CQ/HCQ has genotoxicity that is a double-edged sword, on one hand, it causes harm to human cells, on the other hand it plays an important role in antivirus because it can change cellular susceptibility to virus through altering genome structure which causes gene expression pattern change. This is why CQ/HCQ can exert its antiviral effects on all viral infections. Therefore, to reduce CQ/HCQ's genotoxicity, a low-dose CQ/HCQ must be used. To augment low-dose CQ/HCQ's antiviral activities, another less-toxic genotoxic agent, such as ATRA, should be used together with CQ/HCQ. To further reduce the drug toxicity, local drug administration is necessary, this is why HCQ-ATRA inhaler is proposed. In a word, CQ/HCQ alone (no matter they are used at a low dose or a high dose) will not help COVID-19 patients a lot and thus they should be used together with other genotoxic agent.
Chloroquine and Hydroxychloroquine more dangerous than beneficial in the prophylaxis or management COVID-19 patients.
The studies to date have not shown any beneficial effect of chloroquine, hydroxychlorquine either alone or in combination with azithromycin in prevention or treatment of COVID-19 patients (3). However, there has been serious concerns for these drugs to cause adverse effects including arrhythmias and death due to QT prolongation (4-5)
1. Article A Randomized Trial of Hydroxychloroquine as Postexposure Pro...
2. Article Observational Study of Hydroxychloroquine in Hospitalized Pa...
3. Article Hydroxychloroquine with or without Azithromycin in Mild-to-M...
4. Article Safety considerations with chloroquine, hydroxychloroquine a...
3. Article Hydroxychloroquine and azithromycin combination could be let...