Coronavirus Drug Treatment

Coronavirus Drug Treatment
TL;DR
So far, there is no firm evidence or consensus to support the use of hydroxychloroquine, chloroquine, or any other drug therapies to safely or effectively prevent or treat COVID-19, as it is still very early in the testing process.

Medication Treatments for Coronavirus

We’ve heard a lot about possible treatments for COVID-19 using drugs that we already have. Most notably? Hydroxychloroquine and azithromycin. ⁣

Hydroxychloroquine, which has a similar chemical structure to chloroquine, is an antimalarial (used to treat malaria, a parasitic infection) that also has immunomodulatory effects. It’s used in the treatment of rheumatologic and autoimmune diseases.

Azithromycin is an antibiotic (this is what’s in a Z-Pak), used less often these days due to antibiotic resistance, but still used for the treatment of atypical and viral pneumonia. ⁣

Some data does exist to show that when used together in vitro (in a lab), these drugs have efficacy against SARS-CoV-2 (the coronavirus’s actual name). But the only data we have showing the impacts in vivo (in real life) is extremely limited.

The studies have poor statistical power to detect a true result. Not to mention, the design didn’t control for multiple sources of potential bias. ⁣

Should I Take Hydroxychloroquine, Chloroquine, or Azithromycin to Treat Coronavirus?

Absolutely not. Please, do not start -- or please stop -- taking hydroxychloroquine, chloroquine, or azithromycin in efforts to prevent or treat COVID-19. Or any other self-medicating drug technique, for that matter. 

Most recently (as in, just a few days ago), the FDA announced emergency approval of hydroxychloroquine and Chloroquine to treat the most severe cases of COVID-19. Meaning, these drugs are being used as the last defense mechanism in the most extreme cases. 

Neither chloroquine nor hydroxychloroquine has been appropriately evaluated in controlled studies for COVID-19. They have numerous side effects of their own (which can be deadly).

If you do truly need these drugs, a doctor can and will determine that and prescribe them for you.

Otherwise, additional data is necessary to better understand the efficacy and safety of hydroxychloroquine and chloroquine for this novel coronavirus.

Because people have been racing to get their hands on these drugs, there is now not enough to go around for the people who actually need them. Pharmacies are already having to put restrictions on hydroxychloroquine to save supply for those who truly need it, like people with lupus or rheumatoid arthritis.

Wait for the Trial Results

I know, easier said than done in a time of crisis. But it’s vital.

There have been some studies into remdesivir (a new antiviral that does have in vitro data) and lopinavir-ritonavir (an old combo antiviral that there is in vitro data against).

The WHO recently launched a megatrial called Solidarity, which will measure the efficacy of all these treatments. Hopefully, soon we will have better data, and maybe even better treatments. ⁣

And, by 2021, we should have a vaccine

Science is slow and complicated; we cannot take our medical advice from headlines. Listen to the experts and read the medical journals. ⁣

In the meantime, stay well, stay home, and do not self-medicate with these drugs (or a mixture of them). Please!

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Jordan Hoese, MD, MPH
Mar 31, 2020

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