With the current COVID-19 case tally at 2,200,322, the death toll is inching closer to 150,000. Researchers across the world are working endlessly to develop an effective treatment option for this new contagion.
Broadly speaking, there are three main pathways to a treatment solution. Firstly, we can start using adapt an already approved drug; secondly, the authorities can push an experimental drug through a clinical trial; and lastly, pharmacists can create an entirely new drug or vaccine – which would be the most ideal.
Unfortunately, no new vaccine or treatment has been approved yet and the cases are jumping leaps and bounds by the day. Several countries worldwide are depending on existing antiviral drugs to treat their patients.
A recent clinical trial in Brazil highlights the dangers of two potential COVID-19 treatments: chloroquine and hydroxychloroquine. These are existing drugs used to treat malaria, rheumatoid arthritis and systemic lupus erythematosus (SLE).
Current use of anti-malarial drugs to treat COVID-19
Several parts of the world are racing to develop effective COVID-19 treatments. However, some nations have authorized doctors to give treat patients with antimalarial drugs as part of experimental clinical trials. Many health experts have cautioned against overhyping the results of these studies.
To date, there’s no conclusive evidence showing that these drugs effectively treat COVID-19 or block the virus from infecting cells. In the recent Brazil trial, researchers gave chloroquine to 81 COVID-19 patients in a hospital in Manaus. The study involved two groups: One received a high dose of 12 grams of chloroquine over 10 days, the second group received 2.7 grams over five days.
Both groups also received the antibiotic azithromycin, which poses its own heart risks. By the sixth day of the trial, 11 patients had died. The high-dose group had an especially high risk of suffering heart arrhythmias, a finding also observed in a separate trial on hydroxychloroquine conducted in a hospital in France.
“To me, this study conveys one useful piece of information, which is that chloroquine causes a dose-dependent increase in an abnormality in the ECG that could predispose people to sudden cardiac death,” said Dr. David Juurlink, an internist and the head of the division of clinical pharmacology at the University of Toronto.
Donald Trump’s promotion of the drug
Despite the lack of certainty surrounding the efficacy of the drugs, Donald Trump continues to promote them. He first paraded both chloroquine and hydroxychloroquine as possible cures for COVID-19 in briefings in March. In fact, the American President has done this repeatedly, during a White House media event with people who’ve recovered from COVID-19.
Chloroquine is closely related to the more widely used drug hydroxychloroquine. President Donald Trump has enthusiastically promoted them as a potential treatment for the novel coronavirus despite little evidence that they work. From The New York Times: https://t.co/icNMQVHit4 pic.twitter.com/Y9GKndHfgC
— South Florida Sun Sentinel (@SunSentinel) April 15, 2020
Trump asked if they’d taken “the Hydroxy” and said, “I actually haven’t heard a bad story” about the drug. He went on to indicate that while Americans understood its importance, the news media did not.
A double-blind research study of a drug touted by President Donald Trump early on to treat coronavirus found it to be so dangerous at high doses the trial was shut down after six days. Some researchers worry that his fixation on the drugs has over-highlighted exploring their use over other, potentially more promising drugs.
Chloroquine and hydroxychloroquine showed promise in lab
Both, Chloroquine and hydroxychloroquine, have displayed the ability to inhibit replication of multiple coronaviruses in vitro. Publications anew support the hypothesis that these drugs can improve the prognosis of patients COVID-19.
A Chinese commentary, mentioning 15 trials, reported that Hydroxychloroquine and chloroquine inhibit SARS-CoV-2 in vitro. “Thus far, results from more than 100 patients have demonstrated that chloroquine phosphate is superior to the control treatment in inhibiting the exacerbation of pneumonia”, without giving any further details.
It’s possible that some combination of chloroquine, hydroxychloroquine and azithromycin may be effective at preventing and treating COVID-19
According to Harvard University’s website, “No drug is perfectly safe, but these drugs are quite safe when used for just the several days they might be needed to treat COVID-19”. Given this, several countries started using the drug to treat patients infected with the contagion.
The website also states, “There is strong evidence that both drugs kill the COVID-19 virus in the laboratory dish. The drugs appear to work through two mechanisms. First, they make it harder for the virus to attach itself to the cell, inhibiting the virus from entering the cell and multiplying within it. Second, if the virus does manage to get inside the cell, the drugs kill it before it can multiply.”
But do the drugs work in people with COVID-19?
Current treatments for coronavirus
Several antiviral drugs are being used to treat coronavirus worldwide. It is important to remember that all of these drugs are being used on clinical trials, without any staunch surety of results.
Read more: The Growing COVID-19 Problem In America
“It’s possible that some combination of chloroquine, hydroxychloroquine and azithromycin may be effective at preventing and treating COVID-19, but the researchers in Brazil say that more research is “urgently needed.”
Apart from Chloroquine and Hydroxychloroquine, drugs like remdesivir and high-dose intravenous vitamin C are also in use. However, there is no clear or convincing scientific evidence that they work for COVID-19 infections; neither are they a standard part of treatment for this new infection.
On the other hand, several countries are also using convalescent plasma from recovered patients to treat newer patients. This may sound awry, but convalescent plasma has been used for more than 100 years to treat a variety of illnesses and infections. Patients receive the plasma through blood transfusion. The donor antibodies help the patient fight the illness, possibly shortening the length or reducing the severity of the disease.
Remedesivir – a better alternative?
According to CNN, ‘:OVID-19 patients who are getting an experimental drug called remdesivir have been recovering quickly, with most going home in days”. The patients taking part in a clinical trial of the drug have all had severe respiratory symptoms and fever, but were able to leave the hospital after less than a week of treatment.
Penn State Hershey Medical Center has begun enrolling participants in an international clinical trial investigating if the antiviral drug, remedesivir, can treat COVID-19. https://t.co/npFDvtUMiB
— WPMT FOX43 (@fox43) April 16, 2020
“The best news is that most of our patients have already been discharged, which is great. We’ve only had two patients perish,” Dr. Kathleen Mullane, an infectious disease specialist at the University of Chicago who is leading the clinical trial.
However, the trial does not include a control group; hence, making it difficult to specify if this drug is truly helping patients recover better. Clinical trials with a control arm compare patients with and without the drug. This way, doctors can determine whether it’s the drug that is really affecting their condition.