Chloroquine and Hydroxychloroquine for the Prevention and Treatment of COVID-19: A Fiction, Hope or Hype? An Updated Review.
Identifieur interne : 000644 ( Main/Exploration ); précédent : 000643; suivant : 000645Chloroquine and Hydroxychloroquine for the Prevention and Treatment of COVID-19: A Fiction, Hope or Hype? An Updated Review.
Auteurs : Sultan A M. Saghir [Jordanie] ; Naif A. Algabri [Yémen, Djibouti] ; Mahmoud M. Alagawany [Égypte] ; Youssef A. Attia [Égypte] ; Salem R. Alyileili [Émirats arabes unis] ; Shaaban S. Elnesr [Égypte] ; Manal E. Shafi ; Omar Y A. Al-Shargi ; Nader Al-Balagi ; Abdullah S. Alwajeeh [Qatar] ; Omar S A. Alsalahi [Yémen] ; Amlan K. Patra [Inde] ; Asmaa F. Khafaga [Égypte] ; Ahmed Negida [Royaume-Uni, Égypte] ; Ahmed Noreldin [Égypte] ; Wesam Al-Amarat [Jordanie] ; Amer A. Almaiman ; Khaled A. El-Tarabily [Émirats arabes unis, Australie] ; Mohamed E. Abd El-Hack [Égypte]Source :
- Therapeutics and clinical risk management [ 1176-6336 ] ; 2021.
Abstract
In December 2019, the novel coronavirus disease pandemic (COVID-19) that began in China had infected so far more than 109,217,366 million individuals worldwide and accounted for more than 2,413,912 fatalities. With the dawn of this novel coronavirus (SARS-CoV-2), there was a requirement to select potential therapies that might effectively kill the virus, accelerate the recovery, or decrease the case fatality rate. Besides the currently available antiviral medications for human immunodeficiency virus (HIV) and hepatitis C virus (HCV), the chloroquine/hydroxychloroquine (CQ/HCQ) regimen with or without azithromycin has been repurposed in China and was recommended by the National Health Commission, China in mid-February 2020. By this time, the selection of this regimen was based on its efficacy against the previous SARS-CoV-1 virus and its potential to inhibit viral replication of the SARS-CoV-2 in vitro. There was a shortage of robust clinical proof about the effectiveness of this regimen against the novel SARS-CoV-2. Therefore, extensive research effort has been made by several researchers worldwide to investigate whether this regimen is safe and effective for the management of COVID-19. In this review, we provided a comprehensive overview of the CQ/HCQ regimen, summarizing data from in vitro studies and clinical trials for the protection against or the treatment of SARS-CoV-2. Despite the initial promising results from the in vitro studies and the widespread use of CQ/HCQ in clinical settings during the 1st wave of COVID-19, current data from well-designed randomized controlled trials showed no evidence of benefit from CQ/HCQ supplementation for the treatment or prophylaxis against SARS-CoV-2 infection. Particularly, the two largest randomized controlled trials to date (RECOVERY and WHO SOLIDARITY trials), both confirmed that CQ/HCQ regimen does not provide any clinical benefit for COVID-19 patients. Therefore, we do not recommend the use of this regimen in COVID-19 patients outside the context of clinical trials.
