AUTHOR: SEOK WOO YANG, MD & PhD.
CONTACT: soplab@outlook.kr
DATE: 2020.03.30
CONTENT:
On March 30th, FDA approves hydroxychloroquine or chloroquine to be used in treating COVID-19.
As of today, the main purpose of using hydroxychloroquine and chloroquine is to modulate the cytokine storm and to decrease viral load.
There are several reports to favor the use of hydroxychloroquine and chloroquine in COVID-19. But some are skeptical about this theme.
For example, Guastalegname & Vallone quoted the experimental case of Chikungunya viral infection which is treated with chloroquine. In this experiment, there was a paradoxical effect to show no effect on the acute phase of the disease but the chronic complications of Chikungunya, more frequently in the treated group compared with the control group.
For this reason, they recommended that clinicians should use hydroxychloroquine and chloroquine cautiously.[1]
Coronaviruses and SARS coronaviruses can cause neurologic diseases including loss of smell and taste during a respiratory infection.[2]
Among the viruses inherent in human DNA, herpesvirus including simplex and zoster form should be kept in mind after respiratory viral infection.
Herpesviruses normally reside in the DNA of our cell nucleus and acquire virulent infectivity when our immunity is weakened.
Herpesviruses in the trigeminal ganglion of the brain can cause loss of smell and taste like the cases with COVID-19.
There are several reports that hydroxychloroquine was associated with an increased herpes zoster risk in patients.[3]
For the above reasons, in the cases of COVID-19 with the administration of hydroxychloroquine and chloroquine, clinicians should check the neurologic diseases by herpes zoster or simplex, such as neural hearing loss, neurogenic dyspnea, etc.
REFERENCE:
[1] Guastalegname M, Vallone A. Could chloroquine /hydroxychloroquine be harmful
in Coronavirus Disease 2019 (COVID-19) treatment? Clin Infect Dis. 2020 Mar
24:ciaa321.
[2] Bohmwald K, Gálvez NMS, Ríos M, Kalergis AM. Neurologic Alterations Due to
Respiratory Virus Infections. Front Cell Neurosci. 2018 Oct 26;12:386.
[3] Liao TL, Chen YM, Liu HJ, Chen DY. Risk and severity of herpes zoster in
patients with rheumatoid arthritis receiving different immunosuppressive
medications: a case-control study in Asia. BMJ Open. 2017 Jan 5;7(1):e014032.