A Systematic Review Protocol of the Antiviral Activity of Chloroquine and Hydroxychloroquine against COVID-19

Abstract

Kofi Boamah Mensah, Adwoa Bemah Boamah Mensah, Joseph Attakorah, Varsha Bangalee, Frasia Oosthuizen

Background: The recent outbreak of the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), or COVID-19 with no approved medicines has led to global health threat. Currently, repositioning of old medicines seems the most responsible strategy for potential cure and prevention COVID-19. Hydroxychloroquine and chloroquine have shown promising efficacy against COVID-19 related pneumonia in clinical studies. However, the mode of drug action of chloroquine and hydroxychloroquine against SARS-CoV-2 infection is not clear. This review aims to gather evidence on antiviral activity and possible mechanism of drug action of chloroquine and hydroxychloroquine on SARS-CoV-2, including in-vitro, animal studies, and studies in humans. Method: A structured search of five bibliographic databases namely, Medline, Web of Science, PubMed, Cochrane CENTRAL, and Google Scholar will be undertaken to retrieve studies that describe the antiviral activity and possible mechanism of drug action of chloroquine and hydroxychloroquine on SARS-CoV2. No restrictions will be placed on publication date, but studies will be limited to only publications in English. Duplication of studies will be removed using EndNote reference manager. Three authors will screen the citations independently based on inclusion criteria. Data extraction and assessment of risk of bias will be done independently. Meta-analysis of selected studies will be done wherever suitable. Discussion: We expect that data that will be synthesis will provide enough information to inform COVID-19 care pathways and help clinicians caring for COVID-19 patients. Furthermore, this systematic review will expand our knowledge on the benefits and risks of chloroquine and hydroxychloroquine in management of COVID-19 patients and identify areas of controversies, and quality assessment. This review will provide vital information needed in the development of contextualized guidelines for the management of COVID-19 patients.