Several studies have been conducted assessing the role of chloroquine and hydroxychloroquine alone and in combination with azithromycin for both prophylaxis and treatment of COVID-19, but have failed to provide strong evidence regarding the efficacy of this management option.

A systematic review involving several studies was done by the American College of Physicians (ACP) to develop certain practice points concerning the prophylaxis and treatment of COVID-19 with chloroquine or hydroxychloroquine, alone or in combination with azithromycin. The latest update included a review of 6 new studies, 1 RCT and 6 cohort studies concerning the use of chloroquine and hydroxychloroquine for the management of the coronavirus disease, COVID-19.

All studies stand firm to support the initial review that reports that there is insufficient evidence to prove the efficacy and safety of utilizing chloroquine and hydroxychloroquine, alone or along with azithromycin for the treatment of COVID-19 patients. Furthermore, several other studies also revealed that these drugs had harmful cardiac effects when used prophylactically, against COVID-19. However, the ACPs Scientific Medical Policy Committee (SMPC) has decided to continue to review the ongoing surveillance through November 2020.

The practice points remain to state that chloroquine and hydroxychloroquine should not be used alone or in combination with azithromycin for either prophylaxis or treatment of COVID-19 and that clinicians may only administer chloroquine and hydroxychloroquine alone, or in combination with azithromycin, to hospitalized COVID-19-positive patients in the context of a clinical trial with the informed consent of the patient and their families.