The main basis for hydroxychloroquine (HCQ) treatment in COVID-19 is the compound’s ability to inhibit viral replication in vitro . HCQ also suppresses immunity, mainly by interference in TLR signalling, but reliable clinical data on the extent and nature of HCQ-induced immunosuppression are lacking. Here, we discuss the mechanistic basis for the use of HCQ against SARS-CoV-2 in a prophylactic setting and in a therapeutic setting, at different stages of the disease. We argue that the clinical effect of prophylactic or therapeutic HCQ treatment in COVID-19 depends on the balance between inhibition of viral replication, immunosuppression, and off-target side effects, and that the outcome is probably dependent on disease stage and disease severity. This is supported by the initial outcomes of the well-designed randomized controlled trials: so far, evidence for a beneficial effect of HCQ treatment for COVID-19 is weak and conflicting.
【초록키워드】 COVID-19, Treatment, SARS-CoV-2, Hydroxychloroquine, Immunity, disease severity, Immunosuppression, in vitro, outcome, Prophylactic, Clinical effect, Randomized, Viral, viral replication, therapeutic, target, HCQ, Side effects, Evidence, Interference, balance, Clinical data, disease stage, Stage, TLR, initial, inhibit, the disease, supported, dependent on, suppresse, treatment for COVID-19, 【제목키워드】 COVID-19, Hydroxychloroquine, Effect, TLR,