Clinical Implications of Chloroquine and Hydroxychloroquine Ototoxicity for COVID-19 Treatment: A Mini-Review

2020
At this time of the COVID-19 pandemic, potentially effective treatments are currently under urgent investigation. Benefits of chloroquine and hydroxychloroquine for the treatment of COVID-19 infection have been proposed and clinical trials are underway. Chloroquine and hydroxychloroquine, typically used for the treatment of malaria and autoimmune diseases, have been considered for off-label use in several countries. In the literature, there are reports of ototoxic effects of the drugs causing damage to the inner ear structures, which then result in hearing loss, tinnitus, and/or imbalance. This mini-review represents a summary of the findings from a systematic search regarding ototoxicity of chloroquine and hydroxychloroquine in the published literature. The characteristics of sensorineural hearing loss and/or tinnitus after chloroquine or hydroxychloroquine treatment can be temporary but reports of persistent auditory and vestibular dysfunction exist. These are not frequent, but the impact can be substantial. Additionally, abnormal cochleovestibular development in the newborn was also reported after chloroquine treatment in pregnant women. The suggested dose of chloroquine for COVID-19 infection is considerably higher than the usual dosage for malaria treatment; therefore, it is plausible that the ototoxic effects will be greater. There are potential implications from this review for survivors of COVID-19 treated with chloroquine or hydroxychloroquine. Patient reports of hearing loss, tinnitus, or imbalance should be noted. Those with troublesome hearing loss, tinnitus and/or imbalance are encouraged to be referred for hearing evaluation and interventions once they are stable. Clinical trials of chloroquine or hydroxychloroquine should also consider including audiological monitoring in the protocol.
FRONTIERS IN PUBLIC HEALTH
卷号:8
收录类型
SSCI
发表日期
2020
学科领域
循证公共卫生
国家
英国
语种
英语
DOI
10.3389/fpubh.2020.00252
其他关键词
PHOSPHATE; CHILD; RISK
EISSN
2296-2565
资助机构
UK National Institute for Health Research (NIHR)National Institute for Health Research (NIHR)
资助信息
PP and DB receive support from the UK National Institute for Health Research (NIHR), but their views are their own and do not reflect those of NIHR nor the UK Department of Health and Social Care.
被引频次(WOS)
16
被引更新日期
2022-01
来源机构
University of Nottingham University of Nottingham Nottingham University Hospital NHS Trust Prince of Songkla University
关键词
chloroquine hydroxychloroquine ototoxicity hearing loss tinnitus COVID-19