DOI: 10.2147/TCRM.S301817
PubMed: 33953559
PubMed Central: PMC8092643
Affiliations:
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<author><name sortKey="Alyileili, Salem R" sort="Alyileili, Salem R" uniqKey="Alyileili S" first="Salem R" last="Alyileili">Salem R. Alyileili</name>
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<author><name sortKey="Elnesr, Shaaban S" sort="Elnesr, Shaaban S" uniqKey="Elnesr S" first="Shaaban S" last="Elnesr">Shaaban S. Elnesr</name>
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<author><name sortKey="Shafi, Manal E" sort="Shafi, Manal E" uniqKey="Shafi M" first="Manal E" last="Shafi">Manal E. Shafi</name>
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<author><name sortKey="Al Shargi, Omar Y A" sort="Al Shargi, Omar Y A" uniqKey="Al Shargi O" first="Omar Y A" last="Al-Shargi">Omar Y A. Al-Shargi</name>
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<author><name sortKey="Al Balagi, Nader" sort="Al Balagi, Nader" uniqKey="Al Balagi N" first="Nader" last="Al-Balagi">Nader Al-Balagi</name>
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<author><name sortKey="Alwajeeh, Abdullah S" sort="Alwajeeh, Abdullah S" uniqKey="Alwajeeh A" first="Abdullah S" last="Alwajeeh">Abdullah S. Alwajeeh</name>
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<author><name sortKey="Patra, Amlan K" sort="Patra, Amlan K" uniqKey="Patra A" first="Amlan K" last="Patra">Amlan K. Patra</name>
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<author><name sortKey="Negida, Ahmed" sort="Negida, Ahmed" uniqKey="Negida A" first="Ahmed" last="Negida">Ahmed Negida</name>
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<author><name sortKey="Noreldin, Ahmed" sort="Noreldin, Ahmed" uniqKey="Noreldin A" first="Ahmed" last="Noreldin">Ahmed Noreldin</name>
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<author><name sortKey="Al Amarat, Wesam" sort="Al Amarat, Wesam" uniqKey="Al Amarat W" first="Wesam" last="Al-Amarat">Wesam Al-Amarat</name>
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<author><name sortKey="Almaiman, Amer A" sort="Almaiman, Amer A" uniqKey="Almaiman A" first="Amer A" last="Almaiman">Amer A. Almaiman</name>
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<author><name sortKey="Abd El Hack, Mohamed E" sort="Abd El Hack, Mohamed E" uniqKey="Abd El Hack M" first="Mohamed E" last="Abd El-Hack">Mohamed E. Abd El-Hack</name>
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<sourceDesc><biblStruct><analytic><title xml:lang="en">Chloroquine and Hydroxychloroquine for the Prevention and Treatment of COVID-19: A Fiction, Hope or Hype? An Updated Review.</title>
<author><name sortKey="Saghir, Sultan A M" sort="Saghir, Sultan A M" uniqKey="Saghir S" first="Sultan A M" last="Saghir">Sultan A M. Saghir</name>
<affiliation wicri:level="1"><nlm:affiliation>Department of Medical Analysis, Princess Aisha Bint Al-Hussein College of Nursing and Medical Sciences, Al-Hussein Bin Talal University, Ma'an, 71111, Jordan.</nlm:affiliation>
<country xml:lang="fr">Jordanie</country>
<wicri:regionArea>Department of Medical Analysis, Princess Aisha Bint Al-Hussein College of Nursing and Medical Sciences, Al-Hussein Bin Talal University, Ma'an, 71111</wicri:regionArea>
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<author><name sortKey="Algabri, Naif A" sort="Algabri, Naif A" uniqKey="Algabri N" first="Naif A" last="Algabri">Naif A. Algabri</name>
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<country xml:lang="fr">Yémen</country>
<wicri:regionArea>Pathology Department, Faculty of Veterinary Medicine, Thamar University, Dhamar</wicri:regionArea>
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<affiliation wicri:level="1"><nlm:affiliation>Laboratory of Regional Djibouti Livestock Quarantine, Abu Yasar International Est. 1999, Djibouti, Djibouti.</nlm:affiliation>
<country xml:lang="fr">Djibouti</country>
