Abstract Hydroxychloroquine, initially used as an antimalarial, is used as an immunomodulatory and anti-inflammatory agent for the management of autoimmune and rheumatic diseases such as systemic lupus erythematosus. Lately, there has been interest in its potential efficacy against severe acute respiratory syndrome coronavirus 2, with several speculated mechanisms. The purpose of this review is to elaborate on the mechanisms surrounding hydroxychloroquine. The review is an in-depth analysis of the antimalarial, immunomodulatory, and antiviral mechanisms of hydroxychloroquine, with detailed and novel pictorial explanations. The mechanisms of hydroxychloroquine are related to potential cardiotoxic manifestations and demonstrate potential adverse effects when used for coronavirus disease 2019 (COVID-19). Finally, current literature associated with hydroxychloroquine and COVID-19 has been analyzed to interrelate the mechanisms, adverse effects, and use of hydroxychloroquine in the current pandemic. Currently, there is insufficient evidence about the efficacy and safety of hydroxychloroquine in COVID-19. KEY MESSAGES HCQ, initially an antimalarial agent, is used as an immunomodulatory agent for managing several autoimmune diseases, for which its efficacy is linked to inhibiting lysosomal antigen processing, MHC-II antigen presentation, and TLR functions. HCQ is generally well-tolerated although severe life-threatening adverse effects including cardiomyopathy and conduction defects have been reported. HCQ use in COVID-19 should be discouraged outside clinical trials under strict medical supervision.
【저자키워드】 COVID-19, Hydroxychloroquine, mechanism of action, Cardiotoxicity, 【초록키워드】 coronavirus disease, Efficacy, coronavirus, clinical trial, pandemic, Antiviral, systemic lupus erythematosus, antimalarial, adverse effects, management, immunomodulatory, Efficacy and safety, Autoimmune, mechanisms, HCQ, Antigen presentation, Cardiomyopathy, Autoimmune diseases, mechanism, Evidence, manifestation, rheumatic disease, anti-inflammatory agent, adverse effect, acute respiratory syndrome, in-depth analysis, medical supervision, life-threatening, antigen processing, functions, MHC-II, TLR, analyzed, reported, inhibiting, lysosomal, conduction defect, use of hydroxychloroquine, 【제목키워드】 coronavirus disease,