The Myth Behind Chloroquine Therapy for Prevention and Treatment of Coronavirus

What is Corona-Virus?
  1. This recently discover virus, causes Coronavirus (COVID19), pandemic across the world.
  2. Until now caused multiple-deaths and infection across the world.
What Medications has been approved?
  1. Until the date this article is written (21st March 2010), NO medications have been approved but there are combinations, of various tablets used to treat the Corona-Virus.
What is Chloroquine / Hydroxy-Chloroquine therapy?
  1. This therapy is traditionally used as Ant-malarial therapy
  2. Currently in some patients, this medications is used for CoronaVirus infection who have symptoms:
Why Hydroxy-Chloroquine and Chloroquine?
  1. Until now the evidence behind using these two ant-malarial drugs are limited and based on some studies.
  2. According to a recent study:
    1. The combination of anti-malarial and antibiotics combination COULD reduce the duration of CoronaVirus duration.
    2. The combination include Ant-Malarial (Hydroxy-Chloroquine) and antibiotic (Azathioprim)
    3. Only 30-patients were included in the study (out of 30, 6 patients were completely well with no-symptoms)
    4. Patients who revived the medications did better.
    5. Limitations of the study: This is very small study and CANNOT be generalized for all patients.
  3. A Systemic review (type of study to review the current published material): showed that there is some evidence to rationale and justify further clinical studies on chloroquine and its use in treating Coronavirus.
Status of FDA (FOOD-Drug-Administration Authority-USA)
  1. At present there is not enough evidence regarding the anti-malarial drugs in treating patient with CoronaVirus, therefore these drug are not FDA-Approved for the coronavirus (at present)
  2. FDA says that clinical studies have been approved and there are on-going trials in US.
  3. No evidence to suggest for use of Chloroquine in PREVENTION of coronavirus.
Status of WHO (World-Health-Organization)
  1. The World Health Organization states, that at present there is NO definitive evidence of its effectiveness, but it is part of the continuing trials.
  2. The future recommendations would be based on further available research data.
  3. No evidence to suggest for use of Chloroquine in PREVENTION of coronavirus.
Status of other Countries
  1. Similar to WHO and FDA, NO other countries have approved the drug based on the current research status.
  2. However, China, the US, UK and Spain has on-going clinical trials.
  3. No evidence to suggest for use of Chloroquine in PREVENTION of coronavirus.
Disadvantages of Chloroquine and Hydroxy-Chloroquine
  1. It has been reported that due to the limited information, people has start buying medications and doing SELF-Medications. This should be ABSOLUTELY AVOIDED
  2. There have been reports of overdose/poisoning with Chloroquine/ hydroxyl-Chloroquine from some countries
What are our recommendations?
  1. For Public
    1. Based on the current available research and studies, we should NOT use the medications in patients NOT having Coronavirus.
    2. Based on the current available research and studies, we should NOT use the medications without the consultation of physicians in patients who have CoronaVirus
    3. Avoid Self-medications: This may have serious medical consequences
  2. For Professionals
    1. The use should be based on Monitored Emergency Use of Unregistered Interventions (MEURI) framework or be ethically approved as a trial as stated by the World Health Organization
Reference
  1. A systematic review on the efficacy and safety of chloroquine for the treatment of COVID-19. Cortegiani A, Ingoglia G, Ippolito M, Giarratano A, Einav S. J Crit Care. 2020 Mar 10. pii: S0883-9441(20)30390-7. doi: 10.1016/j.jcrc.2020.03.005.
  2. New insights on the antiviral effects of chloroquine against coronavirus: what to expect for COVID-19? Devaux CA, Rolain JM, Colson P, Raoult D. Int J Antimicrob Agents. 2020 Mar 11:105938. doi: 10.1016/j.ijantimicag.2020.105938.


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