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<author><name sortKey="Alagawany, Mahmoud M" sort="Alagawany, Mahmoud M" uniqKey="Alagawany M" first="Mahmoud M" last="Alagawany">Mahmoud M. Alagawany</name>
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<author><name sortKey="Attia, Youssef A" sort="Attia, Youssef A" uniqKey="Attia Y" first="Youssef A" last="Attia">Youssef A. Attia</name>
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<author><name sortKey="Alyileili, Salem R" sort="Alyileili, Salem R" uniqKey="Alyileili S" first="Salem R" last="Alyileili">Salem R. Alyileili</name>
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<author><name sortKey="Elnesr, Shaaban S" sort="Elnesr, Shaaban S" uniqKey="Elnesr S" first="Shaaban S" last="Elnesr">Shaaban S. Elnesr</name>
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<author><name sortKey="Shafi, Manal E" sort="Shafi, Manal E" uniqKey="Shafi M" first="Manal E" last="Shafi">Manal E. Shafi</name>
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</affiliation>
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<author><name sortKey="Al Shargi, Omar Y A" sort="Al Shargi, Omar Y A" uniqKey="Al Shargi O" first="Omar Y A" last="Al-Shargi">Omar Y A. Al-Shargi</name>
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</affiliation>
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<author><name sortKey="Al Balagi, Nader" sort="Al Balagi, Nader" uniqKey="Al Balagi N" first="Nader" last="Al-Balagi">Nader Al-Balagi</name>
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<wicri:noCountry code="subField">Kingdom of Saudi Arabia</wicri:noCountry>
</affiliation>
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<author><name sortKey="Alwajeeh, Abdullah S" sort="Alwajeeh, Abdullah S" uniqKey="Alwajeeh A" first="Abdullah S" last="Alwajeeh">Abdullah S. Alwajeeh</name>
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<author><name sortKey="Alsalahi, Omar S A" sort="Alsalahi, Omar S A" uniqKey="Alsalahi O" first="Omar S A" last="Alsalahi">Omar S A. Alsalahi</name>
<affiliation wicri:level="1"><nlm:affiliation>Department of Medical Laboratories, Faculty of Medicine and Health Sciences, Hodeidah University, Al Hodaidah, Yemen.</nlm:affiliation>
<country xml:lang="fr">Yémen</country>
<wicri:regionArea>Department of Medical Laboratories, Faculty of Medicine and Health Sciences, Hodeidah University, Al Hodaidah</wicri:regionArea>
<wicri:noRegion>Al Hodaidah</wicri:noRegion>
</affiliation>
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<author><name sortKey="Patra, Amlan K" sort="Patra, Amlan K" uniqKey="Patra A" first="Amlan K" last="Patra">Amlan K. Patra</name>
<affiliation wicri:level="1"><nlm:affiliation>Department of Animal Nutrition, West Bengal University of Animal and Fishery Sciences, Belgachia, Kolkata, India.</nlm:affiliation>
<country xml:lang="fr">Inde</country>
<wicri:regionArea>Department of Animal Nutrition, West Bengal University of Animal and Fishery Sciences, Belgachia, Kolkata</wicri:regionArea>
<wicri:noRegion>Kolkata</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Khafaga, Asmaa F" sort="Khafaga, Asmaa F" uniqKey="Khafaga A" first="Asmaa F" last="Khafaga">Asmaa F. Khafaga</name>
<affiliation wicri:level="1"><nlm:affiliation>Department of Pathology, Faculty of Veterinary Medicine, Alexandria University, Edfina, 22758, Egypt.</nlm:affiliation>
<country xml:lang="fr">Égypte</country>
<wicri:regionArea>Department of Pathology, Faculty of Veterinary Medicine, Alexandria University, Edfina, 22758</wicri:regionArea>
<wicri:noRegion>22758</wicri:noRegion>
</affiliation>
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<author><name sortKey="Negida, Ahmed" sort="Negida, Ahmed" uniqKey="Negida A" first="Ahmed" last="Negida">Ahmed Negida</name>
<affiliation wicri:level="1"><nlm:affiliation>School of Pharmacy and Biomedical Sciences, University of Portsmouth, Portsmouth, UK.</nlm:affiliation>
<country xml:lang="fr">Royaume-Uni</country>
<wicri:regionArea>School of Pharmacy and Biomedical Sciences, University of Portsmouth, Portsmouth</wicri:regionArea>
