Graduate Medical Sciences, Boston University School of Medicine, 72 E Concord St L-317, Boston, MA, 02118, USA.
Division of Rheumatology, Inflammation, and Immunity, Brigham and Women's Hospital and Harvard Medical School, 60 Fenwood Road, #6016U, Boston, MA, 02115, USA.
Best Pract Res Clin Rheumatol. 2021 Mar;35(1):101658. doi: 10.1016/j.berh.2020.101658. Epub 2021 Jan 1.
A variety of treatment modalities have been investigated since the beginning of the Coronavirus Disease-19 (COVID-19) pandemic. The use of antimalarials (hydroxychloroquine and chloroquine) for COVID-19 treatment and prevention has proven to be a cautionary tale for widespread, off-label use of a medication during a crisis. The investigation of antimalarials for COVID-19 has also been a driver for a deluge of scientific output in a short amount of time. In this narrative review, we detail the evidence for and against antimalarial use in COVID-19, starting with the early small observational studies that influenced strategies worldwide. We then contrast these findings to later published larger observational studies and randomized controlled trials. We detail the emerging possible cardiovascular risks associated with antimalarial use in COVID-19 and whether COVID-19-related outcomes and cardiovascular risks may differ for antimalarials used in rheumatic diseases.
自新冠肺炎（COVID-19）大流行开始以来，已经研究了多种治疗方法。抗疟药（羟氯喹和氯喹）在 COVID-19 治疗和预防中的应用，为在危机期间广泛、超说明书使用药物提供了一个警示故事。对 COVID-19 抗疟药物的研究也推动了大量科学产出在短时间内涌现。在这篇叙述性综述中，我们详细介绍了抗疟药物在 COVID-19 中的应用的证据，首先是早期影响全球策略的小型观察性研究。然后，我们将这些发现与后来发表的更大规模的观察性研究和随机对照试验进行对比。我们详细介绍了 COVID-19 中使用抗疟药物可能出现的新的心血管风险，以及 COVID-19 相关结果和心血管风险是否因风湿性疾病中使用的抗疟药物而不同。
