Ototoxic and Vestibulotoxic Effects of Chloroquine/ Hydroxychloroquine and Remdesivir in the Treatment of COVID-19: Update Review

Vida  Rahimi; Elham  Tavanai; Mohammad Ehsan  Khalili; Ghassem Mohammadkhani

doi:10.18502/jmr.v17i3.13062

Vida Rahimi ِDepartment of Audiology, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran.
Elham Tavanai Department of Audiology, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran.
Mohammad Ehsan Khalili Department of Audiology, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran.
Ghassem Mohammadkhani Department of Audiology, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran.

DOI: https://doi.org/10.18502/jmr.v17i3.13062

Keywords: Severe acute respiratory syndrome coronavirus (SARS- CoV-2); COVID-19; Ototoxic drugs; Hearing loss; Antiviral drugs

Abstract

Introduction: Antiviral drugs have been extensively used as a potential treatment during the COVID-19 pandemic. Based on previous studies, there were concerns about some of these drugs’ ototoxic and vestibulotoxic effects. Still, these concerns were exacerbated by the widespread use of these drugs at the beginning of the COVID-19 pandemic. Therefore, this article was done to comprehensively review the effects of ototoxicity and vestibulotoxicity of chloroquine (CQ)/hydroxychloroquine (HCQ) and remdesivir with different administration models and compare with the COVID-19 treatment guidelines in the world and Iran.

Materials and Methods: This study collected the related published studies in PubMed, Scopus, Google Scholar, and Web of Science with the main keywords “chloroquine”, “hydroxychloroquine”, “remdesivir”, “ototoxicity”, “vestibulotoxicity”, and “COVID-19”.

Results: The dose or duration of used HCQ/CQ drugs that caused ototoxic or vestibulotoxic effects in some diseases was reported mainly more than in COVID-19 guidelines, especially in Iran. These findings align with a recent study on slight HCQ-induced ototoxicity in patients with COVID-19 at low doses and short lengths of use. No evidence of possible cochlear damage after taking remdesivir is reported.

Conclusion: It seems that the concern about the ototoxic effects of some drugs used in the COVID-19 pandemic should be according to some factors that affect the pharmacological effects of drugs, such as dose, length of use, and co-administration of drugs. Therefore, lower dosage and length of use in some administration models in COVID-19 treatment, such as Iran, are associated with limited and reversible ototoxicity effects. However, further studies are needed,