Chloroquine for Treatment of COVID19 from Geoff Modest A systematic review of the efficacy and safety of chloroquine (see covid Chloroquine reviewjcitcare2020in dropbox, or doi.org/10.1016/j.jcrc.2020.03.005) Details: — 6 articles were reviewed (one letter, one in-vitro study, one editorial, one expert consensus paper, and 2 national guideline documents) — there are 23 ongoing clinical trials in China using chloroquine or hydroxychloroquine in different groups and looking at different outcomes: patients with mild to severe to critically ill Covid-19, with outcomes including conversion to a negative PCR assay, normalizing clinical symptoms, clinical recovery time, length of hospital stay, mortality rate, etc. A few studies are comparing it to lopinavir/ritonavir Results: — one Chinese lab study found that of 7 antivirals tested, remdesivir and chloroquine were remarkably effective in suppressing SARS-CoV-2, even at quite low doses. chloroquine, unlike remdesivir, functioned at blocking both SARS-CoV-2 cell entry as well as at the post-entry stages of infection, remdesivir only the latter (see covid Chloroquine reviewjcitcare2020 in dropbox, or Wang M. Cell Research 2020; 30: 269), and chloroquine has good penetration into lung tissue — another article found that in more than 100 patients chloroquine inhibited the exacerbation of pneumonia, improved lung imaging findings, promoted a virus conversion to negative, and shortened the disease course. I should add that the above systematic review of chloroquine did not find evidence of such data in their trial registries — a Chinese multi-collaborative expert consensus concluded that chloroquine 500 mg twice a day for 10 days was recommended for people with mild, moderate, and severe cases of SARS-CoV-2 pneumonia. They also suggested blood testing to rule out the development of anemia, thrombocytopenia, or leukopenia as well as electrolyte disturbances or hepatic/renal dysfunction, and an EKG to rule out development of QTc prolongation. Of note, this consensus document was relying on information that has not yet been published — the Dutch Center of Disease Control suggested administering chloroquine to treat severe infections requiring admission to the hospital and oxygen therapy or admitted to the ICU, though treating with optimal supportive care was also considered a reasonable option — the Italian Society of Infectious and Tropical Disease recommended the use of chloroquine or hydroxychloroquine for 5 to 20 days according to the clinical disease severity, but including those with mild respiratory symptoms who had comorbidities