<wicri:noRegion>Portsmouth</wicri:noRegion>
</affiliation>
<affiliation wicri:level="1"><nlm:affiliation>Zagazig University Hospitals, Faculty of Medicine, Zagazig University, Zagazig, Egypt.</nlm:affiliation>
<country xml:lang="fr">Égypte</country>
<wicri:regionArea>Zagazig University Hospitals, Faculty of Medicine, Zagazig University, Zagazig</wicri:regionArea>
<wicri:noRegion>Zagazig</wicri:noRegion>
</affiliation>
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<author><name sortKey="Noreldin, Ahmed" sort="Noreldin, Ahmed" uniqKey="Noreldin A" first="Ahmed" last="Noreldin">Ahmed Noreldin</name>
<affiliation wicri:level="1"><nlm:affiliation>Histology and Cytology Department, Faculty of Veterinary Medicine, Damanhour University, Damanhour, 22511, Egypt.</nlm:affiliation>
<country xml:lang="fr">Égypte</country>
<wicri:regionArea>Histology and Cytology Department, Faculty of Veterinary Medicine, Damanhour University, Damanhour, 22511</wicri:regionArea>
<wicri:noRegion>22511</wicri:noRegion>
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<author><name sortKey="Al Amarat, Wesam" sort="Al Amarat, Wesam" uniqKey="Al Amarat W" first="Wesam" last="Al-Amarat">Wesam Al-Amarat</name>
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<country xml:lang="fr">Jordanie</country>
<wicri:regionArea>Department of Medical Support, Al-Karak University College, Al-Balqa' Applied University, Salt</wicri:regionArea>
<wicri:noRegion>Salt</wicri:noRegion>
</affiliation>
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<author><name sortKey="Almaiman, Amer A" sort="Almaiman, Amer A" uniqKey="Almaiman A" first="Amer A" last="Almaiman">Amer A. Almaiman</name>
<affiliation><nlm:affiliation>Department of Applied Medical Sciences, Community College of Uniazah, Qassim University, Buraydah, 51431, Kingdom of Saudi Arabia.</nlm:affiliation>
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<author><name sortKey="El Tarabily, Khaled A" sort="El Tarabily, Khaled A" uniqKey="El Tarabily K" first="Khaled A" last="El-Tarabily">Khaled A. El-Tarabily</name>
<affiliation wicri:level="1"><nlm:affiliation>Department of Biology, College of Science, United Arab Emirates University, Al-Ain, 15551, United Arab Emirates.</nlm:affiliation>
<country xml:lang="fr">Émirats arabes unis</country>
<wicri:regionArea>Department of Biology, College of Science, United Arab Emirates University, Al-Ain, 15551</wicri:regionArea>
<wicri:noRegion>15551</wicri:noRegion>
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<affiliation wicri:level="1"><nlm:affiliation>Biosecurity and One Health Research Centre, Harry Butler Institute, Murdoch University, Murdoch, Western Australia, 6150, Australia.</nlm:affiliation>
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<wicri:regionArea>Biosecurity and One Health Research Centre, Harry Butler Institute, Murdoch University, Murdoch, Western Australia, 6150</wicri:regionArea>
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<author><name sortKey="Abd El Hack, Mohamed E" sort="Abd El Hack, Mohamed E" uniqKey="Abd El Hack M" first="Mohamed E" last="Abd El-Hack">Mohamed E. Abd El-Hack</name>
<affiliation wicri:level="1"><nlm:affiliation>Department of Poultry, Faculty of Agriculture, Zagazig University, Zagazig, 44511, Egypt.</nlm:affiliation>
<country xml:lang="fr">Égypte</country>
<wicri:regionArea>Department of Poultry, Faculty of Agriculture, Zagazig University, Zagazig, 44511</wicri:regionArea>
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<series><title level="j">Therapeutics and clinical risk management</title>
<idno type="ISSN">1176-6336</idno>
<imprint><date when="2021" type="published">2021</date>
