Corona virus [COVID-19] also known as SAR COV-2], emerged in Wuhan, china. WHO declared this corona virus as pandemic
Most of people affected with COVID-19 may experience mild to moderate symptoms with or without respiratory illness like shortness of breath. Mostly people having high immune power may be recovered by treatment following protocol whereas people with underlying disease conditions like diabetes, CVD, renal problems, respiratory problems may develop severe illness and may finally leads to death in some cases. Person to person transmission may be through droplets of saliva or discharge from nose, respiratory exudates, cough, and close contact. Molecular assays may be done to diagnose corona virus.
There is no specific treatment (drugs) or vaccines approved for treating corona virus. Many clinical trials are going on to evaluate potential treatment.
Hydroxychloroquine is anti-malarial drug which is similar to chloroquine. The drug gained lot of fame within short period of time in treatment of corona virus.
A recent study in France and china revealed that hydroxychloroquine in combination with azithromycin to reduce duration of illness and virus levels in our body.
Hydroxychloroquine is interferon blocker , which mainly works by diminishing immune systems response to viral infections. It alo works by increasing Endosomal ph and interferes with glycosylation of cellular receptor of corona virus and thereby has potential to block corona virus. It may also works by inhibiting quinone reductase-2.hydroxy moiety of hydroxychloroquine makes faster clearance and lesser risk of retinal toxicity. Long term safety of hydroxychloroquine is better than chloroquine. Hydroxychloroquine in dose of 400mg twice a day is mostly recommended.
But many clinicians warned hydroxychloroquine may cause several side effects like abnormal heart rhythm, low blood pressure, muscle damage and nerve damage. Hydroxychloroquine has anti-viral mechanism like inhibition of inflammatory cytokines such as IL-1, IL-6 AMD TNF-∞.
Effect of hydroxychlorouine has been studied invitro, demonstrating that it might be probably due to inhibition of virus ACE-2 receptor.
Many of studies revealed that hydroxychloroquine in combination with azithromycin may reduce illness but no clinical outcomes and tudy was conducted by using les number of sample size.
Recently los angeles times stated that hydroxychloroquine fails in treatment of corona virus in controlled studies. Recent study in brazil stated that high dose of hydroxychloroquine leads to occurrence of ventricular tachycardia. 2 patients out of 30 patients died due to ventricular tachycardia which is severe side effect observed due to administration of high dose of hydroxychloroquine.
Hydroxychloroquine is readily available, safe, less cot. But however the use of hydroxychloroquine along with other medications in patients with underlying disease conditions may leads to change in metabolism and leads to occurrence of potential side effects.
President TRUMP stated hydroxychloroquine , A GAME CHANGER , but many clinicians warned of using hydroxychloroquine as self medication.
A recent study in marcellies where the study included 36 patients with average age of 51 yrs treated using hydroxychloroquine [600mg along with azithromycin in dose of 500 mg] out of which 3 patients dies due to side effects of hydroxychloroquine as they experienced irregular heartbeat, abnormal ECG.
Even though several studies and several clinical trials going on in study of hydroxychloroquine for treatment of COVID-19 , but till no proper confirmative evidence describing the safety of usage of hydroxychloroquine for treatment of corona virus.
As hydroxychloroquine is used in treatment of lupus, rheumatoid arthritis and malaria but the usage of hydroxychloroquine in treatment of COVID-19 results from research study data is too limited to make conclusion regarding effective in treating corona virus.
Previously as RONALD TRUMP, president of United States stated hydroxychloroquine as game changer but many clinicians presently stating that use of hydroxychlorquine in elderly people is also one of main reason for death rate in United states due to experiencing sudden cardiac arrhythmias like ventricular tachycardia, further leading to death of patients. Hence in recent studies and recent articles published by Los Angeles stated that hydroxychloroquine fails to treat corona virus.
The use of Hydroxychloroquine in 84 patients out of which 8 patients experienced cardiac problems like QT prolongation , ventricular tachycardia which leads to immediate discontinuation of drug. French researchers stated that use of hydroxychloroquine in some patient leads to immediate discontinuation of drug or leads to admission of patient in intensive care unit. French researchers concluded that hydroxychlorouine is not effective in treatment of corona virus.
Novartis, stated that they are going to conduct phase III clinical trials of usage of hydroxychloroquine in treating corona virus patients. Initially the doctors in south Korea, china stated that hydroxychlorquine is effective in treating corona virus later on due to increase in admissions and several research studies on corona virus clinicians stating that hydroxychloroquine is not standard drug used to treat COVID19 as many side effects like cardiac problems have been experiencing by people.
The final conclusion includes that no proper definitive study has been conducted and no definitive conclusion has been declared related to effectiveness of hydroxychloroquine in treating corona virus patient. The studies done in this aspect is very small and hence no proper conclusion or evidence is declared in using HCQ in treating COVI-19.Recent studies stating that HCQ is not effective in treating corona virus patients due to side effects experienced by patients. The use of hydroxychloroquine in some patients leads to immediate withdrawal of drug or admission of patient in Intensive care unit due to various adverse effects like QT interval prolongation, ventricular tachycardia and cardiac problems have been experienced by patient.
The evidence of effectiveness of hydroxychloroquine in treatment of corona virus is not yet completely proved and therapeutic response of hydroxychloroquine in patients may be dose dependent. In older patients with many other co morbidities [ other health problems] , the use of hydroxychlorouine in such patients with higher dose may leads to change in drug metabolism as the patient also uses drugs related to other health conditions and finally leads to experience of several adverse effects which leads to stoppage of administration of drug or may leads to admission in intensive care unit.
- Singh AK, Singh A, Shaikh A, Singh R, Misra A. Chloroquine and hydroxychloroquine in the treatment of COVID-19 with or without diabetes: a systematic search and a narrative review with a special reference to India and other developing countries. Diabetes & Metabolic Syndrome: Clinical Research & Reviews. 2020 Mar 26.
- Yazdany J, Kim AH. Use of Hydroxychloroquine and Chloroquine During the COVID-19 Pandemic: What Every Clinician Should Know. Annals of Internal Medicine. 2020 Mar 31.
- Frie K, Gbinigie K. Chloroquine and hydroxychloroquine: Current evidence for their effectiveness in treating COVID-19. Centre for Evidence-Based Medicine, Nuffield Department of Primary Care Health Sciences University of Oxford–25 maart. 2020 Mar 25.
- Pannu J. Running ahead of Pandemics: Achieving In-Advance Antiviral Drugs. Special Edition Policy Brief. 2020 March
Author Name: Thumma Vineela
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