As the world prepares for what’s being termed the apocalypse, doctors and researchers around the world are busy working on a potential cure for the COVID-19 pandemic. At a recent press conference, the American president, Donald Trump, was heard promoting the use of hydroxychloroquine for treatment of coronavirus disease 2019 (COVID-19) despite claims by the FDA (U.S. Food and Drug Administration) of it not being approved for treatment, as yet.
The remarks come as a result of a recent French study published in the International Journal of Antimicrobial Agents that claimed to treat the virus using a combination of Hydroxychloroquine and Azithromycin. This was a non-randomized clinical trial performed on 36 confirmed cases of COVID-19. Out of the 36 patients, 6 were asymptomatic, 22 had upper respiratory tract symptoms and 8 showed lower respiratory tract symptoms. The patients received 600mg of the antimalarial hydroxychloroquine daily and their nasopharyngeal swabs were done daily to check for the viral load. The antibiotic, azithromycin was added to the treatment depending on the patient’s clinical presentation. 20 patients were treated with hydroxychloroquine while 16 were controls.
Despite the small sample size, the study was able to show that hydroxychloroquine significantly reduces the viral load within 6 days and is even more effective when combined with azithromycin.
However, according to Dr. Anthony Fauci, the director of the National Institute of Allergy and Infectious Diseases, the evidence for establishing hydroxychloroquine as a safe and effective treatment for COVID-19 is thin and anecdotal. When asked about the clinical trial he said, “information that you are referring to specifically is anecdotal — it was not done in a controlled clinical trial — so you really can’t make any definitive statement about it.” The small sample size and a lack of randomization limit the scientific merit of the study.
The clinical trial is not the first study to look into hydroxychloroquine as a potential treatment for the virus. A recent study by Chinese researchers showed that the antimalarial blocked the virus SARS-COV-2 from entering cells in-vitro. Although the antimalarial holds a lot of potential, it’s also known for its side effects which include headaches, permanent vision problems, stomach distress, cardiac arrhythmias, and even death if not taken in the correct dosage.
There are currently no confirmed treatments for COVID-19 however, researchers around the world are testing multiple coronavirus treatments including anti-HIV drugs, plasma-derived from recovered coronavirus patients and, drugs used for other global outbreaks such as Ebola and, SARS. The NIH is currently conducting a clinical trial to investigate the safety and efficacy of the antiviral, remdesivir in treating COVID-19. Clinical trials for remdesivir are also ongoing in China.
The best treatment for the virus remains to be regular handwashing and social distancing which are measures aimed to prevent a person from getting infected.
Gautret et al. (2020) Hydroxychloroquine and azithromycin as a treatment of COVID‐19: results of an open‐label non‐randomized clinical trial. International Journal of Antimicrobial Agents – In Press 17 March 2020
Liu, J., Cao, R., Xu, M. et al. Hydroxychloroquine, a less toxic derivative of chloroquine, is effective in inhibiting SARS-CoV-2 infection in vitro. Cell Discov 6, 16 (2020).