The drugs chloroquine (CQ) and hydroxychloroquine(HCQ), a less toxic derivative of QC, are used to treat malariaand autoimmune conditions.

They now have been proposedto have antiviral activity against severe acute respiratory syn-drome coronavirus 2 (SARS-CoV-2),

which is responsiblefor the coronavirus disease 2019 (COVID-19) pandemic.Recentin vitrostudies

and a small nonrandomized clinicaltrial of 36 patients from France3had promising results andinitiated

the trend of using CQ/HCQ to treat COVID-19.However, the integrity of the nonrandomized

clinical trialhas been questioned by the International Society of Antimi-crobial

Chemotherapy for the trial’s unclear inclusion criteriaand triage of patients.

Although a subsequent smallerrandomized clinical trial of 30 patients showed

little to noeffect,5a larger randomized clinical trial of 62 patientsshowed that HCQ

significantly reduced the incidence andduration of COVID-19 pneumonia.

These studies do nothave sufficient statistical power to unequivocally prove

thepositive effects of HCQ on COVID-19. Nevertheless, the ur-gency of the pandemic has resulted in 

the United StatesFood and Drug Administration (FDA) issuing an emergencyuse authorization

for CQ/HCQ as treatment of COVID-19, anaction that has been criticized by former FDA leaders;

and (2)a call by the World Health Organization (WHO) for rapid,large, global CQ/HCQ clinical trials

.Although CQ and HCQ have become the focus as treat-ment of COVID-19,

they remain unendorsed by many physi-cians because of  limited clinical outcome data;

availability of other potentially more effective antiviral andinterleukin inhibitors,

such as remdesivir and tocilizumab,respectively; and  potential risk of malignant

arrhythmiaand sudden cardiac death (SCD) due to QT prolongation

In response to the trend of using CQ/HCQ for treatment ofCOVID-19,

the Mayo Clinic,9the Heart Rhythm Society