The risks of these treatments have become more complex as a result of findings that COVID-19 is actually a multisystem disease. While respiratory symptoms are the major clinical manifestations, cardiovascular abnormalities, including arrhythmias, myocarditis, heart failure, and ischemic stroke, have been reported in a significant number of COVID-19 patients. Patients with preexisting cardiovascular conditions (hypertension, arrhythmias, etc.) are at increased risk of severe COVID-19 and death. From pharmacological and cardiovascular perspectives, therefore, the treatment of COVID-19 with chloroquine and its derivatives should be systematically evaluated, and patients should be routinely monitored for cardiovascular conditions to prevent lethal adverse events.</div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">32968208</PMID><DateCompleted><Year>2020</Year><Month>11</Month><Day>05</Day></DateCompleted><DateRevised><Year>2021</Year><Month>04</Month><Day>27</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1745-7254</ISSN><JournalIssue CitedMedium="Internet"><Volume>41</Volume><Issue>11</Issue><PubDate><Year>2020</Year><Month>Nov</Month></PubDate></JournalIssue><Title>Acta pharmacologica Sinica</Title><ISOAbbreviation>Acta Pharmacol Sin</ISOAbbreviation></Journal><ArticleTitle>Pharmacological and cardiovascular perspectives on the treatment of COVID-19 with chloroquine derivatives.</ArticleTitle><Pagination><MedlinePgn>1377-1386</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1038/s41401-020-00519-x</ELocationID><Abstract><AbstractText>The novel severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) causes coronavirus disease 2019 (COVID-19) and an ongoing severe pandemic. Curative drugs specific for COVID-19 are currently lacking. Chloroquine phosphate and its derivative hydroxychloroquine, which have been used in the treatment and prevention of malaria and autoimmune diseases for decades, were found to inhibit SARS-CoV-2 infection with high potency in vitro and have shown clinical and virologic benefits in COVID-19 patients. Therefore, chloroquine phosphate was first used in the treatment of COVID-19 in China. Later, under a limited emergency-use authorization from the FDA, hydroxychloroquine in combination with azithromycin was used to treat COVID-19 patients in the USA, although the mechanisms of the anti-COVID-19 effects remain unclear. Preliminary outcomes from clinical trials in several countries have generated controversial results. The desperation to control the pandemic overrode the concerns regarding the serious adverse effects of chloroquine derivatives and combination drugs, including lethal arrhythmias and cardiomyopathy. The risks of these treatments have become more complex as a result of findings that COVID-19 is actually a multisystem disease. While respiratory symptoms are the major clinical manifestations, cardiovascular abnormalities, including arrhythmias, myocarditis, heart failure, and ischemic stroke, have been reported in a significant number of COVID-19 patients. Patients with preexisting cardiovascular conditions (hypertension, arrhythmias, etc.) are at increased risk of severe COVID-19 and death. From pharmacological and cardiovascular perspectives, therefore, the treatment of COVID-19 with chloroquine and its derivatives should be systematically evaluated, and patients should be routinely monitored for cardiovascular conditions to prevent lethal adverse events.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y" EqualContrib="Y"><LastName>Zhang</LastName><ForeName>Xiao-Lei</ForeName><Initials>XL</Initials><AffiliationInfo><Affiliation>Laboratory of Pharmacology and Toxicology, School of Pharmaceutical Sciences, National and Local United Engineering Lab of Druggability and New Drug Evaluation, Guangdong Engineering Laboratory of Druggability and New Drug Evaluation, Guangdong Provincial Key Laboratory of New Drug Design and Evaluation, Sun Yat-sen University, Guangzhou, 510006, China.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y" EqualContrib="Y"><LastName>Li</LastName><ForeName>Zhuo-Ming</ForeName><Initials>ZM</Initials><AffiliationInfo><Affiliation>Laboratory of Pharmacology and Toxicology, School of Pharmaceutical Sciences, National and Local United Engineering Lab of Druggability and New Drug Evaluation, Guangdong Engineering Laboratory of Druggability and New Drug Evaluation, Guangdong Provincial Key Laboratory of New Drug Design and Evaluation, Sun Yat-sen University, Guangzhou, 510006, China.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Ye</LastName><ForeName>Jian-Tao</ForeName><Initials>JT</Initials><AffiliationInfo><Affiliation>Laboratory of Pharmacology and Toxicology, School of Pharmaceutical Sciences, National and Local United Engineering Lab of Druggability and New Drug Evaluation, Guangdong Engineering Laboratory of Druggability and New Drug Evaluation, Guangdong Provincial Key Laboratory of New Drug Design and Evaluation, Sun Yat-sen University, Guangzhou, 510006, China.