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Hydroxychloroquine or chloroquine therapy should occur in the context of a clinical trial or registry, until sufficient evidence is available for use in clinical practice. Hydroxychloroquine or chloroquine use outside of a clinical trial should occur at the direction of an infectious disease or COVID expert, with cardiology input regarding QT monitoring. Additional sources of expert guidance with detailed and general arrhythmia monitoring considerations are also available. The intensity of QT and arrhythmia monitoring should be considered in the context of potential drug benefit, drug safety, resource availability and quarantine considerations. In vitro and preliminary clinical research have suggested that hydroxychloroquine alone and in combination with azithromycin could prove to be an effective treatment for COVID Based on this study, clinicians in many countries have begun using these medications in clinical practice, and multiple randomized trials are being initiated.

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