You have probably read or heard about the drug hydroxychloroquine as a potential treatment for COVID-19. A french study called The Marseille Study looked at 25 positive COVID-19 patients and was a non-randomized, unblinded study but showed an impressive reduction in viral load with hydroxychloroquine. After 6 days, the percentage of patients testing positive for COVID-19 who received the drug fell to 25% verses 90% for those who did not receive the treatment. Those who received hydroxychloroquine plus Azithromycin showed an even further reduction with the percentage of cases still carrying the virus as no more than 5%.
Even though this sounds like the perfect treatment we’ve been looking for, we must be cautious. This study was small with only 25 people and non-randomized and unblinded which means participants could choose which group to be in and are fully aware if they are receiving the treatment drug or not. This can cause alot of bias in the analysis. We need to remember the goal of good research is to ensure objective results as well as unbiased analyses of said results.
There have been some positive results in a preliminary Chinese study in 100 patients which showed that hydroxychloroquine reduced the viral load, and reduced the length and severity of symptoms. So this could reduce the number of carriers. Hydroxychloroquine is being examined in a number of clinical studies in China and some in France following Dr. Prof Raoult’s findings in the Marseille Study. It is being used in almost all (about 50) hospitalized patients except those who refuse it or who have contraindications.
So how does this drug work?
Hydroxychloroquine can alter the acidity of the intracellular compartment where viruses enter the host cell. So this can interfere with the ability of the virus to get into the cell and start replicating. This drug also has subtle effects on a variety of immune cells and one of these effects may help stimulate the body’s ability to fight off COVID-19 according to Robin May, Professor of Infectious Disease at the University of Birmingham in England.
The clinical trial in Marseille is a promising start. But science requires larger unbiased studies that can be repeated several times to say whether or not it works. Studies are on-going so we will undoubtedly get more information as it comes in.
Reference: Lecrubier, A. COVID-19Could Hydroxychloroquine Really Be the Answer? March 18, 2020. Medscape.com