A small trial from China may already question whether a treatment touted as a way to save people with severe covid-19 really works. No evidence was found that the existing drug hydroxychloroquine was more effective on patients hospitalized with the new coronavirus than standard care alone. However, the results are no more definitive than the earlier ones research that suggested the drug can work.
Hydroxychloroquine and its close relative chloroquine are both existing medicines used to treat acute cases of the infectious disease malaria and for certain autoimmune diseases such as lupus. But scientists have long speculated that both drugs have a broad antiviral effect. Previous research in the lab had specifically shown that these drugs can kill the SARS virus, closely related to the new one coronavirus known as SARS-CoV-2. Most recently, reports from physicians in China and France treatment of severe covid-19 patients reported success with the use of hydroxychloroquine, sometimes in combination with the antibiotic azithromycin.
Those reports has prompted President Donald Trump to praise these drugs and to call for their immediate use in hospitals in the United States. However, Trump’s own public health experts and external researchers have been hit more careful tone, arguing that more rigorous research is needed to test a promising treatment for covid-19 before it can be widely used. This week, the World Health Organization announced that hydroxychloroquine / chloroquine would be one of the drugs evaluated in a large, worldwide clinical trial of Covid-19 treatments.
But given the early anecdotal success of these drugs, doctors have already started to run their own small, controlled clinical trials. This last one, reported the Journal of Zhejiang University involved 30 patients in China who were hospitalized with covid-19. Half received standard care and the other half received hydroxychloroquine in addition to this care for five days. In the patients, their throat was also routinely changed for the genetic presence of the virus, with a negative result indicating that the active infection had disappeared.
On day sevenMost people in both groups had negative throat swabs, with no apparent benefit to those taking hydroxychloroquine. Also, there was no significant difference in the time it took patients in both groups to stop symptoms such as high fever (one person’s condition in the hydroxychloroquine group worsened severely, but everything improved at the end of the trial).
The findings appear to be the first of a randomized and, more importantly, controlled study with hydroxychloroquine. But the sample size is still very small. It also did not test the combination of azithromycin, which researchers theorize may have an additional anti-inflammatory effect and may help treat severe covid-19 cases in which people are infected by bacteria along with the coronavirus.
In other words, this study is not a death knell for hydroxychloroquine and chloroquine, bHowever, it can be a clear lesson as to why hyperventimental treatment should not be hyped too early.
After Trump’s announcement, people in the United States, including doctors, are already rushing to it stock these drugs, which may affect their offer for patients who rely on it for its intended purpose. Tragically, one person has died after tablets with chloroquine originally intended to treat parasitic pests in aquariums while that person’s wife is in a critical condition (chloroquine can easily be toxic in too high a dose).