We read the recent letter by De Franceschi et al. [1] attributing acute intravascular hemolysis in a patient with COVID-19 infection to intake of hydroxychloroquine (HCQ). We would like to highlight some inconsistencies and a lack of clarity in the report. Moreover, we would like to do a thorough literature review on the existing controversy [2] on whether hemolysis is induced by chloroquine (CQ) or HCQ in G6PD-deficient patients to which the authors were relied on.