Hydroxychloroquine Treatment Option for COVID-19

Coronavirus frequently infects mammals and birds. A virus is transmitted from animal to animal, animal to human, and human to human. The coronavirus causes seasonal mild to moderate upper respiratory tract infection in humans, and such coronavirus was named SARS-CoV1. The seasonal coronavirus infection often diagnosed as a common cold. The flu virus and coronavirus SARS-CoV1 cause the most common cold and influenza-like symptoms. Every few years, life-threatening coronavirus infection spreads like an epidemic infection. A mutated coronavirus often causes such infection. In the past, pandemic coronavirus infection caused by the mutated virus was named SARS, MERS, and present COVID-19 infection. COVID-19 coronavirus infection is caused by coronavirus classified as SARS-CoV2. SARS-CoV2 and SARS-CoV1 belong to the same family of coronavirus, but SARS-CoV2 causes serious life-threatening lung disease.1

Coronavirus SARS-CoV2 (COVID-19)

Coronavirus is a single-stranded RNA virus.2 RNA is a short form of ribonucleic acid. Several molecules of nucleic acid form the ribonucleic acid. Most coronaviruses are created by 26 to 32 kilobases of protein molecules. Most coronaviruses belong to family Coronaviridae.3 Size of coronavirus is 0.07 to 0.09 micro-meter (70 to 90 Nanometer)2 In comparison, the bacteria are larger in diameter than a virus. The Size of bacteria varies from 0.2 to 2 micro-meter.4 Similarly, malaria parasites are larger in diameter than bacteria. Size of the malaria parasite is 1 to 20 micro-meter in diameter.5

Hydroxychloroquine

Hydroxychloroquine is derived from chloroquine. Chloroquine was synthesized in 1934 by Bayer pharmaceutical company in Germany. The medications were used to treat malaria in 1945. Hydroxychloroquine is also known as Plaquenil. Hydrochloroquin was approved in 1955 for medical use in the USA. Hydroxychloroquine is widely used as anti-malarial and anti-arthritis medication. The drug can cause rare complications in patients suffering from heart diseases. The side effects were not observed in patients who had no cardiac abnormalities. More than 5 million Hydrochloroquin prescriptions were written in 2017 in the USA for arthritis, joint pain, and prophylactic malaria treatment for travelers in the endemic area.

Hydroxychloroquine Treatment Option for COVID-19

Hydroxychloroquine Treatment Option for COVID-19

The data published on April 17, 2020, suggests 2.23 million people (0.03% of the world population) suffered from coronavirus, and 153,000 infected individuals died across the globe. Several clinical trials are being performed in the USA, Europe, and Asia. These trials were looking at the anti-COVID-19 effects of hydroxychloroquine (antimalarial), azithromycin (antibiotic), and remdesivir (antiviral) medications.1 There are other trials conducted to evaluate the anti-COVID-19 effects of newer drugs.

On April 9, 2020, Professor Didier Raoult from France released the results of a coronavirus treatment using Hydroxychloroquine and azithromycin. Treatment Study involved 1061 Patients.6 The study found 973 (91.7%) patients were cured in 10 days with no hospitalization, 31 patients needed hospitalization, ten patients were treated in ICU, and five patients died during treatment. None of the patients had cardiac toxicity. Similarly, another published study involving 19 patients suggests hydroxychloroquine treatment was effective in treating patients suffering from COVID-19.7

The published data of COVID-19 treatment using hydroxychloroquine and azithromycin was encouraging for few treating physicians but yet not convincing to many other physicians and scientists. At present several physicians across the globe have used hydroxychloroquine to treat COVID 19 infection and have reported favorable results. But data published from a few control studies do not indicate beneficial effects. Most treating physicians preferred hydroxychloroquine since there were no alternative anti-COVID-19 medications available to treat COVID 19 infection. The U.S. Food and Drug Administration (FDA) has approved hydroxychloroquine for malaria, lupus, and rheumatoid arthritis treatment. FDA has allowed off label use of hydroxychloroquine to treat COVID-19 if physician prefers the medications and patients approve the use of off label medication.

We all are hoping soon there should one or more medications that are specific to treat COVID-19 infection. Until then, physicians and patients have a choice to consider hydroxychloroquine or other medicines that are thought to be effective in treating and reducing the severity of the disease.

References:

    1. Chloroquine for COVID-19 Infection Nicholas Moore, Drug Saf. 2020 Apr 7 : 1–2.
    2. Identification of Coronavirus Isolated from a Patient in Korea with COVID-19 Jeong-Min Kim,a Yoon-Seok Chung,a Hye Jun Jo,a Nam-Joo Lee,a Mi Seon Kim,a Sang Hee Woo,a Sehee Park,a Jee Woong Kim,b Heui Man Kim,a and Myung-Guk Hana,* Osong Public Health Res Perspect. 2020 Feb; 11(1): 3–7.
    3. Complete Genomic Sequence of Human Coronavirus OC43: Molecular Clock Analysis Suggests a Relatively Recent Zoonotic Coronavirus Transmission Event Leen VijgenEls KeyaertsElien MoësInge ThoelenElke WollantsPhilippe LemeyAnne-Mieke Vandamme, and Marc Van Ranst* J Virol. 2005 Feb; 79(3): 1595–1604.
    4. Bacteria: Size, Shape and Arrangement https://www.microscopemaster.com/bacteria-size-shape-arrangement.html
    5. Malaria: Obstacles and Opportunities. Institute of Medicine (US) Committee for the Study on Malaria Prevention and Control; Oaks SC Jr., Mitchell VS, Pearson GW, et al., editors. Washington (DC): National Academies Press (US); 1991.
    6. Professor Didier Raoult Releases the Results of a New Hydroxychloroquine Treatment Study on 1061 Patients http://covexit.com/professor-didier-raoult-releases-the-results-of-a-new-hydroxychloroquine-treatment-study-on-1061-patients
    7. Hydroxychloroquine and azithromycin as a treatment of COVID-19: results of an open-label non-randomized clinical trial. Gautret P1Lagier JC2Parola P1Hoang VT3Meddeb L4Mailhe M4Doudier B4Courjon J5Giordanengo V6Vieira VE4Dupont HT2Honoré S7Colson P2Chabrière E2La Scola B2Rolain JM2Brouqui P2Raoult D8. Int J Antimicrob Agents. 2020 Mar 20:105949.

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