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Hydroxychloroquine is a small molecule 4-aminoquinoline derivative traditionally used as an antimalarial and for the treatment of autoimmune conditions like systemic lupus erythematosus and rheumatoid arthritis. In the context of the COVID-19 pandemic, it was investigated for its potential antiviral and immunomodulatory effects. This specific intervention, developed and studied by the Nucleo De Pesquisa E Desenvolvimento De Medicamentos (NPDM) at the Universidade Federal do Ceará in Brazil, involves the administration of hydroxychloroquine in combination with zinc sulfate. The rationale for this combination is based on hydroxychloroquine's ability to increase endosomal pH and interfere with lysosomal activity, potentially inhibiting viral entry and replication, while zinc is hypothesized to inhibit viral RNA-dependent RNA polymerase. The combination was evaluated in a randomized, open-label Phase 3 clinical trial (NCT04384458) as a prophylactic treatment for asymptomatic healthcare workers exposed to SARS-CoV-2.
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