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Lu</LastName><ForeName>Jing</ForeName><Initials>J</Initials><AffiliationInfo><Affiliation>Laboratory of Pharmacology and Toxicology, School of Pharmaceutical Sciences, National and Local United Engineering Lab of Druggability and New Drug Evaluation, Guangdong Engineering Laboratory of Druggability and New Drug Evaluation, Guangdong Provincial Key Laboratory of New Drug Design and Evaluation, Sun Yat-sen University, Guangzhou, 510006, China.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Ye</LastName><ForeName>Lingyu Linda</ForeName><Initials>LL</Initials><AffiliationInfo><Affiliation>Center for Phenomics of Traditional Chinese Medicine of the Affiliated Traditional Chinese Medicine Hospital, Southwest Medical University, Luzhou, 646000, China.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Zhang</LastName><ForeName>Chun-Xiang</ForeName><Initials>CX</Initials><AffiliationInfo><Affiliation>Institute of Cardiovascular Research and the Affiliated Hospital, Southwest Medical University, Luzhou, 646000, China.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Liu</LastName><ForeName>Pei-Qing</ForeName><Initials>PQ</Initials><AffiliationInfo><Affiliation>Laboratory of Pharmacology and Toxicology, School of Pharmaceutical Sciences, National and Local United Engineering Lab of Druggability and New Drug Evaluation, Guangdong Engineering Laboratory of Druggability and New Drug Evaluation, Guangdong Provincial Key Laboratory of New Drug Design and Evaluation, Sun Yat-sen University, Guangzhou, 510006, China. liupq@mail.sysu.edu.cn.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Duan</LastName><ForeName>Dayue D</ForeName><Initials>DD</Initials><AffiliationInfo><Affiliation>Center for Phenomics of Traditional Chinese Medicine of the Affiliated Traditional Chinese Medicine Hospital, Southwest Medical University, Luzhou, 646000, China. dduan@swmu.edu.cn.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D016454">Review</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2020</Year><Month>09</Month><Day>23</Day></ArticleDate></Article><MedlineJournalInfo><Country>United States</Country><MedlineTA>Acta Pharmacol Sin</MedlineTA><NlmUniqueID>100956087</NlmUniqueID><ISSNLinking>1671-4083</ISSNLinking></MedlineJournalInfo><ChemicalList><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D000998">Antiviral Agents</NameOfSubstance></Chemical><Chemical><RegistryNumber>886U3H6UFF</RegistryNumber><NameOfSubstance UI="D002738">Chloroquine</NameOfSubstance></Chemical></ChemicalList><SupplMeshList><SupplMeshName Type="Protocol" UI="C000705127">COVID-19 drug treatment</SupplMeshName></SupplMeshList><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000998" MajorTopicYN="N">Antiviral Agents</DescriptorName><QualifierName UI="Q000494" MajorTopicYN="N">pharmacology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D000086382" MajorTopicYN="N">COVID-19</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D002318" MajorTopicYN="N">Cardiovascular Diseases</DescriptorName><QualifierName UI="Q000150" MajorTopicYN="Y">complications</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D002738" MajorTopicYN="N">Chloroquine</DescriptorName><QualifierName UI="Q000031" MajorTopicYN="Y">analogs & derivatives</QualifierName><QualifierName UI="Q000494" MajorTopicYN="N">pharmacology</QualifierName><QualifierName UI="Q000627" MajorTopicYN="Y">therapeutic use</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D018352" MajorTopicYN="N">Coronavirus Infections</DescriptorName><QualifierName UI="Q000150" MajorTopicYN="Y">complications</QualifierName><QualifierName UI="Q000188" MajorTopicYN="Y">drug therapy</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D058873" MajorTopicYN="N">Pandemics</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D011024" MajorTopicYN="N">Pneumonia, Viral</DescriptorName><QualifierName UI="Q000150" MajorTopicYN="Y">complications</QualifierName><QualifierName UI="Q000188" MajorTopicYN="Y">drug therapy</QualifierName></MeshHeading></MeshHeadingList><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">COVID-19</Keyword><Keyword MajorTopicYN="N">arrhythmias</Keyword><Keyword MajorTopicYN="N">cardiomyopathy</Keyword><Keyword MajorTopicYN="N">chloroquine</Keyword><Keyword MajorTopicYN="N">hydroxychloroquine</Keyword><Keyword MajorTopicYN="N">toxicity</Keyword></KeywordList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2020</Year><Month>05</Month><Day>15</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2020</Year><Month>08</Month><Day>20</Day></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2020</Year><Month>9</Month><Day>25</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2020</Year><Month>11</Month><Day>6</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2020</Year><Month>9</Month><Day>24</Day><Hour>5</Hour><Minute>31</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">32968208</ArticleId><ArticleId IdType="doi">10.1038/s41401-020-00519-x</ArticleId><ArticleId IdType="pii">10.1038/s41401-020-00519-x</ArticleId><ArticleId 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