COVID-19: Therapeutics and Their Toxicities

J Med Toxicol. 2020 Jul;16(3):284-294. doi: 10.1007/s13181-020-00777-5. Epub 2020 Apr 30.


SARS-CoV-2 is a novel coronavirus that emerged in 2019 and is causing the COVID-19 pandemic. There is no current standard of care. Clinicians need to be mindful of the toxicity of a wide variety of possibly unfamiliar substances being tested or repurposed to treat COVID-19. The United States Food and Drug Administration (FDA) has provided emergency authorization for the use of chloroquine and hydroxychloroquine. These two medications may precipitate ventricular dysrhythmias, necessitating cardiac and electrolyte monitoring, and in severe cases, treatment with epinephrine and high-doses of diazepam. Recombinant protein therapeutics may cause serum sickness or immune complex deposition. Nucleic acid vaccines may introduce mutations into the human genome. ACE inhibitors and ibuprofen have been suggested to exacerbate the pathogenesis of COVID-19. Here, we review the use, mechanism of action, and toxicity of proposed COVID-19 therapeutics.

Keywords: COVID-19; Pandemic; SARS-CoV-2; Therapeutic; Toxicity.

Publication types

  • Review

MeSH terms

  • Antiviral Agents / therapeutic use*
  • Antiviral Agents / toxicity*
  • Betacoronavirus / drug effects
  • COVID-19
  • Chloroquine / therapeutic use*
  • Chloroquine / toxicity*
  • Coronavirus Infections / drug therapy*
  • Humans
  • Hydroxychloroquine / therapeutic use*
  • Hydroxychloroquine / toxicity*
  • Pandemics
  • Pneumonia, Viral / drug therapy*
  • SARS-CoV-2
  • United States


  • Antiviral Agents
  • Hydroxychloroquine
  • Chloroquine