Administration of Chlorpromazine as a Treatment for COVID-19

Introduction The COVID-19 pandemic has resulted in over 6 million confirmed infected cases worldwide and over 397,000 deaths as of June 8th, 2020 according to the World Health Organization. Currently, there is no specific medication for COVID-19, as there are different protocols of treatments that is not fully tested to prove its effectiveness by randomized control trials.

Due to high infectious potentials of COVID-19, all healthcare facilities are burdened out by an extra ordinary load which is reflected on the economy of the health sector. In Addition to public health measures like self-quarantine, isolation and social distancing, coming up with proved effective treatment for Covid-19 will help markedly in restoration of normal daily activity of people. In Egypt, public health measures are not much fruitful due to lack of people awareness to properly perform self-quarantine, economic burden for performing mass nasal swabs, some other factors such as uncertainty regarding the survival of the virus in air are subsequently adding much concern to the vast quarantine task.

Hence, the focus has now been directed toward evaluating and implementing other strategies like chemoprophylaxis and vaccination. In fact, the development of vaccine will take around two years as current human trials are being employed. Thus, the hope will be shifted towards the repurposing of an actually used drug to target the viral replication cycle.

Chlorpromazine is an antagonist of the dopamine receptor D2 (DRD2) and has been effectively and safely employed for over half a century in the treatment of psychiatric disorders (Adams, Awad, Rathbone, Thornley, & Soares-Weiser, 2014). The USA Food and Drug Administration approved the chlorpromazine as a first-generation antipsychotic. It is classified as a phenothiazine as its primary use is in the management of mental disorders to control mania and treatment of schizophrenia and it has several additional approved and off-label uses. Heart conduction abnormalities related to chlorpromazine use is only related to high doses. The most commonly reported signs and symptoms of acute toxicity are severe extrapyramidal reactions, hypotension, and sedation (Beckett, 2014).

Significance of the study Globally COVID-19 has led to large numbers of infection and death. In Egypt, number of confirmed cases increased above 30,000 according to the Egyptian Ministry of Health by 8th of June 2020. Furthermore, there is a change of the treatment protocol according to the severity of signs and symptoms aiming to decrease the load on the health facilities in Egypt.