Hydroxychloroquine (HCQ)is a drug primarily used to prevent
or treat malaria. It is also employed to treat rheumatoid arthritis, lupus, and
porphyria cutanea tarda. Now after the invasion of novel coronavirus, physicians
started using it; employing the experience of outbreak of MERS in 2012, when
scientists conducted hit and trial method on number of drugs and got to know
that chloroquine had the ability to block MERS infection; So, keeping in view
that experience, the physicians once again used chloroquine to treat new
version; COVID 19 but without any tangible scientific evidence. The Food and
Drug Administration approved the use of hydroxychloroquine and chloroquine to
treat COVID-19 at a pinch. The drug was hyped by President Trump as a “game
changer” for COVID-19; that drew worldwide attention. Now, HCQ is under random
studies in many countries; with promising result.
CHINESE STUDY
Chinese scientists gave hydroxychloroquine to coronavirus patients of COVID-19
in Renmin Hospital, Wuhan. The results showed that the 31 patients who received
the drug, showed a lessening of their symptoms one day earlier than patients in
the control group. In addition, pneumonia symptoms improved in 25 of the 31
patients contrasted with 17 of 31 in the control group.
FRENCH STUDY
French scientists conducted study on 36 patients of COVID-19 by using
hydroxychloroquine along with an antibiotic and found that all the patients
recovered within 6 days; showing 100% result. They also organized a second trial
on 80 patients. It showed clinical improvement in all cases except two (one man
aged 80 and the other 74. Both apparently had some preexisting health issues).
USA STUDIES
Dr. Vladimir Zelenko conducted trial on 699 COVID-19 cases, with 100% success
rate, using Hydroxychloroquine Sulfate, Zinc and azithromycin (Z-Pak);
antibiotic added to handle secondary infection which occurred when it hit the
lungs. Dr Zelenko is now recommending to follow his finding to hit the virus
hard and early.
Dr. William Grace, an oncologist, has been using hydroxychloroquine and an
antibiotic in Lenox Hill Hospital in New York. He claimed that 100 COVID 19
patients were treated successfully. He disclosed in Fox News interview.
NIH STUDY
There was yet another study done by the NIH in vitro using hydroxychloroquine.
They found it was a potent killer of the coronavirus. There was an additional
study by the NIH using zinc showing a decrease in morbidity relating to lower
respiratory tract infections.
HOW HCQ WORKS TO KILL CORONAVIRUS ?
FIRST VIEW
Dr. William Grace said, it works in two ways. “As you know, the death rate goes
up as the age goes up. And what I think is that the more mature your immune
response, the more likely you are to have what we call a cytokine storm, which
means that people with viral pneumonia die because their lungs fill up with
fluids largely from an immune response. And this drug works not only inhibiting
virus replication but also inhibits the immune response.”
SECOND VIEW
Dr. Eric Berg disclosed that hydroxyquine allow zinc to penetrate the cell
membrane and zinc disrupts the viral machinery to stops reproduction of
virus.30Zn does the killing but HCQ open the door to allow zinc to penetrate
inside the cell.
THIRD VIEW
It has been suggested that the chloroquines can change the acidity at the
surface of the cell, thereby preventing the virus from infecting it.
Its antiviral property is written HARRISON'S PRINCIPLES OF INTERNAL MEDICINE,
Edition 10, page 477, published in 1983. It reads as: "Viruses: Certain viruses
that are surrounded by a lipid envelope bind to the plasma membrane of target
cells by attaching to specific proteins on the cell surface. These viruses are
then internalized by receptor-mediated endocytosis and delivered to lysosomes.
At acid pH the membrane surrounding the virus fuses with the membrane of the
lysosome, allowing the nucleic acid of the virus to cross the lysosomal membrane
and enter the cytoplasm where the virus replicates. Infection of tissue culture
cells by these viruses (such as Semliki Forest virus, vesicular stomatitis
virus, and certain strains of influenza virus) can be prevented by chloroquine,
an agent that blocks the function of lysosomes. Chloroquine is a weak base that
diffuses into lysosomes and becomes protonated, raising the pH and the ionic
strength of the lysosomes. When the pH rises, the lysosomal enzymes fail to
function. Virus that require acid pH to fuse with cell membrane can no longer do
so in the presence of chloroquine, and the cells are protected from
infection......."
FUTURE STUDY
The future study will be conducted by the Henry Ford Health System after seeking
3,000 volunteers from health workers. Depending on response, the researchers aim
to begin study next week. The researcher head, Dr. William W. O’Neil said, in a
press release, that the goal is to seek a more definitive scientific answer to
the question of whether or not hydroxychloroquine might work as a preventative
medicine to help protect medical front-line workers with greater risk exposure
from contracting the coronavirus.
HCQ has not been evaluated in controlled studies; it is imminent to know that it
has numerous mild, moderate and even deadly side effects. Pure scientific
approach doesn’t allow to take a drug that has not been proven safe and
effective for a disease for which it is not approved. There are just so many
issues that can arise, from side effects to serious toxicity and death due to
possible interactions with other medications and other underlying health
conditions. At present scientists are trapped between Scylla and Charybdis;
administering HCQ may lead to drastic side effect and not giving may end up with
sever condition of COVID patient.
However, Scientists are inching near to find the exact mode of action of
chloroquine and its suitability to treat COVID19 and sooner the gape among the
support group and the opposed group of HCQ will bridge out.