Abstract
Introduction Severe acute respiratory syndrome coronavirus 2 was first described in December 2019
in China leading to a Public Health Emergency of International Concern. It was named
by the World Health Organization as Coronavirus Disease 2019 (COVID-19), and it garnered
unprecedented attention from public health researchers around the world, and studies
analyzing chloroquine and hydroxychloroquine as a possible therapy have arisen in
the last 2 months.
Objective To review the literature and describe updated facts about the ototoxicity of chloroquine
and hydroxychloroquine, an important side effect that can be present in patients with
COVID-19 treated with these drugs.
Data Synthesis The most typical treatment regimen is 5 days of hydroxychloroquine at daily doses
of 400 to 600 mg. There is no randomized clinical trial that can prove so far the
efficacy of this medication, and few studies have evaluated adverse events potentially
linked to their use in patients with COVID-19. While there is no concrete evidence
on the incidence of ototoxicity using chloroquine in the short term, we need to consider
that, as a pandemic disease, millions of patients with COVID-19 may receive this treatment,
and ototoxicity can be a possible adverse event.
Conclusion Despite the urgent global situation caused by the COVID-19, the risk of irreversible
hearing loss may outweigh the unproven benefit of using hydroxychloroquine or chloroquine,
especially in patients with mild forms of COVID-19, who may be cured with supportive
treatment. The potential hearing loss that can be caused by these medications may
advise against their use in COVID-19 patients.
Keywords
ototoxicity - hearing loss - COVID-19 - hydroxychloroquine - chloroquine
