Hydroxychloroquine (HCQ) may be beneficial for COVID-19 patients, for patients with no cardiac or weight issues, but not for those at risk of cardiovascular disease or pre-existing conditions, states a report in the Journal of Neuroimmune Pharmacology.
HCQ has exhibited efficacy and safety in attenuating COVID-19 associated pneumonia and reduction of viral load. Recent studies found no benefit but more side effects and deaths.
HCQ can control the overproduction of IL-1β and GM-CSF in acute rheumatic fever and reduce IL-6 in patients with rheumatoid arthritis and therefore, may be beneficial for COVID-19 patients via its antioxidant and anti-inflammatory properties. HCQ treatment inhibits glycosylation of ACE2 receptors, preventing binding and cell entry of SARS-CoV-2. However, inhibition of ACE2 generally leads to increases in vasoconstriction and decreases in vasodilation, increasing the chances of inducing or aggravating cardiovascular diseases, posing risks for patients with pre-existing cardiovascular issues, hypertension, and obesity.
CD4+ and CD8+ T cells are closely related to disease severity and outcome in COVID-19. Attenuating T cell proliferation with HCQ may exhibit adverse effects on severe COVID-19 patients.
HCQ may be beneficial for patients who do not have a history of cardiovascular disease or obesity, but not for patients at risk of cardiovascular disease or older patients with pre-existing conditions.