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Is hydroxychloroquine recommended for every COVID-19 affected person?

Is hydroxychloroquine recommended for every COVID-19 affected person?

Last Reviewed : 12/16/2020
Is hydroxychloroquine recommended for every COVID-19 affected person?

Hydroxychloroquine received extensive publicity over the last few weeks as a curative medication for COVID-19. This publicity was fueled by the president of the United States, Mr. Trump, when he requested hydroxychloroquine supplies from India. It also received excess attention when U.S. Food and Drug Administration (FDA) authorized emergency approval to use hydroxychloroquine for patients with COVID-19, on March 28, 2020.

Hydroxychloroquine has been showing promising results in the research studies. However, the studies are very limited and included fewer patients. One Chinese review article that included 15 studies with more than 100 patients demonstrated positive results with hydroxychloroquine treatment. Another study from France looked at the combination of hydroxychloroquine and azithromycin to treat COVID-19. The results were very impressive but the study included only twenty patients. There are multiple other non-peer reviewed, unpublished articles and abstracts that revealed beneficial effects of hydroxychloroquine in patients with COVID-19.

However, so far, there are no large published studies that concluded the benefits of hydroxychloroquine treatment in COVID-19 patients. Without large trials, hydroxychloroquine may not be provided to every COVID-19 affected person. One large clinical trial, ORCHID trial, was recently initiated by the National Institutes of Health (NIH). Results are expected to be published in 1-2 months.

Meanwhile, FDA authorized emergency approval to use hydroxychloroquine on a limited basis. It is recommended only for COVID-19 patients admitted to the hospital. Even in the acute care hospital setting, hydroxychloroquine is provided only to patients who have moderate to severe illness. Because of the side effects, especially abnormal heart rhythms, hydroxychloroquine is avoided in patients with mild COVID-19 illness. It is also avoided in an outpatient setting.

Outside the United States, Hydroxychloroquine is being used for most of the COVID-19 affected people in India and China. It is also used more frequently in France and certain parts of Europe. There are no consensus guidelines recommended outside China because of the limited research data available on hydroxychloroquine.

In summary, hydroxychloroquine shows some promising results. We may have to wait for larger studies to use it on a broader scale. For now, it is provided only to people who have moderate to severe COVID-19 illness in the United States and most of the countries.

 

References:

  1. Chen J, et al. (2020) A pilot study of hydroxychloroquine in treatment of patients with common coronavirus disease-19 (COVID-19). Journal of ZheJiang University (Medical Sciences) 49(1)
  • Gautret P et al. Hydroxychloroquine and azithromycin as a treatment of COVID-19: results of an open-label non-randomized clinical trial. Int J Antimicrob Agents. 2020 Mar 20:105949. doi: 10.1016/j.ijantimicag.2020.105949.
  1. Gao J, et al. Breakthrough: chloroquine phosphate has shown apparent efficacy in treatment of COVID-19 associated pneumonia in clinical studies. Biosci Trends2020;14:72-3. doi:10.5582/bst.2020.01047 pmid:32074550

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