Table 6.
Summary of studies included: COVID-19 case reports related to chloroquine or hydroxychloroquine adverse effects in patients with suspected or confirmed COVID-19 or who were prophylactically treated.
| Organ Affected | Number of Patients | Adverse Effect, Drug Combination If Required (Number of Patients) (First Author, Year) | Long-Term Consequences |
|---|---|---|---|
| CQ | |||
| Cardiac | 2 | Major QT prolongation and recurrent torsade de pointes (1) (Szekely Y, 2020) [188] |
ECGs showed gradual normalization of QT interval |
| Wide complex tachycardia, along with AZM (1) (Gracia-Ramos AE, 2021) [189] |
Death after cardiac arrest | ||
| Hematologic and metabolic | 1 | G6PD deficiency-associated haemolysis and methaemoglobinaemia (1) (Kuipers MT, 2020) [184] |
The patient’s methaemoglobin normalized within 6 days |
| Psychiatric | 3 | Psychotic symptoms, along with AZM (1) (Benjelloun R, 2020) [195] |
Resolution after 48 h |
| Acute and intense anxiety, along with AZM (1) (Benjelloun R, 2020) [195] |
No | ||
| Psychosis episode (1) (Ambar Akkaoui M, 2021) [193] |
NA | ||
| HCQ | |||
| Cardiac | 6 | Right bundle brunch block and critically prolonged QTc (1) (Asli R, 2020) [181] |
Resolution |
| QT interval prolongation in a patient on AZM (1) (Mitra RL, 2020) [186] |
Death owing to progressive metabolic acidosis and multiorgan system failure | ||
| QTc prolongation and torsade de pointes, along with dexamethasone (1) (Aslam W, 2021) [190] |
NA | ||
| Suspected HCQ-induced sinus bradycardia and QTc interval prolongation (1) (Kang Y, 2020) [191] |
A temporary pacemaker was implanted | ||
| QTc prolongation, along with AZM (1) (Patel J, 2020) [192] |
No | ||
| Sinus bradycardia, along with AZM and corticosteroids (1) (Patel J, 2020) [192] |
No | ||
| Dermatological | 12 | Psoriasis exacerbation (1) (Kutlu Ö, 2020) [185] |
NA |
| AGEP with erythema multiforme-like lesions (1) (Robustelli Test E, 2020) [187] |
Slow but progressive resolution | ||
| Rash (1) (Kurd R, 2020) [202] |
NA | ||
| AGEP (1) (Enos T, 2020) [199] |
Resolved with prednisone after 38 days | ||
| AGEP (1) (Delaleu J, 2020) [198] |
NA | ||
| Erythema multiforme (1) (Monte-Serrano J, 2020) [197] |
NA | ||
| Urticaria with maculopapular rash, palmoplantar itching (1) (Sardana K, 2020) [196] |
NA | ||
| Urticaria (1) (Sardana K, 2020) [196] |
NA | ||
| Palmoplantar itching (1) (Sardana K, 2020) [196] |
NA | ||
| DRESS syndrome, along with AZM and LPVr (1) (Castro Jiménez A, 2021) [200] |
NA | ||
| Purpuric erythematous rash with non-follicular pustules, on the trunk and limps, with intense involvement of armpits and scalp (1) (Abadías-Granado I, 2021) [201] |
No | ||
| Purpuric erythematous rash with non-follicular pustules and targetoid lesions on the back (1) (Abadías-Granado I, 2021) [201] |
No | ||
| Hematologic, muscular and metabolic | 6 | Worsening of haemolysis (1) (Beauverd Y, 2020) [183] |
NA |
| Haemolysis in a G6DP-deficient patient (1) (Maillart E, 2020) [204] |
NA | ||
| Haemolytic anemia in a G6DP-deficient patient (1) (Aguilar J, 2020) [206] |
NA | ||
| Acute haemolytic anemia in a G6DP-deficiency patient (1) (Chaney SI, 2020) [205] |
NA | ||
| Thrombotic thrombocytopaenic purpura (1) (Arıkan F, 2020) [203] |
No | ||
| Hepatic | 1 | Hepatotoxicity (1) (Falcão MB, 2020) [182] |
NA |
| Ophthalmology | 1 | Myasthenic syndrome (1) (Koc G, 2020) [194] |
No |
| Gastrointestinal | 1 | Nausea, vomiting, diarrhea (1) (Patel J, 2020) [192] |
NA |
AGEP: acute generalised exanthematous pustulosis, AZM: azithromycin, CQ: chloroquine, DRESS: drug rash with eosinophilia and systemic symptoms, ECGs: electrocardiograph, G6PD: glucose-6-phosphate dehydrogenase, HCQ: hydroxychloroquine, LPVr: lopinavir plus ritonavir, NA: not available/not applicable.