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To consider or not antimalarials as a prophylactic intervention in the SARS-CoV-2 (Covid-19) pandemic
  1. Francesca Romana Spinelli,
  2. Fulvia Ceccarelli,
  3. Manuela Di Franco,
  4. Fabrizio Conti
  1. Dipartimento di Scienze Cliniche, Internistiche, Anestesiologiche e Cardiovascolari—Reumatologia, Sapienza University of Rome, Roma, Lazio, Italy
  1. Correspondence to Dr Francesca Romana Spinelli, Dipartimento di Scienze Cliniche, Internistiche, Anestesiologiche e Cardiovascolari - Reumatologia, Sapienza University of Rome, Roma, Lazio 00161, Italy; francescaromana.spinelli{at}

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These days, the entire scientific community is facing the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) emergency, characterised last 11 March by WHO as a pandemic. Social behaviour modification measures may somehow limit the spreading of the infection. However, in the case of an extremely contagious pathogen, the huge number of infected people may be a challenge for the health system. What if there was a prophylactic drug?

In the light of their in vitro effect and early clinical results, antimalarial drugs chloroquine (CQ) and hydroxychloroquine (HCQ) have been proposed for patients with SARS-CoV2-related pneumonia (Covid-19) and are now included in the Chinese guidelines for the management of Covid-19 (version 7, 3 March 2020).

Antiviral activity of antimalarials has been known for more than 10 years (see online supplementary text).

Supplemental material


Recently, Wang et al demonstrated that at low micromolar concentration CQ was able to potently block viral replication of Covid-19, in vitro; the …

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  • Handling editor Josef S Smolen

  • FRS and FC contributed equally.

  • Contributors FRS and FC discussed the topic of the letter, did the literature search and drafted the manuscript. MDF and FC reviewed and approved the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; internally peer reviewed.