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<front><div type="abstract" xml:lang="en">In December 2019, the novel coronavirus disease pandemic (COVID-19) that began in China had infected so far more than 109,217,366 million individuals worldwide and accounted for more than 2,413,912 fatalities. With the dawn of this novel coronavirus (SARS-CoV-2), there was a requirement to select potential therapies that might effectively kill the virus, accelerate the recovery, or decrease the case fatality rate. Besides the currently available antiviral medications for human immunodeficiency virus (HIV) and hepatitis C virus (HCV), the chloroquine/hydroxychloroquine (CQ/HCQ) regimen with or without azithromycin has been repurposed in China and was recommended by the National Health Commission, China in mid-February 2020. By this time, the selection of this regimen was based on its efficacy against the previous SARS-CoV-1 virus and its potential to inhibit viral replication of the SARS-CoV-2 in vitro. There was a shortage of robust clinical proof about the effectiveness of this regimen against the novel SARS-CoV-2. Therefore, extensive research effort has been made by several researchers worldwide to investigate whether this regimen is safe and effective for the management of COVID-19. In this review, we provided a comprehensive overview of the CQ/HCQ regimen, summarizing data from in vitro studies and clinical trials for the protection against or the treatment of SARS-CoV-2. Despite the initial promising results from the in vitro studies and the widespread use of CQ/HCQ in clinical settings during the 1st wave of COVID-19, current data from well-designed randomized controlled trials showed no evidence of benefit from CQ/HCQ supplementation for the treatment or prophylaxis against SARS-CoV-2 infection. Particularly, the two largest randomized controlled trials to date (RECOVERY and WHO SOLIDARITY trials), both confirmed that CQ/HCQ regimen does not provide any clinical benefit for COVID-19 patients. Therefore, we do not recommend the use of this regimen in COVID-19 patients outside the context of clinical trials.</div>
</front>
</TEI>
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<DateRevised><Year>2021</Year>
<Month>05</Month>
<Day>08</Day>
</DateRevised>
<Article PubModel="Electronic-eCollection"><Journal><ISSN IssnType="Print">1176-6336</ISSN>
<JournalIssue CitedMedium="Print"><Volume>17</Volume>
<PubDate><Year>2021</Year>
</PubDate>
</JournalIssue>
<Title>Therapeutics and clinical risk management</Title>
<ISOAbbreviation>Ther Clin Risk Manag</ISOAbbreviation>
</Journal>
<ArticleTitle>Chloroquine and Hydroxychloroquine for the Prevention and Treatment of COVID-19: A Fiction, Hope or Hype? An Updated Review.</ArticleTitle>
<Pagination><MedlinePgn>371-387</MedlinePgn>
</Pagination>
<ELocationID EIdType="doi" ValidYN="Y">10.2147/TCRM.S301817</ELocationID>
<Abstract><AbstractText>In December 2019, the novel coronavirus disease pandemic (COVID-19) that began in China had infected so far more than 109,217,366 million individuals worldwide and accounted for more than 2,413,912 fatalities. With the dawn of this novel coronavirus (SARS-CoV-2), there was a requirement to select potential therapies that might effectively kill the virus, accelerate the recovery, or decrease the case fatality rate. Besides the currently available antiviral medications for human immunodeficiency virus (HIV) and hepatitis C virus (HCV), the chloroquine/hydroxychloroquine (CQ/HCQ) regimen with or without azithromycin has been repurposed in China and was recommended by the National Health Commission, China in mid-February 2020. By this time, the selection of this regimen was based on its efficacy against the previous SARS-CoV-1 virus and its potential to inhibit viral replication of the SARS-CoV-2 in vitro. There was a shortage of robust clinical proof about the effectiveness of this regimen against the novel SARS-CoV-2. Therefore, extensive research effort has been made by several researchers worldwide to investigate whether this regimen is safe and effective for the management of COVID-19. In this review, we provided a comprehensive overview of the CQ/HCQ regimen, summarizing data from in vitro studies and clinical trials for the protection against or the treatment of