Chloroquine (CQ) and its analogue hydroxychloroquine (HCQ) have been thrust into our everyday vernacular because some believe, based on very limited basic and clinical data, that they might be helpful in preventing and/or lessening the severity of the pandemic coronavirus disease 2019 (COVID-19). However, lacking is a temperance in enthusiasm for their possible use as well as sufficient perspective on their effects and side-effects. CQ and HCQ have well-known properties of being diprotic weak bases that preferentially accumulate in acidic organelles (endolysosomes and Golgi apparatus) and neutralize luminal pH of acidic organelles. These primary actions of CQ and HCQ are responsible for their anti-malarial effects; malaria parasites rely on acidic digestive vacuoles for survival. Similarly, de-acidification of endolysosomes and Golgi by CQ and HCQ may block severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) integration into host cells because SARS-CoV-2 may require an acidic environment for its entry and for its ability to bud and infect bystander cells. Further, de-acidification of endolysosomes and Golgi may underly the immunosuppressive effects of these two drugs. However, modern cell biology studies have shown clearly that de-acidification results in profound changes in the structure, function and cellular positioning of endolysosomes and Golgi, in signaling between these organelles and other subcellular organelles, and in fundamental cellular functions. Thus, studying the possible therapeutic effects of CQ and HCQ against COVID-19 must occur concurrent with studies of the extent to which these drugs affect organellar and cell biology. When comprehensively examined, a better understanding of the Janus sword actions of these and other drugs might yield better decisions and better outcomes.

氯喹 (CQ) 及其类似物羟氯喹 (HCQ) 已被纳入我们的日常用语中，因为一些人认为，基于非常有限的基础和临床数据，它们可能有助于预防和/或减轻 2019 年大流行冠状病毒病的严重程度（2019冠状病毒病）。然而，人们缺乏对其可能使用的热情的节制，也缺乏对其作用和副作用的充分认识。CQ 和 HCQ 具有众所周知的二质子弱碱特性，优先积聚在酸性细胞器（内溶酶体和高尔基体）中并中和酸性细胞器的腔内 pH 值。CQ 和 HCQ 的这些主要作用决定了它们的抗疟疾作用；疟原虫依靠酸性消化液泡生存。同样，CQ 和 HCQ 对内溶酶体和高尔基体的脱酸可能会阻止严重急性呼吸综合征冠状病毒 2 (SARS-CoV-2) 整合到宿主细胞中，因为 SARS-CoV-2 可能需要酸性环境才能进入并发挥作用。出芽和感染旁观者细胞的能力。此外，内溶酶体和高尔基体的脱酸可能是这两种药物免疫抑制作用的基础。然而，现代细胞生物学研究清楚地表明，脱酸会导致内溶酶体和高尔基体的结构、功能和细胞定位、这些细胞器和其他亚细胞细胞器之间的信号传导以及基本细胞功能的深刻变化。因此，研究 CQ 和 HCQ 对 COVID-19 的可能治疗作用必须与这些药物影响细胞器和细胞生物学的程度的研究同时进行。当进行全面检查时，更好地了解这些药物和其他药物的“两面剑”作用可能会产生更好的决策和更好的结果。