There is no cure yet for the coronavirus. However, many (including President Donald Trump) have touted the use of an anti-malarial drug as the best treatment for COVID-19 patients. Now, a study raises questions on the effectiveness of this anti-malarial drug (hydroxychloroquine) to cure patients infected with the coronavirus.
Hydroxychloroquine linked to higher death rate
A study by the VA and academic researchers considered 368 male patients nationwide. Of these, 97 received hydroxychloroquine, 113 received a combination of hydroxychloroquine and antibiotic azithromycin, while 158 did not receive any hydroxychloroquine.
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The study found that the anti-malarial drug had no benefit in treating coronavirus patients. Instead, it was linked to higher death rates among the Veterans Affairs patients hospitalized with the novel coronavirus. As per the study, the death rate for those who got the drugs was worse than those who did not get the drugs. Moreover, the number of patients on ventilators was also almost the same in both cases.
“In this study, we found no evidence that use of hydroxychloroquine, either with or without azithromycin, reduced the risk of mechanical ventilation in patients hospitalized with Covid-19," the authors note.
Talking of results, over 27% of the patients who received hydroxychloroquine died, while 22% of those who got the combination died. The death rate was 11.4% among the category of patients who were not given any drugs.
"These findings highlight the importance of awaiting the results of ongoing prospective, randomized, controlled studies before widespread adoption of these drugs," note the authors of the study, who are affiliated with the University of South Carolina, University of Virginia, and the VA system in Columbia, South Carolina.
This study has been funded by the University of Virginia and the National Institutes of Health. A point to note, it was an observational study and not a randomized placebo-controlled clinical trial. This study was published on medrxiv.org, a clearinghouse for the academic studies on coronavirus that are not yet peer-reviewed or published in any academic journals.
Nevertheless, the study still raises a question on the effectiveness of a treatment, which has been prescribed by many doctors and hospitals worldwide.
Anti-malarial drug not effective against coronavirus
Separately, a panel of experts convened by the National Institute of Allergy and Infectious Diseases, recommended doctors against the use of a combination of hydroxychloroquine and azithromycin for treating the patients infected with coronavirus.
"The combination of hydroxychloroquine and azithromycin was associated with QTc prolongation in patients with COVID-19," the study says. QTc prolongation raises the risk of sudden cardiac death.
The use of these drugs peaked after Trump recommended it in White House news conferences. Trump made reference to a French study in March, which has since faced questions over its trial size and methods. This recommendation from the experts would be a blow to Trump, who last month suggested the combination could prove a game changer in the “history of medicine."
HYDROXYCHLOROQUINE & AZITHROMYCIN, taken together, have a real chance to be one of the biggest game changers in the history of medicine. The FDA has moved mountains - Thank You! Hopefully they will BOTH (H works better with A, International Journal of Antimicrobial Agents).....
— Donald J. Trump (@realDonaldTrump) March 21, 2020
On the use of hydroxychloroquine or chloroquine alone, the panel says there is insufficient clinical data to either approve or disapprove it. The panel said the same about the use of the drug remdesivir.
In a separate study in France, researchers studied the medical records of 181 Covid-19 patients. These patients had pneumonia and needed supplemental oxygen. About half of these patients were given hydroxychloroquine and the other half none.
The study found statistically no significant difference in the death rates between the two groups of patients. Nor, was there any significant difference in their chances of being taken to the ICU (intensive care unit). However, the study did find that the eight patients who got the drug developed abnormal heart rhythms.
This study also has not been peer reviewed or published in any medical journal.
Guidelines to treat COVID-19 patients
Meanwhile, the NIH has come up with guidelines for the doctors treating COVID-19 patients. The guidelines are critical against the use of experimental medications, noting that the conclusions lack strong scientific evidence.
For instance, the guidelines do not recommend the use of the Lopinavir/ritonavir or other HIV protease inhibitors. Also, it is against the use of interferon as it may make patients with SARS and MERS worse.
"We just plowed through everything that was, and apart from supportive care, there wasn't anything that was working terribly well," a panel member said, according to NPR.
Further, the panel said there is not much data to approve or recommend any treatment to prevent coronavirus infection, or to prevent the progression of symptoms. The clinical trials, however, are underway, and the recommendations could change as more data becomes available.
Most recommendations from the panel are something that doctors are already aware of. A person who tests positive for the coronavirus, but does not exhibit any symptoms should self-isolate for seven days.
Those showing mild symptoms should be monitored closely, while those with moderate symptoms may need hospitalization and supportive therapy. Severe patients may need oxygen, while patients with critical conditions may be placed on a respirator.