Insights in Chloroquine Action: Perspectives and Implications in Malaria and COVID-19

Cytometry A. 2020 Sep;97(9):872-881. doi: 10.1002/cyto.a.24190. Epub 2020 Aug 21.

Abstract

Malaria is a threat to human mankind and kills about half a million people every year. On the other hand, COVID-19 resulted in several hundred thousand deaths since December 2019 and remains without an efficient and safe treatment. The antimalarials chloroquine (CQ) and its analog, hydroxychloroquine (HCQ), have been tested for COVID-19 treatment, and several conflicting evidence has been obtained. Therefore, the aim of this review was to summarize the evidence regarding action mechanisms of these compounds against Plasmodium and SARS-CoV-2 infection, together with cytometry applications. CQ and HCQ act on the renin angiotensin system, with possible implications on the cardiorespiratory system. In this context, flow and image cytometry emerge as powerful technologies to investigate the mechanism of therapeutic candidates, as well as for the identification of the immune response and prognostics of disease severity. Data from the large randomized trials support the conclusion that CQ and HCQ do not provide any clinical improvements in disease severity and progression of SARS-CoV-2 patients, as well as they do not present any solid evidence of increased serious side effects. These drugs are safe and effective antimalarials agents, but in SARS-CoV-2 patients, they need further studies in the context of clinical trials. © 2020 International Society for Advancement of Cytometry.

Keywords: Plasmodium; SARS-CoV-2; autophagy; clinical trials; renin angiotensin system; side effect; viral invasion.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Animals
  • Antimalarials / adverse effects
  • Antimalarials / therapeutic use*
  • Antiviral Agents / adverse effects
  • Antiviral Agents / therapeutic use*
  • Betacoronavirus / drug effects*
  • Betacoronavirus / immunology
  • Betacoronavirus / pathogenicity
  • COVID-19
  • COVID-19 Drug Treatment
  • Chloroquine / adverse effects
  • Chloroquine / therapeutic use*
  • Coronavirus Infections / diagnosis
  • Coronavirus Infections / drug therapy*
  • Coronavirus Infections / immunology
  • Coronavirus Infections / virology
  • Flow Cytometry
  • Host Microbial Interactions
  • Host-Parasite Interactions
  • Humans
  • Malaria / diagnosis
  • Malaria / drug therapy*
  • Malaria / immunology
  • Malaria / parasitology
  • Pandemics
  • Plasmodium / drug effects*
  • Plasmodium / immunology
  • Plasmodium / pathogenicity
  • Pneumonia, Viral / diagnosis
  • Pneumonia, Viral / drug therapy*
  • Pneumonia, Viral / immunology
  • Pneumonia, Viral / virology
  • SARS-CoV-2
  • Treatment Outcome

Substances

  • Antimalarials
  • Antiviral Agents
  • Chloroquine