SARS-CoV-2. Despite the initial promising results from the in vitro studies and the widespread use of CQ/HCQ in clinical settings during the 1st wave of COVID-19, current data from well-designed randomized controlled trials showed no evidence of benefit from CQ/HCQ supplementation for the treatment or prophylaxis against SARS-CoV-2 infection. Particularly, the two largest randomized controlled trials to date (RECOVERY and WHO SOLIDARITY trials), both confirmed that CQ/HCQ regimen does not provide any clinical benefit for COVID-19 patients. Therefore, we do not recommend the use of this regimen in COVID-19 patients outside the context of clinical trials.</AbstractText>
<CopyrightInformation>© 2021 Saghir et al.</CopyrightInformation>
</Abstract>
<AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Saghir</LastName>
<ForeName>Sultan A M</ForeName>
<Initials>SAM</Initials>
<AffiliationInfo><Affiliation>Department of Medical Analysis, Princess Aisha Bint Al-Hussein College of Nursing and Medical Sciences, Al-Hussein Bin Talal University, Ma'an, 71111, Jordan.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>AlGabri</LastName>
<ForeName>Naif A</ForeName>
<Initials>NA</Initials>
<AffiliationInfo><Affiliation>Pathology Department, Faculty of Veterinary Medicine, Thamar University, Dhamar, Yemen.</Affiliation>
</AffiliationInfo>
<AffiliationInfo><Affiliation>Laboratory of Regional Djibouti Livestock Quarantine, Abu Yasar International Est. 1999, Djibouti, Djibouti.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Alagawany</LastName>
<ForeName>Mahmoud M</ForeName>
<Initials>MM</Initials>
<AffiliationInfo><Affiliation>Department of Poultry, Faculty of Agriculture, Zagazig University, Zagazig, 44511, Egypt.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Attia</LastName>
<ForeName>Youssef A</ForeName>
<Initials>YA</Initials>
<AffiliationInfo><Affiliation>Department of Agriculture, Faculty of Environmental Sciences, King Abdulaziz University, Jeddah, 21589, Kingdom of Saudi Arabia.</Affiliation>
</AffiliationInfo>
<AffiliationInfo><Affiliation>Department of Animal and Poultry Production, Faculty of Agriculture, Damanhour University, Damanhour, Egypt.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Alyileili</LastName>
<ForeName>Salem R</ForeName>
<Initials>SR</Initials>
<AffiliationInfo><Affiliation>Department of Integrative Agriculture, College of Food and Agriculture, United Arab Emirates University, Al-Ain, 15551, United Arab Emirates.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Elnesr</LastName>
<ForeName>Shaaban S</ForeName>
<Initials>SS</Initials>
<AffiliationInfo><Affiliation>Department of Poultry Production, Faculty of Agriculture, Fayoum University, Fayoum, 63514, Egypt.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Shafi</LastName>
<ForeName>Manal E</ForeName>
<Initials>ME</Initials>
<AffiliationInfo><Affiliation>Department of Biological Sciences, Zoology, King Abdulaziz University, Jeddah, 21589, Kingdom of Saudi Arabia.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Al-Shargi</LastName>
<ForeName>Omar Y A</ForeName>
<Initials>OYA</Initials>
<AffiliationInfo><Affiliation>Department of Pharmacology, College of Pharmacy, Riyadh Elm University, Riyadh, Kingdom of Saudi Arabia.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Al-Balagi</LastName>
<ForeName>Nader</ForeName>
<Initials>N</Initials>
<AffiliationInfo><Affiliation>Ministry of Health, Riyadh, Kingdom of Saudi Arabia.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Alwajeeh</LastName>
<ForeName>Abdullah S</ForeName>
<Initials>AS</Initials>
<AffiliationInfo><Affiliation>Anti-DopingLab, Doha, Qatar.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Alsalahi</LastName>
<ForeName>Omar S A</ForeName>
<Initials>OSA</Initials>
<AffiliationInfo><Affiliation>Department of Medical Laboratories, Faculty of Medicine and Health Sciences, Hodeidah University, Al Hodaidah, Yemen.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Patra</LastName>
<ForeName>Amlan K</ForeName>
