Hydroxychloroquine in Patients with Covid-19
Recent study results published in The New England Journal of Medicine provide insight into the use of Hydroxychloroquine in patients with Covid-19.
What is Hydroxycholoroquine?
Hydroxycholoroquine has been known since 1935. It has been a prescription medicine since January 15, 2020 and it is also prescribed against malaria, but also as a slow-acting treatment against rheumatoid arthritis, certain lupus and the prevention of lucitis., under the name of Nivaquina.
Since the beginning of the current health crisis, one of its derivatives, the hydroxychloroquine molecule, which has shown promising avenues for the treatment of certain patients affected by Covid-19. This medicine is marketed under the name Plaquenil in France, it is also prescribed against rheumatoid arthritis, lupus and Lucites.
Use and Review of Hydroxychloroquine in Patients with Covid-19
Hydroxychloroquine, what do studies generally reveal?
Faced with an unknown virus and in the absence of a specific vaccine and treatment, one of the therapeutic strategies is to search among the already available and clinically proven drugs, if any of them is effective. Its benefit / risk balances and side effects have already been studied (however, without allowing for deadlock in safety testing) this could speed up the investigation. Among these, the latest hype: Hydroxychloroquine.
If the latter stood out quickly, it was thanks to the publication of a video: a lecture given by Professor Didier Raoult, director of the Institute of Mediterranean Infection in Marseille on February 25, 2020. The specialist cites the study by Chinese Scientists in the journal BioScienceTrends, which is based on other studies in ten hospitals in China. “Results from about 100 patients have shown that chloroquine phosphate is more effective than other treatments,” the scientists said in the original study. See the video below:
A new study conducted on 80 patients.
At the moment for Professor Raoult, this study represents a clue that needs to be deepened. “As forgotten and forgotten for SARS at the time, he regrets in the video that chloroquine is active in vitro against coronaviruses.” Many reports claim that 75% of patients participating in this Chinese trial have recovered from treatment, and that in the remaining 25%, there has been no worsening.
His words quickly buzzed. Since then the population has wondered. Is it true? And if so, why is the country not taking action? For their part, many doctors and scientists denounce individuals who give false hope and request larger studies to judge their real effectiveness and possible risks (side effects, mixing with certain treatments …).
A controversial treatment
Throughout March, on the side of the entire scientific community, opinions are much more measured. Several points are troublesome, as shown in a study conducted from early March to March 16th of Hydroxychloroquine in patients with Covid-19. Too small number of patients in whom treatment was tried. The duration of the study also, which does not allow us to know what side effects could be triggered or if the disease is no longer present and if it is likely to return or not; not all patients were in the same stage of the disease (16.7% asymptomatic, 61.1% with involvement of the upper respiratory tract, 22.2% with involvement of the lower respiratory tract);
It was also a non-randomized study, that is, the patients were not strictly comparable in the constituted groups. The results of the study focused on decreasing the viral load in nasopharyngeal secretions. The virus could still be in the lungs and that’s where many specialists attack it.
In the past four months, dozens of trials have been conducted on Hydroxychloroquine in patients with Covid-19. Despite the more frequently established inefficiency, the impression remains that the debate is definitely not settled.
Hydroxychloroquine, popularized by Marseille professor Didier Raoult and The President of the United States (Donald Trump), has been in the spotlight since the coronavirus spread across the world.
The latest publication in The New England Journal of Medicine describes the results of 811 patients from “a large medical center in New York City” taking Hydroxychloroquine and their resulting end-points (deaths) and treatment. Their conclusion was that more randomized and controlled testing was needed. Testing for Hydroxychloroquine in patients with Covid-19 requires more standardized scientific methods and control groups to further analyze its effect.
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