<Initials>AK</Initials>
<AffiliationInfo><Affiliation>Department of Animal Nutrition, West Bengal University of Animal and Fishery Sciences, Belgachia, Kolkata, India.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Khafaga</LastName>
<ForeName>Asmaa F</ForeName>
<Initials>AF</Initials>
<AffiliationInfo><Affiliation>Department of Pathology, Faculty of Veterinary Medicine, Alexandria University, Edfina, 22758, Egypt.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Negida</LastName>
<ForeName>Ahmed</ForeName>
<Initials>A</Initials>
<Identifier Source="ORCID">0000-0001-5363-6369</Identifier>
<AffiliationInfo><Affiliation>School of Pharmacy and Biomedical Sciences, University of Portsmouth, Portsmouth, UK.</Affiliation>
</AffiliationInfo>
<AffiliationInfo><Affiliation>Zagazig University Hospitals, Faculty of Medicine, Zagazig University, Zagazig, Egypt.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Noreldin</LastName>
<ForeName>Ahmed</ForeName>
<Initials>A</Initials>
<AffiliationInfo><Affiliation>Histology and Cytology Department, Faculty of Veterinary Medicine, Damanhour University, Damanhour, 22511, Egypt.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Al-Amarat</LastName>
<ForeName>Wesam</ForeName>
<Initials>W</Initials>
<Identifier Source="ORCID">0000-0001-6909-455X</Identifier>
<AffiliationInfo><Affiliation>Department of Medical Support, Al-Karak University College, Al-Balqa' Applied University, Salt, Jordan.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Almaiman</LastName>
<ForeName>Amer A</ForeName>
<Initials>AA</Initials>
<AffiliationInfo><Affiliation>Department of Applied Medical Sciences, Community College of Uniazah, Qassim University, Buraydah, 51431, Kingdom of Saudi Arabia.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>El-Tarabily</LastName>
<ForeName>Khaled A</ForeName>
<Initials>KA</Initials>
<Identifier Source="ORCID">0000-0002-8189-7088</Identifier>
<AffiliationInfo><Affiliation>Department of Biology, College of Science, United Arab Emirates University, Al-Ain, 15551, United Arab Emirates.</Affiliation>
</AffiliationInfo>
<AffiliationInfo><Affiliation>Biosecurity and One Health Research Centre, Harry Butler Institute, Murdoch University, Murdoch, Western Australia, 6150, Australia.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Abd El-Hack</LastName>
<ForeName>Mohamed E</ForeName>
<Initials>ME</Initials>
<Identifier Source="ORCID">0000-0002-2831-8534</Identifier>
<AffiliationInfo><Affiliation>Department of Poultry, Faculty of Agriculture, Zagazig University, Zagazig, 44511, Egypt.</Affiliation>
</AffiliationInfo>
</Author>
</AuthorList>
<Language>eng</Language>
<PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType>
<PublicationType UI="D016454">Review</PublicationType>
</PublicationTypeList>
<ArticleDate DateType="Electronic"><Year>2021</Year>
<Month>04</Month>
<Day>28</Day>
</ArticleDate>
</Article>
<MedlineJournalInfo><Country>New Zealand</Country>
<MedlineTA>Ther Clin Risk Manag</MedlineTA>
<NlmUniqueID>101253281</NlmUniqueID>
<ISSNLinking>1176-6336</ISSNLinking>
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<KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">COVID-19</Keyword>
<Keyword MajorTopicYN="N">SARS-CoV-2</Keyword>
<Keyword MajorTopicYN="N">antiviral drugs</Keyword>
<Keyword MajorTopicYN="N">chloroquine</Keyword>
<Keyword MajorTopicYN="N">drug safety</Keyword>
<Keyword MajorTopicYN="N">hydroxychloroquine</Keyword>
<Keyword MajorTopicYN="N">treatments</Keyword>
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<CoiStatement>The authors report no conflicts of interest for this work and declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.</CoiStatement>
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<affiliations><list><country><li>Australie</li>
<li>Djibouti</li>
<li>Inde</li>
<li>Jordanie</li>
<li>Qatar</li>
<li>Royaume-Uni</li>
<li>Yémen</li>
<li>Égypte</li>
<li>Émirats arabes unis</li>
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